Singaporeans may soon have the option of remaining at home - with the necessary personal and nursing care around the clock - as they grow old, sickly and less able.
A new offering is now under study: assisted living facilities or services, Health Minister Gan Kim Yong disclosed in an interview with The Sunday Times.
They allow seniors with physical or mental health needs and varying degrees of mobility to retain their independence by living at home, instead of in a more institutionalised setting such as a nursing home.
The options being considered may include shared residences, where three to four seniors live together and share common areas. They could also live with their families, with personal or home care services offered. These could be layered on as and when required. For instance, a senior may start out just needing help with meals but can get more aid including nursing care when he becomes more frail.
Mr Gan said the Ministry of Health (MOH) is looking into how to provide more such eldercare help - commonly seen in countries such as Finland and Japan - as the pace of ageing in Singapore quickens. He declined to disclose further details on the likely options, which he said will be announced in the near future. His ministry would likely carry out pilot projects, including determining if assisted living models can be developed in the current configuration of HDB estates.
In recent years, small pockets of assisted living options have been explored in Singapore. For instance, the integrated HDB development Kampung Admiralty, which opened last August, will offer services such as those of a handyman or home medical and nursing care. But they are limited: for example, there is no caregiver on standby for those with dementia.
Another is St Bernadette Lifestyle Village, a private facility in Bukit Timah Road that provides a 24-hour medical concierge and meals, if required. Its eight residents get help to live independently, including going on supervised trips to shopping malls. Fees are at $3,650 a month.
By 2030, almost one in three of those in Singapore is forecast to need some form of eldercare service. One in four Singaporeans will be aged 65 and above.
But a 2016 report, commissioned by the Lien Foundation and Khoo Chwee Neo Foundation on nursing homes, found that seniors have few housing options apart from living in a nursing home if they grow frail and do not have anyone to care for them at home.
Ms Teoh Zsin Woon, MOH's deputy secretary for development, said assisted living facilities abroad often take the form of gated communities. But Singapore's dense HDB clusters are an advantage that should be tapped, she said.
MOH will study how seniors can get help to age in place within their HDB homes, and possibly offer options beyond what Kampung Admiralty now provides, said Ms Teoh. It will also look at new HDB estates and other projects to work on how they can be better designed to support care for seniors, she added.
Lien Foundation chief executive Lee Poh Wah believes assisted living is an attractive option. Many Singaporeans are in nursing homes not because they need skilled nursing or medical care, but because they need personal care such as help with dressing or going to the toilet, he said. He suggested building group homes for seniors on one or two floors of an HDB or condominium block, and offering them to those who want to downsize.
Ms Peh Kim Choo, chief executive of Tsao Foundation, said the "litmus test" of assisted living in Singapore is whether a person can continue to stay put even as his physical and mental health condition changes as he grows older.
"At the same time, it needs to answer to people's needs for connection, growth and development to eradicate depression and social isolation."