I agree with Senior Minister of State for Health Koh Poh Koon's assertion that "caring for seniors in the community as far as possible" is important and that "institutionalising them in nursing homes... should be the very last resort for our elderly" (8 new nursing homes set up in past 5 years, Aug 5).

While we applaud the Government for taking a stand against institutionalising the country's seniors, Singapore is also faced with the challenges of a super-ageing society.

With increasing affluence and improved economic and health status among our seniors, the number who would require nursing home care, which is the highest cost in the care continuum of seniors, should decline in time, in tandem with their aspirations for alternative desirable care options in the community.

As seniors age, they lose their ability to perform instrumental activities of daily living (iADLs) - such as cooking, cleaning and grocery shopping - for various reasons such as back or knee problems and forgetfulness.

This comes before their basic ADLs - such as their ability to walk, shower, toilet, dress, transfer and eat independently - become impaired.

The main crux of caring for seniors in the community, as Dr Koh had alluded to, is "if they do have care needs, try and localise them within the community".

With their need for iADL assistance, seniors may consider getting a foreign domestic helper or moving in with their children.

It is ideal that such helpers are supervised, and seniors themselves may not be up to this task while their children may be too busy to do so.

Seniors living with their families can be lonely as the young are often away at work for a large part of the day.

The Assisted Living Facilities Association of Singapore (Alfa) has been trying to educate the public on the benefits of organising the assisted living care model for seniors in the community.

Our proof of concept at St Bernadette Lifestyle Village, which has shown the efficacy of assisted living as a way to keep seniors well for longer in the community, has gained sufficient traction for the Government to pilot the Harmony Village @ Bukit Batok which will be ready in 2024.

The cost savings of a shared economy among a small group of seniors living in a home-like environment with round-the-clock care, provision of iADL support and proper safeguards in place has been practised in countries such as the United States and Japan, and would certainly suit the aspirations of Singapore's seniors now and in the future.

As Singapore does not have the luxury of space, Alfa has advocated retrofitting existing seniors' homes or suitable buildings located within the community, and delivering the assisted living model of care to them.

In this way, more seniors can age in place and delay their entry into a nursing home, if at all.

Indeed, if assisted living is well organised and safe, there may not be a need to build more nursing homes in Singapore.

Belinda Wee (Dr)

Director

Assisted Living Facilities Association