Speech by Minister-of-State for Health and Manpower Dr Amy Khor at the “Ageing-in-place: How prepared are we?” Roundtable

Prof Brenda Yeoh, Dean, Faculty of Arts and Social Sciences, NUS

A/Prof Michelle Lazar, Head, Singapore Research Nexus, NUS

Distinguished guests

Ladies and gentlemen

I am delighted to be here this morning.

2. We are in a conversation today on the Singapore we want to see in the next twenty years. The topic of the discussion today is core to this conversation because by 2030, one in five of us will be above 65 years old - myself included. We will have a much older society and how prepared we are to support such a population will surely define, to a large measure, the Singapore we see by then.

3. It is therefore timely that we have this roundtable discussion today to take stock of where we are in preparing for an ageing population and what more needs to be done to help seniors age in place. Let me say that “ageing in place” is not just a slogan. We all recognize the need to preserve and even attenuate the social, physical and community networks that can help the elderly live more healthy and fulfilling lives. Hence, we have quite deliberately directed much of our policy for the elderly toward this goal.

4. We have many experts here today who will speak in-depth on various issues relating to this subject. Perhaps what I can do here is to provide a preamble to this discussion by sharing some of my thoughts, along what I see as the 4 “P”s.

Philosophy

5. The first “P” is philosophy. What underpins our conversation must be a set of values and beliefs about the kind of society which our seniors, and in fact we ourselves in the future, will live in.

6. Having sired us, showered their love and care on their children and help build our society, our elders need to be given, and deserve, respect, love and care and be very much an integral part of our families and society. Our society needs to evolve structures, systems and arrangements such that our seniors live as part of, and not apart from, our community.

7. To reiterate, a central philosophy underpinning many of our policies is “ageing-in-place”. We want to help our seniors to age gracefully in an environment familiar to them, and close to their loved ones, for as long as is possible. This is because ultimately, it is the quality of life of our seniors that matters. And the quality of life must surely relate to the strength of family ties, love and kinship between seniors and their sons and daughters and grandchildren, and the friendship and connection they feel to their friends and their immediate community.

Physical Environment

8. The second “P” is the physical environment. Our city, our towns, our neighbourhoods, must support our vision of ageing in place. We need to design and evolve our physical environment to keep up with the needs of an ageing population. Seniors can continue to live actively and independently if their living environment empowers them to step out of their homes and to move around confidently and easily. In other words, we need to make every neighbourhood a senior-friendly neighbourhood.

9. We have taken initial steps in this area, beginning with our public housing estates. Such efforts implemented by the Housing & Development Board (HDB) include the Home Improvement Programme for its flats, and more recently, the Enhancement for Active Seniors Programme, or EASE, for short to provide subsidised senior-friendly home modifications to Singapore citizens living in HDB flats. The home modifications under EASE include grab bars and anti-slip treatment to bathroom floor tiles, and aim to minimise the risk of seniors falling at home.

10. Within the immediate vicinity of homes, HDB has also implemented the Lift Upgrading Programme (LUP) which upgrades existing lifts to serve every floor. Barrier free access ramps and universal design features are also common in HDB towns.

11. We are now planning for new amenities in our towns to make them “senior-ready”. We will develop more than 100 eldercare facilities in various residential estates by 2016 to support the needs of our ageing population.

12. The number of seniors living alone is expected to rise from 35,000 today to 83,000 in 2030. This group of seniors is especially vulnerable. We need to ensure that they have good social networks so they have others looking out for them and do not just face the four walls at home everyday. We will be building 56 Senior Activity Centres (SACs) which we hope will be hubs where seniors gather to make friends, participate in activities and look out for each other. We hope that seniors living alone can still have friends at these centres, take part in activities at the centres, and stay active and happy. The friends and volunteers at these centres can also help to look out for the elderly or each other in terms of their needs and health status to avoid the unfortunate incident of seniors falling sick and even passing away without anyone knowing.

13. We will also be building 39 Senior Care Centres (SCCs) and 10 Nursing Homes (NHs) which will be sited in different neighbourhoods across the island. By locating these facilities within the community, our seniors can receive care when they need it close to their homes. The SCCs and NHs will also provide necessary support to the seniors’ families and caregivers and this will in turn enable them to care for their seniors longer and better. Taken together with the investment in new hospitals and primary care facilities, we hope to have a robust care system that can support our seniors to age well and age with dignity, within the community.

Policies

14. The third “P” is policies. Our policies need to be reviewed regularly because policies made in the context of a younger population may not necessarily apply as our population ages significantly. In this context, we have made a number of policy changes to facilitate ageing in place.

14. For example, the HDB launched the Ageing-in-Place Priority Scheme earlier this year. Under the scheme, seniors who wish to right-size to a studio apartment close to their current areas of residence are given more chances during balloting for HDB flats. Hence, even if seniors wish to shift to a smaller home that may be more amenable to them in their old age, we encourage them to remain where they are, but in a familiar environment, so they can age-in-place surrounded by family and friends.

15. We are also doing more to support home and community-based care so that our seniors can be cared for at home. This year, we raised the qualifying per capita monthly income for home and community-based services subsidies. This widens the net significantly, such that up to two-thirds of Singaporean families today are eligible for the subsidy. In addition, families can now apply for a $120 grant each month to offset the cost of hiring a foreign domestic worker to take care of elderly members who may be unable to take care of themselves.

16. The government appreciates that it can be stressful for caregivers to juggle work and care for seniors at home, especially if they are frail and need a lot of attention. We are looking into how we can support our caregivers better, for example through enhancing respite care services, and making counselling support and emergency services more accessible to them. I look forward to hearing more ideas from you, on how we can further support Singaporeans to care for their parents and grandparents in their own homes for as long as they can.

17. As we facilitate ageing in place, we are also helping our seniors to improve their retirement adequacy. We are reviewing schemes like the enhanced Lease Buyback Scheme that will give seniors more options to supplement their incomes in their old age. Starting from next year, Singaporeans turning 55 with $40,000 or more in their Retirement Accounts will also join CPF LIFE. Unlike the current Minimum Sum Scheme which provides payouts for about 20 years, CPF LIFE will provide Singaporeans with an income for life and a peace of mind that their savings will not run out in their old age.

People

18. The final “P”, and which is the most important, is “People”. To achieve our vision of “ageing-in-place”, we need a collective effort by everyone, to support seniors and to make them feel valued and appreciated as cherished members of our society.

19. At the individual level, how do we each treat and react to seniors as individuals? How do we plan for the care of our parents and grandparents? What do we teach our young in terms of respecting and caring for seniors?

20. How ready are we as a people, for a scenario where one in five Singaporeans are above 65 years old? How ready are we for a community where many more are in their silver years? We will need to think through how we, as a society, can imbue everyone with a sense of obligation toward our elderly members so that they can live out their golden years with dignity, and the rest of us can be greatly enriched by the experience of looking after those who have gone ahead of us.

Conclusion

21. I think we are only at the beginning of the journey. Prime Minister recently said that we are not ready for an ageing society. I agree. Much more needs to be done.

22. I thank NUS for organizing this roundtable discussion today. Ageing is a multi-dimensional issue, and we will certainly benefit from a multi-disciplinary discussion on this issue. I would be very interested to hear your views and ideas on what else we can do, in each of the four “P”s, to facilitate ageing in place.

22. Let me end by saying that we should not see ageing as a problem. In fact, I think we are at a very exciting point in time where we can concretely shape a better and more caring society for our seniors in the near future. I wish all of you a fruitful and meaningful discussion. Thank you.