Singapore will be 'super aged' in just two years. Is the country ready?

Singapore has done well in building the infrastructure to support a rapidly ageing society, but mindsets towards ageing have to change so that the elderly do not feel like a burden to their families.

She is just 34, but Ms Priya Elangovan is already worried about growing old in Singapore.

“I’ve seen cars honk impatiently as they wait for the elderly to cross the road. I also find that people can be impatient when younger seniors are unfamiliar with using mobile apps,” said the media professional.

These concerns are compounded by fears she has about being able to afford ageing comfortably, or whether she would have a support system and community to grow old in.

“I worry about growing old in a country where I cannot rely on anyone for help. While my parents can rely on me now to help them get around, what happens if I am old, single and trying to buy food or cross the road? I will have to fend for myself.”

While Ms Elangovan contemplates the bleak scenario of her own golden years, there are many who are already living the reality of being old in Singapore.

Mr Anthony, a 75-year-old security officer, who lives alone, told CNA TODAY that he prefers to keep to himself.

He limits his interactions with his neighbours, saying he does not wish to “disturb” them. He has also been estranged from his family and children since his divorce, and does not have many friends in Singapore, having spent a significant portion of his younger days working overseas.

But for others, like 74-year-old Doris Tang, growing older has been a treat. She enjoys her retirement years as she now has the time to pursue her own interests, learn new skills and serve the community.

Since retiring in 2012 from her role as a production worker in a factory, Ms Tang has been caregiving for her grandson, volunteering and picking up new digital skills.

“I see people living longer now, into their eighties and nineties. This means I still have another 20 years... so I think about how I want to spend these two decades,” she said.

“I feel like I still have the energy and capability to do and learn things, so I want to do them. I don’t want to waste (my abilities). As long as you believe you still have value, you will be happy.”

The contrasting daily lives of Mr Anthony and Ms Tang reflect how ageing in Singapore is not a uniform experience, and how the country must grapple with increasingly varied needs as its population greys.

Not only is Singapore’s ageing population growing, but the demographic profile of its elderly is also changing — they are living longer, ageing healthier and tend to be more highly-educated and more affluent than earlier cohorts, which could give rise to differing expectations and needs as they age.

As Dr Ad Maulod, a senior research fellow at Duke-NUS Medical School’s Centre for Ageing Research and Education, noted: “Older Singaporeans are not a homogenous monolithic, they are incredibly diverse, and will become more so in the future.”

Getting to grips with ageing has taken on an added urgency, with the country projected to attain “super aged” status in 2026, as more than one in five here is expected to be 65 years old or older. By 2030, one in four Singaporeans will be aged 65 or above.

Already, as of June this year, almost one in five (19.9 per cent) Singaporeans were aged 65 years old and above, according to the annual Population in Brief released by the Prime Minister’s Office on Sept 24.

And while the Government has long stepped up efforts to prepare for an ageing Singapore, it still remains a work in progress.

RAMPING UP ELDERLY-FRIENDLY INFRASTRUCTURE

When it comes to preparing for an ageing society, there is one area where Singapore has excelled: Infrastructure.

In January last year, the Ministry of Health (MOH) rolled out a refreshed Action Plan for Successful Ageing, an update of a blueprint launched in 2015.

The 2023 plan has three key aims:

• Empowering the elderly to take care of their physical and mental well-being
• Enabling older persons to continue to contribute their knowledge and expertise and remain engaged in society 
• Supporting the elderly to stay connected to their loved ones and society

The plan also includes key initiatives and targets set by the authorities as they accelerate the pace of building elderly-friendly infrastructure. 

Still, the experts said more needs to be done to enable Singapore to meet the varying needs and preferences of future cohorts of older persons.

A simple case in point: Retired policeman Sunny Ong, 75, is a regular at the Active Ageing Centre in his neighbourhood. He drops by almost every weekday morning to play table tennis with others he has come to befriend at the centre, but he knows the game is not appealing to all elderly.

“Individuals all think differently. What makes me happy may not make the next person happy.”

Certain activities, such as mahjong, for example, could be more attractive to Chinese elderly, yet potentially exclude older persons of other races, he noted, so ageing centres should offer a wide variety of activities.

Dr Ad from Duke-NUS noted: “I think in Singapore’s case, we seem more equipped to tackle challenges related to physical infrastructure. What is harder to address is whether manpower and issues of competency can be ramped up in tandem with the ramping up of services and activities.”

But even as Singapore strives to do its best, it will be an uphill task.

