Commentary: An elderly public housing project is a game-changer but mindsets still need shifting

SINGAPORE: In his volume, Being Mortal, author Atul Gawande writes movingly about the departure between an ageing person living out their final years in the comfort of habitation versus in an institution where all sense of self is eroded every bit they are treated like patients rather than people.

The launch of the public housing project to provide 160 assisted living units in Bukit Batok is a game changer much in line with how Gawande envisions ageing.

In offer older Singaporeans who need some amount of daily health assistance, simply without the restrictions of institutionalised residential living of a nursing abode, it is a step towards dignified ageing.

Seniors can buy a charter of up to 35 years on a property bundled with a bones service package of health and social intendance, to which they tin add other payable services as their care needs change.

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A collaborative effort by two ministries and the Housing Development Lath (HDB), the Bukit Batok concept is some other pace towards integrating the "hardware"- physical infinite - and "software"- basic services and customs interaction - that are essential enablers of ageing in place and all-round healthier living.

Earlier projects like Kampong Admiralty and Heartbeat@Bedok offered older Singaporeans purpose-built public housing with co-located healthcare facilities and community spaces for enhanced ease of access, only those did not package home ownership with the delivery of domiciliary care services.

AN ESSENTIAL Add-on

The Bukit Batok development introduces an entirely new but essential component into the country's intendance eco-organization at the wellness systems level, bringing the country on par with others like the US, where assisted living has long been part of long-term care options.

At the Tsao Foundation, which provides multidisciplinary care for domicile-dwelling elders, we have seen many older persons landing in nursing homes fifty-fifty when the assistance they actually needed was less than a nursing home's scope of services and facilities.

Too ofttimes, this had been against their wishes to remain living at dwelling, in the community well-nigh familiar to them.

The Community Care Apartments will exist designed with an open layout. There will exist a sliding partition to separate the bedroom and living room. (Photo: Housing & Evolution Board)

It could happen when immediate or reliable help cannot exist put into place for the elder, who could otherwise live independently, to take his essential medication, or adequately manage toileting and personal hygiene.

READ: Assisted living flats for seniors would plug gap in housing market, fulfil diverse needs: Experts

This trend has been somewhat mitigated by the burgeoning of intermediate- and long-term care services for home-habitation elders, especially in the last three to five years.

This can be seen in the plethora of home- help services, dwelling- care services, day centres and community-based care management services listed under the AIC's Care Services pages.

ASSISTED LIVING HAS TO Laissez passer A CRITICAL TEST

The development of assisted living facilities within public housing estates will certainly bolster the option to keep living at home despite frailty, and should aid to thwart the painful — and resource-draining — "nursing-abode-as-first-stop" track.

Even so, there is one critical test for the assisted living project: How successful will it be in delaying nursing home admission or cutting its inappropriate employ?

By blueprint, the project should exist able to practise both as it provides comprehensive dwelling house help services, home medical care and programmes to promote social and health activities over a resident'due south life course, equally well every bit the option to buy other services that they need on height of the basic package.

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Nonetheless, assisted living cannot function as a standalone solution. Non only volition the residents need care services from external providers, they might well spend bouts of time in other care settings such as stays at an acute infirmary, or a community hospital for rehabilitative care or recuperation, or indeed, admission into the nursing home.

Given this, the relationships betwixt the assisted living facility and other stakeholders working jointly in a seamless, integrated manner as the older person'southward care partners are of critical importance to the health of its residents and its own success.

Senior citizens at the void deck of an HDB Block. (Photo: Ray Yeh) Elderly living in rental flats in Jalan Bukit Merah. (Photograph: Ray Yeh)

The extent of its chapters to provide a feasible alternative between home and institutionalised care may well depend on the profile of the people information technology accepts into the project; how well it defines its deliverables and manages expectations; its own service quality, including service linkages; and cost efficiencies.

NOT Allowing ELDERLY " GHETTOS "

At both the societal and personal level, healthy ageing and the "good life" look across achieving merely physiological wellness, of import though it is.

We all strive to find pregnant, make connection, participate and contribute at every stage of our lives: the continuing capacity to do these are the authentication of successful ageing.

As such, whatever initiative to enable ageing-in-identify must necessarily support and empower individuals and their community in these aspirations.

The Bukit Batok development tries to meet these needs past providing furnished communal spaces for its residents to gather, share a meal or participate in arranged activities equally role of the basic service package.

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It remains to be seen whether the arranged activities include promoting connection with other Bukit Batok residents or facilitating the elders to become active members and leaders in the wider customs.

Yet well-significant it is, a edifice with 160 flats designed solely for the occupation of people above 65 raises the question of whether it volition become an "elders ghetto".

Past this I mean the neighbourhood can become a space only for elders and professional caregivers. The void deck downstairs is likely to see wakes rather than other activities. Therefore, the connection to mainstream life is critical.

WHERE ELDERS HAVE A VOICE

The Tsao Foundation embarked on its ground-breaking project, the Customs for Successful Ageing (ComSA) in Whampoa in 2013. There were three cardinal components to this: An integrated care organization that promotes the physiological, social and emotional health of the older person over the life form and across care settings.

A robust infrastructure that takes into business relationship the built environment and linkages within and across Whampoa and finally, a community evolution programme that empowers older persons in their choices.

We start with the premise that connection and meaningful contributions are what lifts the human spirit and gives life to the daily grind.

Within its bounds at the Whampoa Community Gild, ComSA houses a primary healthcare dispensary integrated with intendance management and counselling services, a day intendance centre and a training centre, all serving primarily older people — likewise every bit a drop-in cafe, run past older persons, open up to all.

READ: Commentary: You don't have to historic period and grow frail alone. Nurses have your dorsum

A key component of the ComSA is that information technology offers skills training and facilitates opportunities for older persons to speak up, atomic number 82 and organise initiatives for themselves and their wider community.

This has resulted in, for case, several roving exhibitions of their cherished heirlooms and family recipes equally artefacts of Whampoa'southward cultural legacy.

What we accept learnt at ComSA is primal: Information technology's non which institutions you lot are near to just whom yous tin call and talk to that matters the most.

A care eco-organisation that works for the older person is one where he or she has the agency to make decisions and everyone around them – family unit members, care-givers, health professionals – all have strong relationships with them.

ComSA, after seven years, is still a work in progress, but those of usa on the footing are ever more than convinced of the disquisitional demand to facilitate and support connections and platforms whereby elders are consulted on what affects their own lives and where they live.

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In merely x years' fourth dimension, Singapore volition have at least 25 per cent of its population aged 65 and above. Customs-based care, equally opposed to institutionalised living arrangements, is the lynchpin of the health ecosystem being developed and viable assisted living options will exist a disquisitional office of information technology.

Beyond building infrastructure and improving service capacity, at that place is urgent need to recalibrate how ageing and the older person are viewed, and to dedicate efforts to creating a society for all ages where elders thrive and more importantly, where they are allowed dignity and agency in their dusk years.

Peh Kim Choo is the CEO at the Tsao Foundation.

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Source: https://cnalifestyle.channelnewsasia.com/commentary/commentary-elderly-public-housing-project-game-changer-mindsets-still-need-shifting-291231

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