Forum: Assisted living is part of the care continuum as a person ages

I refer to Mr Colin Loh Yoon Fui's letter (Assisted living flats not suited for those who need permanent help with daily activities, Dec 15).

Assisted living, as its name suggests, is not a retirement village per se, but is instead a part of the care continuum as a person ages.

Up until 2015, when Singapore's first assisted living facility was rolled out, the only care option that seniors had was nursing homes if they could not cope with care at home.

Assisted living hopes to fill this yawning gap between independent living and nursing-home-level care.

Each person has instrumental activities of daily living (ADLs) such as cooking, cleaning and shopping, and the six basic ADLs of washing, toileting, dressing, feeding, mobility and transferring.

As a person ages, instrumental ADLs are the first to be lost for various reasons such as back problems, osteoarthritis and mild cognitive impairment.

Subsequently, the senior may start to require help with one or two basic ADLs.

Assisted living facilities are specifically designed to cater to seniors who require assistance with their instrumental ADLs as well as one or two basic ADLs.

The Assisted Living Facilities Association (Alfa) has advocated that assisted living facilities admit seniors who may need help with a maximum of two basic ADLs, after which they should be transitioned to a higher-care needs facility like a nursing home for safety reasons.

The care transition plan that has been thoughtfully put in place at the Community Care Apartments ensures that seniors who are assessed to need assistance with more than two basic ADLs will have priority for placement at the nearby Bukit Batok Care Home.

The retirement village that Mr Loh may be referring to should ideally encompass the entire continuum of care, including independent living, assisted living and nursing home levels of care. The Community Care Apartments do not.

Senior ageing is a continuous process. Alfa has identified assisted living as the missing link in Singapore's eldercare landscape and is thus hoping to educate the public on its features and benefits.

Mr Loh may want to consider Kampung Admiralty instead as an alternative for independent living. I hope this helps to clarify the concept of assisted living and I invite the public to contact Alfa for more information.

Belinda Wee (Dr)


Assisted Living Facilities Association

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