Innovation in Care Models for Dementia Patients

Name and Constituency of Member of Parliament

Mr Leon Perera
Non-Constituency MP 

Question No. 8

To ask the Minister for Health what is the Ministry doing to promote experimentation and innovation in the eldercare sector so as to encourage care models that provide greater privacy for dementia patients in a space-efficient way.  

Oral Reply

1.                    MOH has been making innovations in care for our elderly, including those with dementia, with our partners.  For instance, in some of our new purpose-built nursing homes, we have created closed-loop outdoor gardens next to dementia wards, to enable seniors with dementia to move around independently, and enjoy the greenery.

2.                  We are also experimenting with a dementia-friendly concept of “cluster living” in Ren Ci’s new nursing home in Ang Mo Kio, which is in the midst of construction. The home is designed in the form of small “clusters”. Each cluster consists of bedrooms with a smaller number of beds compared to other nursing homes, sharing a common living space, including activity and dining area as well as bathrooms. This design allows for a smaller-scale and more familiar environment to support residents with dementia, and yet promotes interaction among seniors and does not segregate or confine seniors in single rooms which may be more challenging in terms of monitoring and care. This design is the result of a brainstorming workshop with Ren Ci, facilitated by Dr. Emi Kiyota, an environmental gerontologist based in the US, who is most noted for her work in championing the concept of the “Ibasho” or a place where seniors can live in safety, comfort and dignity.

3.                   We have also implemented several dementia-friendly initiatives at our acute and community hospitals. The Institute of Mental Health (IMH) has renovated a dementia ward to create a more homely living environment which includes a garden designed to allow dementia patients to move around safely. The ward includes a reminiscence room, and a sensory room to provide dementia-specific therapy. Khoo Teck Puat Hospital (KTPH) is also operating a ward which is designed to have minimal distractions from the hospital environment. This is to provide better and more personalised care for dementia patients who may find the unfamiliar environment in a hospital disconcerting and stressful. St Luke’s Hospital (SLH) and St Andrew’s Community Hospital (SACH) have also introduced dementia-friendly wards which are designed to provide a more private and safer environment for dementia patients to move around, participate in group activities and interact with one another. Staff in these wards received additional training in dementia care to provide care that is tailored to the unique needs and personality of each dementia patient.

4.                   Dementia care is evolving in Singapore, and we are continually seeking to learn and experiment on better models. Even in land-scarce Singapore, it is possible to design spaces that strike a balance between providing for the privacy and dignity of users, and ensuring the cost-effectiveness and sustainability of the care model. We will continue to learn and adopt new thinking into our local efforts in designing dementia care facilities.

5.                   But good dementia care goes beyond the physical attributes of the care facility. Good care has to come from quality hardware design, coupled with good care delivery. MOH is also piloting innovative care models within the community for persons with dementia so that they can continue to be cared for and supported at home and in the community, with funding support provided under the Community Mental Health Masterplan. For example, Tsao Foundation offers a dementia home intervention service where they provide advice to caregivers on how to better care for their loved ones at home. NTUC Health and Thye Hua Kwan also provide eldersitting services, where care staff accompany persons with dementia at their homes, and engage them in activities according to their personal interests. We have also worked with Tote Board to put in place a Community Healthcare Fund to support new pilots in the community, including in dementia care. These include Montfort Care’s Happy Kopitiam programme which provides caregivers with education and support, while giving an avenue for caregivers and persons with dementia to participate in activities together, and Alzheimer’s Disease Association’s Family of Wisdom programme where caregivers take part in the day care sessions with their loved ones with dementia, and provide mutual support.

6.                   The government also provides funding support to further catalyse new models of care and ideas. Most recently, we set up the National Innovation Challenge on Active and Confident Ageing under the Action Plan for Successful Ageing to catalyse innovative ideas and research to transform the experience of ageing in Singapore. Last year, MOH launched a grant for innovative preventive programmes to delay the onset of dementia, and new models of dementia care in the community. The grant call attracted close to 40 proposals from multi-disciplinary research teams that comprise clinicians, engineers, sociologists and care providers.

7.                   We will continue to enhance the access, quality and affordability of care to seniors. We will partner our aged care providers to innovate and make eldercare better and more resource-effective.