Singapore nursing home models ‘need to balance benefits, cost’

Dr Jun Sasaki (at right) said research has shown the benefits of single rooms compared with shared ones. With him is Dr Kenichi Sato, a consultant and instructor at the Japan Primary Care Association. Mrs Yoshiko Takahashi, 81, and her husband Akio T
Mrs Yoshiko Takahashi, 81, and her husband Akio Takahashi, 82, have lived in Life and Senior House Ribbon City Kawaguchi, in Japan's Saitama prefecture, for the last 10 years after selling their condo unit to buy a unit there. It is not uncommon for the elderly to sell their homes to finance their stay in an eldercare facility in Japan.ST PHOTOS: SEOW BEI YI, JANICE TAI
Dr Jun Sasaki (at right) said research has shown the benefits of single rooms compared with shared ones. With him is Dr Kenichi Sato, a consultant and instructor at the Japan Primary Care Association. Mrs Yoshiko Takahashi, 81, and her husband Akio T
Dr Jun Sasaki (at right) said research has shown the benefits of single rooms compared with shared ones. With him is Dr Kenichi Sato, a consultant and instructor at the Japan Primary Care Association. ST PHOTOS: SEOW BEI YI, JANICE TAI

When Mr Akio Takahashi, 82, steps out onto his balcony, he sees a sprawling park and towering shopping mall. The Kawaguchi station is a stone's throw away, where a train can take him to the city centre in Tokyo in just over 10 minutes.

His unit has two rooms, a living room and a kitchen. If his wife Yoshiko, 81, is too tired to cook or clean, they can order their meals or call for laundry service.

"It is very convenient here. We sold our condominium unit to purchase this at about the same price," he said. The couple have lived in Life and Senior House Ribbon City Kawaguchi, in Japan's Saitama prefecture, for the last 10 years.

They also moved in as it offers independent living and nursing rooms in the same building, meaning they will not need to move to a new place if they need more care.

Their lifestyle reflects the shift that Japan has made towards private apartments and single rooms, from public facilities and multi-bed rooms, in its long-term care sector.

FINDING NEW MODELS OF CARE

We will also work with providers to explore new models of care that give residents greater independence and autonomy...

We are constantly trying out new designs for our nursing homes so that they can offer a more home-like environment, while not impacting affordability for patients significantly.

MINISTRY OF HEALTH SPOKESMAN


BENEFITS OF PRIVATE ROOMS

I don't think private rooms are considered a luxury. It is a basic right and research has shown the benefits of single rooms compared with shared ones.

DR JUN SASAKI, chief executive of Yushoukai Medical Corporation, the largest home-care clinic group in Tokyo.

Singapore is also trying to offer more living and care options for the elderly, the Ministry of Health (MOH) told The Sunday Times.

Most seniors who are frail and need long-term nursing care now opt for the typical six- to eight-bedded rooms in nursing homes here. Nursing home fees range from $1,200 to $3,500 a month, before government subsidies of 10 per cent to 75 per cent. Others usually pay between $4,000 and $6,500 monthly for private single-bed rooms.

"MOH appreciates the aspiration for our seniors to age in more homely environments that provide dignified and enabling care," said a spokesman. "We are taking into account this desire in our ongoing work to provide a diversity of living and care options and nursing home services for seniors in Singapore."

For instance, it is trying out a dementia-friendly concept of "cluster living" in Ren Ci's new nursing home in Ang Mo Kio. Each cluster has rooms with four beds, a shared living space, activity area, dining area and bathrooms.

"We will also work with providers to explore new models of care that give residents greater independence and autonomy," said the MOH spokesman.

She added: "We are constantly trying out new designs for our nursing homes so that they can offer a more home-like environment, while not impacting affordability for patients significantly."

 

Last year, a nursing home project that aimed to pioneer a model of care for dementia patients by providing single or twin en suite rooms was aborted after it failed to get government subsidies.

Its single rooms were deemed by MOH to be similar to private or A-class ward configurations. This makes them hard to subsidise, as such parameters will be hard to scale up or be made financially sustainable if applied to the rest of the aged-care sector, it said then.

But some experts said people typically stay less than a week in a hospital, but live for years in a nursing home, and the same subsidy model should not apply.

Said Dr Jun Sasaki, chief executive of Yushoukai Medical Corporation, the largest home-care clinic group in Tokyo: "I don't think private rooms are considered a luxury. It is a basic right and research has shown the benefits of single rooms compared with shared ones."

Studies found that residents in single rooms have fewer infections, less hospitalisation and anxiety, and see their quality of life improving.

In countries such as Britain and the United States, single- and double-bed rooms are the norm.

Dr Jeremy Lim, partner at consultancy firm Oliver Wyman, said: "We believe the longer-term benefits are significant for nursing home residents, both in terms of overall cost savings and quality of life."

Peacehaven nursing home executive director Low Mui Lang said: "The benefits are more stark for dementia patients, who get disorientated or into disagreements more easily with their fellow residents in a shared room."

MOH is estimated to have spent spent over $360 million on the nursing care sector in financial year 2015, and is projected to spend more than $1.1 billion on infrastructure to ramp up nursing home capacity.

Said Lien Foundation chief executive Lee Poh Wah: "We now have a critical window period when MOH is building 5,000 more beds by 2020. We need to ask ourselves: What kind of nursing home or home do we and our parents want to live in when we are old?"

•Lien Foundation is conducting a survey on what Singaporeans want of eldercare services and nursing homes. To participate, go to http://bit.do/LFsurvey

A version of this article appeared in the print edition of The Sunday Times on July 31, 2016, with the headline 'S'pore nursing home models 'need to balance benefits, cost''. Print Edition | Subscribe