Speech by Minister for Health Mr Gan Kim Yong at the Annual Singapore Conference on Ageing (ASCA) 2012, Thursday 10 May 2012, 9.00am, Orchard Hotel

  Good morning. To our distinguished guests from overseas, welcome to Singapore.

Introduction

2.         I am very pleased to be here at the inaugural Annual Singapore Conference on Ageing 2012. I am glad that such a platform has been organised as ageing is an important issue facing not only Singapore society but humanity in general. I am glad that Singapore can play our part in hosting such a forum where experts from different parts of the world and fields come together to share ideas and explore solutions.

3.         The theme for this conference is aptly titled ‘Ageing and Mental Health’. It is indeed timely to go beyond physical wellbeing of the elderly to explore how we can improve their mental well-being as well. Singapore is happy to share our experience and learn from experts around the world.

4.         Dementia and depression are some of the key mental health conditions affecting our society. The World Health Organisation (WHO) recently published a report[1] on dementia and stressed the importance of making it a public health policy priority. There are currently 35.6 million people with dementia worldwide and this number is expected to be doubled by 2030. In Singapore, we currently have about 28,000 elderly aged 60 years and above with dementia, and this is expected to more than double to 80,000 by 2030. We need to act now to improve public and professional understanding of dementia, and enhance the quality of care and support provided to patients and their caregivers.

6.         In March this year, I shared in Parliament about our Healthcare 2020 action plan. Part of this plan includes building up the community mental health sector. I would like to take this opportunity to share how these efforts will help our elderly, particularly those with concerns for mental health issues through our three pronged approach. These three prongs are (a) more early intervention efforts, (b) more holistic services and (c) more support for caregivers.

More Screening and Early Intervention Efforts

7.         My Ministry recognises that prevention and early intervention plays a vital role in managing mental health problems in the elderly. There is a symposium today specifically focusing on prevention and early intervention in dementia. The Health Promotion Board (HPB) has established several outreach and education programmes targeted at the elderly and their mental health. A retrofitted ‘Positive Wellbeing Bus’ has been dispatched to HDB estates to screen senior citizens for risk of depression since last year. A total of 2860 senior citizens were screened over a period of 12 weeks in 7 heartland locations. Collaterals were given to participants to help raise their awareness about depression. Those who were identified to be at risk were offered counselling and follow up.

8.         HPB also established a psycho-social educational programme called the ‘Mental First Aid Kit’ which engages senior citizens through therapies and games in order to retain their cognitive functions and optimise their mental wellbeing. More than 2000 seniors from 20 constituencies have participated in the programme since it commenced in March last year.

9.         Engagement of the community and peers is important, and HPB is doing this through their Senior Health Ambassador Programme. This programme equips ambassadors with knowledge and skills on healthy ageing, communication and mentoring. The ambassadors then empower others to stay healthy through formal and informal settings such as workshops, road shows, exercise classes or through their personal contacts and networks. There are currently 1,000 seniors who have signed up for the programme and HPB aims to recruit another 3,000 Senior Health Ambassadors through various community platforms and road shows by 2015.

10.       These programmes not only help in early detection, but by directly engaging our elderly, aim to keep them mentally and physically active.

More Holistic Services for the Elderly with Mental Health Problems

11.       Over the next few years, we will work with our partner agencies to implement a community-based mental health plan to complement our hospital-based services. This will be done as part of our efforts to develop the Regional Health Systems (RHS) and build a network of services that are integrated with our primary care and long-term care services.  This will allow our patients with mental conditions to receive the appropriate and integrated care in the community, so that they can age in place. This is in line with the Ministerial Committee on Ageing’s efforts to develop home- and community-based eldercare services, so that seniors can age with dignity and grace.

12.       In Singapore today, there is a variety of mental health services for the elderly through several avenues. Memory clinics are available in our public hospitals to diagnose and manage patients with dementia. Multidisciplinary teams under the Community Psychogeriatric Programme (CPGP) provide direct care and treatment to home-bound elderly with mental health conditions. There are also dedicated Voluntary Welfare Organisations (VWOs) such as the Singapore Action Group of the Elders (SAGE) and O’Joy Care Services, that provide social counselling and day care services for the elderly.

13.       Over the next 3 years, public hospitals will progressively expand the capacity of their memory clinics. This will allow us to reach out to more dementia patients effectively in a timely manner. We will also be establishing up to 2 shared care teams by the end of next year to support care for dementia patients in the community. These shared care teams will comprise of specialists, allied health professionals and psychologists who will provide assessment, treatment, and support for the General Practitioners in the management of more sophisticated patients.

More Support for Caregivers

14.       I am also pleased to note that one of the conference symposiums is dedicated to the discussion on the burden of care. Mental health conditions in the elderly often place a significant burden on their caregivers, and it is important that caregivers be given adequate support. Many Singaporeans have shared with me that they wish to care for their elderly with dementia but the burden of care can sometimes be overwhelming for an individual.

15.       The Alzheimer’s Disease Association (ADA) offers caregiver training programmes to teach caregivers essential knowledge and coping skills that they require to care for a family member with dementia. ADA also has caregiver support groups which provide assistance and counselling to caregivers who need emotional support.

16.       We have collaborated with ADA to pilot a Dementia Eldersit, and Dementia Home Intervention Programme. Eldersit programme provides caregivers with respite while engaging dementia patients in one-to-one therapeutic activities. The Home Intervention Programme is for caregivers who are facing difficulties in their care-giving roles, perhaps due to the more advance nature of the disease. It aims to provide counselling support, dementia management skills, and advice on environmental modifications that will help ease the burden of care-giving.

17.       Moving forward, we will support ADA to triple the capacity of Eldersit and Home Intervention Programme over the next 4 years in order to reach out to 120 more caregivers at any one time. We are happy to work with other providers who wish to provide good quality care for dementia patients and their caregivers.

Conclusion

18.       As our population ages rapidly, the number of elderly with dementia and depression is likely to rise. It is crucial that we continuously enhance our healthcare services to meet these rising challenges. With appropriate care, adequate family and social support, these elderly can still enjoy a meaningful and good quality of life. As announced in Parliament previously, my ministry will spend over $100million to support more community mental health projects over the next five years which include some of the services mentioned earlier. My ministry will continue to work towards the seamless and holistic care for the mental health of our seniors by stepping up our awareness and outreach efforts, expanding the capacity and accessibility of mental health services and enhancing the assistance provided to patients and their caregivers in the community. Ultimately, our goal is to help the elderly to age in place with their loved ones.

19.       This conference is timely given the challenges we are facing today and I am sure that all of us will benefit greatly from the discussions at the conference today. I wish you all a fruitful conference.

20.       Thank you.

[1] Dementia: a public health priority. World Health Organisation and Alzheimer’s Disease International. 2012.