Health and social needs tend to be "inter-related" and the healthcare system must change to reflect this, Health Minister Gan Kim Yong said yesterday.

Social workers, in particular, are key to making sure such needs are met, he added. "With the focus on Singapore's healthcare shifting towards primary and community care, the people will... need the continued support of social workers in navigating the healthcare and social support systems to better manage their conditions and live healthier lives," he said.

Mr Gan was speaking at the opening of the International Conference on Social Work in Health and Mental Health, which is being held until Thursday at the National University of Singapore's University Town.

Also present at yesterday's conference was former president S R Nathan. The 91-year-old, who suffered a stroke last year, used to be a medical social worker and helped to set up the Singapore Council of Social Service, the predecessor of the current National Council of Social Service.

Dr Chew Yat Peng, who studies seniors who have early dementia and live alone, said dementia is one example of a medical condition with social implications.

"They (the patients) can feed and shower themselves but, at the same time, their judgment can be impaired," said Dr Chew, a senior counsellor at O'Joy Care Services.

Her team keeps a close eye on such patients, making sure their needs are met and that they stay out of institutions for as long as possible. "They are ambulant, and they don't want to be kept locked up in a nursing home," she said.

Ms Zahara Mahmood, head of community care at Eastern Health Alliance, said many of her clients have financial or mobility issues in addition to their medical conditions.

"When we come in, just talking about medication alone is not enough," said Ms Zahara, who has been involved in social work for 25 years. "Sometimes, after you talk to them, you find that people are actually very depressed."

Under a programme called Neighbours for Active Living, her team identifies seniors who are "frequent fliers" - those who are admitted to hospital three or more times a year.

The team looks after their needs, sometimes by roping in their neighbours as befrienders.

"Some of them are fiercely independent - they need help but they don't want help," Ms Zahara explained. "But when their neighbours come in, it's like a kampung- style befriending."