The report on the pervasiveness of ageism worldwide is timely (Widespread ageism worsened by pandemic, says UN, March 19).

The joint report by four United Nations agencies warned: "Ageism is widespread in institutions, laws and policies across the world. It damages individual health and dignity as well as economies and societies writ large. It denies people their human rights and their ability to reach their full potential."

Representatives of the agencies in a joint statement added that "older people have been often seen as uniformly frail and vulnerable".

The Assisted Living Facilities Association of Singapore (Alfa) has in the last three years been advocating assisted living as a more dignified and economically sustainable way for seniors to age, compared with nursing homes or being home alone with or without a helper.

However, Alfa has encountered instances where our existing policies remain "ageist" in spirit. Perhaps it is our Asian culture of having respect for seniors which actually engenders ageism.

In our desire to keep seniors safe for what we think is their own good, we are in effect robbing them of their dignity and sense of purpose.

Hence, Alfa has advocated "discerned autonomy" for our seniors. This is a safeguard for seniors who may not be able to safely manage certain aspects of their autonomy, for example, money management or wayfinding, and would thus require assistance in those areas in order to remain independent and retain their dignity.

One of our Alfa members has been actively trying to engage government agencies to start an assisted living facility (ALF) for seniors in a vibrant and culturally rich commercial district of Singapore, but has met many hurdles and obstacles.

Among such hurdles are policies which view ALF seniors as "uniformly frail and vulnerable", who should live only in dwellings with institutional fire safety requirements.

This failure to stratify seniors according to their needs and offer them choices in the name of safety is what we should be trying to combat.

Dr Philip Yap, a senior consultant geriatrician, had been quoted in the 2016 Lien Foundation publication Safe But Soulless: Nursing Homes Need A New Narrative as saying, "if you're only focused on safety and efficiency, you can actually compromise a person's quality of life, well-being and sense of self-worth".

In the same publication, Dr Angel Lee, a senior consultant in palliative care, said: "We should always aim to make homes safe. But we should also be prepared to take risks and accept that residents in the end may prefer the freedom to live as they like and maybe their lives would be shorter as a result, but that's okay for them... It's the culture of overprotection that needs to change."

With 950,000 seniors in Singapore today, we as a nation need to urgently come together to consider if ageism is indeed endemic in our society, and if we think it important to eradicate this scourge in our policies and mindset.

Belinda Wee (Dr)

Director

Assisted Living Facilities Association