Dr Corinne Ghoh, an associate professor of social work from the National University of Singapore (NUS) and a former senior consultant at the MOH Ageing Planning Office, said: “Implementation-wise, I do not think that countries are ever ready in supporting an ageing population as there will always be evolving challenges across the life spectrum, with cohort differences in expectations and changing demographic trends.”

What Singapore can and should do is to strengthen its abilities and competencies to pivot, so it can meet emerging and changing needs in tandem with the speed of ageing, she added.

One way to achieve this is through giving adults a bigger say in shaping how they age, said Dr Shannon Ang, an assistant professor of sociology at the Nanyang Technological University (NTU).

“Many in the later-born cohorts of older adults are educated and have valuable skills. The onus should be on them to decide how they want to age, but society (and the state) also needs to know how to empower them to do so,” Dr Ang added.

This could take the form of simplifying bureaucratic processes and approvals needed to form societies and run events, or encouraging more civic participation, he suggested.

STRENGTHENING SOCIAL SUPPORT

Beyond building elderly-friendly facilities, an ageing society needs stronger social support and safety nets for older persons.

Singapore has made moves in this regard over the years. For example, last November, the authorities launched Age Well SG, a national programme that offers, among other things, transport facilities, befriending initiatives and support to caregivers who provide crucial assistance to the elderly.

Indeed, expanding support not just for older persons but for their caregivers will be crucial as Singapore continues greying, experts said.

With shrinking family units, it will become increasingly unsustainable for Singapore to rely solely on formal caregivers in the healthcare and eldercare service sectors, or on informal caregivers such as the elderly’s family members, they noted.

There is thus a need to create a more expansive caregiving pool, and one viable solution is to involve other older persons to provide peer-to-peer support and caregiving.

Ms Edna Claudine Leong, executive director of senior volunteering organisation RSVP Singapore, said a network of elderly contributors would create a “self-sustaining eldercare ecosystem” that grows alongside the ageing demographic.

“As the number of seniors increases, having peers to support and befriend each other will help ease the strain on more formal eldercare services, while also nurturing a community of seniors who age well together,” she added.

Over time, industry players expect that the older adults will grow from being care recipients to becoming peer supporters for other elderly in their midst.

But according to a spokesperson for Lions Befrienders, a growing trend it is seeing is that of elderly caregivers providing care to their loved ones while also having to manage their own health issues.

These senior caregivers must receive adequate support, so that they can fulfil their caregiving duties while maintaining their own physical, mental, and emotional health at optimal levels, the spokesperson added.

Several elderly interviewed by CNA TODAY have already embraced this network of peer-to-peer community of care.

Among them is Ms Carol Chan, 78, who volunteers her time weekly as a befriender at an Active Ageing Centre in Jalan Besar.

As a befriender, she reaches out to other elderly like Mdm Alimah Kassim, 73, who was initially withdrawn from the community, especially after her husband’s death five years ago.

Ms Leong from RSVP said that another benefit of leveraging on older volunteers is that they are able to form deep and meaningful bonds with each other, as they understand the emotional and physical challenges that come with ageing.

Similarly, Retiree Tang Wai Han, 66, who is the caregiver to her 94-year-old mother with dementia, said she relies on neighbours and stall vendors at the coffee shop near her mother’s house to look out for the older woman – especially as the pair do not live together.

Ms Tang recalls having fallen a few times while rushing between her home and her mother’s place. Bringing her mother out can also be challenging at times, as she has to support her mother’s weight.

“There are challenges, especially when we are also getting weaker. As we age, we are not as fast or as nimble as we used to be,” said Ms Tang.

Ms Tang also actively extends her care to other older persons in need. She took up driving lessons in her late fifties so she could help to ferry her elderly neighbour after his radiotherapy treatments. 

Ms Tang said: “If somebody has a car but cannot drive, I can use my skills to drive and send them to the hospital. Somehow, maybe because I used to be a teacher, I’ll keep a lookout for opportunities to reach out. That is how I look at it: Seniors serving seniors.”

RESHAPING MINDSETS ON AGEING

The final piece of the puzzle in creating an even more elderly-friendly country is improving societal attitudes towards older persons and ageing, which are currently less than ideal, experts said.

This includes addressing ageist attitudes and discrimination towards the elderly – whether internalised in how they perceive themselves and ageing, or in how the general population views older persons in their midst.

Indeed, several elderly interviewed spoke of a fear of being a “burden” to those around them.

Mr Anthony the security officer said that being sick and in the hospital is a worry for him in his older years, as he does not want to become a “burden to all”.

Mr Nadarajah, 75, told CNA TODAY that being able to live and function independently is most crucial to him as he ages. He tries to stay healthy by exercising daily, as he does not want to have to overly rely on his children or spouse.

Such worries are just as pronounced among the elderly who are more actively engaged, including Mr Ong, the retired police officer, who said he tries not to “bother” his three grown children. 

Likewise, Ms Tang said that her biggest wish is to stay active and healthy as she grows older, so that she does not have to “burden” her family members.

Dr Ang from NTU noted that the term “successful ageing” – traditionally taken to refer to older persons who are socially engaged, free from illness and who enjoy high physical functioning – first emerged to challenge the assumption that later life is an inevitable process of degeneration.

While well-meaning, the term could also prove highly unhelpful as it may end up devaluing those who are unable to achieve that ideal, he said.

“(Successful ageing) provided possibilities to strive towards. It was aspirational, pushing back against fatalism,” said Dr Ang.

In Singapore, however, such discourse around “successful ageing” is also inextricably linked to broader conversations about success, which is often “too tightly linked with the idea of an economically productive citizen”, he said.

In older adults’ cases, this logic could thus extend to not “being a burden” in light of increasing healthcare costs, added Dr Ang.

Dr Ad also noted that Singapore’s model of successful ageing emphasises self-responsibility – urging individuals to take necessary action to maximise good health and avoid disease and disability.

However, this overemphasis on independence, healthy longevity and delaying decline “ignores the reality of later lives”, Dr Ad cautioned.

“The problem with the successful ageing framework is that it idealises the superhuman: The older person who is still independent, healthy, robust and actively contributing to society,” he said.

“In contrast, older people who are sick, frail and disabled – which ironically, speaks more to the realities of ageing – are excluded from narratives of successful ageing.”

Such “ableist concepts” arguably places pressure on older persons to stay active in spite of their limitations, which can be demoralising and ultimately perpetuate low self-esteem and a sense that one is no longer valued in society, said Dr Ad.

OVERCOMING THE TENSION

Given the inevitable tension between promoting the ideals of “successful ageing” and addressing the physiological challenges posed by the passage of time, experts said it is crucial to broaden societal understanding of what it means to age “productively” or “successfully”.

Productive ageing can take many forms, said Dr Carol Ma, the head of gerontology programmes at the Singapore University of Social Sciences (SUSS), such as caring for one’s grandchildren, staying socially active with friends or volunteering.

To help the elderly lead purposeful lives within their abilities, non-profit organisation TOUCH Community Services has been flexible in creating and adapting its volunteering roles to different seniors’ interests and capabilities.

TOUCH lets the older adults choose how to help, while minimising pressure by allowing them to choose how often to do so, said Mr Andy Ang, the organisation’s head of Active Ageing.

Such is the case with Madam Sreedharan Kamala, a 73-year-old retired spa therapist and trainer, who volunteers her expertise at one of TOUCH’s Active Ageing Centres in Yishun.

Mdm Kamala told CNA TODAY that she offers facial treatments to other elderly at the centre, and helps to cut the nails of those who are less mobile.

The volunteering opportunity was specially created for Mdm Kamala, who wanted to serve the elderly around her in the best way that she knew.

TOUCH also helps to stagger the hours she spends volunteering and the number of elderly she serves each time, so it is not taxing on her.

For others who may be less mobile but who still wish to contribute, they may also do so at a pace and level that is comfortable for them, said Mr Ang.

Citing the case of a frail older adult volunteering at one of the organisation’s centres, Mr Ang said that the woman contributes by helping to observe and monitor her peers in the community – flagging when someone has not shown up for a while, so that others at the centre may follow up with them.

Besides these, experts said public education and social media can also help to reframe ageing in a more positive light for younger people.

SUSS’ Dr Ma noted that negative mindsets about growing older often stem from societal perceptions that associate ageing with decline and a loss of capabilities. Such perceptions are further reinforced by the use of terms like “silver tsunami”.

“We need to educate the public about the ageing process, self-care, and (have) open discussions about topics like disease, caregiving and end-of-life care," she said. 

“When people accept and embrace ageing as a natural process, they can approach it with less fear and negativity." 

Agreeing, Mr Ong, the retiree, said: “Every morning, when I wake up, I will say: ‘Wow, I get another day, what am I going to do today?’ I’m not going to think of what happened yesterday or in the past – this is my policy when I reach this age.”

Ms Tang added: “Don’t look at (ageing) like it’s the end of the road for you. It’s just the beginning of another passage of life. You must have that kind of positive, growth mindset. 

“We are all social beings. So be a befriender, take the initiative to go and ‘jio’ (dialect for ‘invite’) people rather than wait for things to happen. My motto is: Don’t wait for things to happen. Make things happen, and many baby steps (will eventually) make a big step.”

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