With many countries facing the challenges posed by an ageing population, global thought leaders, leading eldercare practitioners and philanthropists gathered at the seventh Credit Suisse Philanthropists Forum to discuss trends in strategic philanthropy and the social issues resulting from the "silver tsunami".
"Ageing and opportunities in eldercare philanthropy" was the topic on the agenda at one of the panels of the forum, an annual flagship event held at Clifford Pier on Nov 16.
In Singapore, issues related to eldercare have increased in significance over the past decade as the society ages. Out of a total population of 5.6 million, 18 per cent (about one million people) were over 60 years old in 2015. This figure is forecast to rise to 31 per cent (two million) by 2030.
Charities receive government funding for 80 per cent of the cost of state-funded programmes. They are thus under constant pressure to raise additional resources from private donors to allow them to add extra value by innovating, doing research and investing in training.
Autonomy in ageing
Keynote speaker Mary Ann Tsao, vice-chairman of Tsao Holdings and chairman and founding director of the Tsao Foundation, shared what her grandmother said: that "society is unkind to people in old age".
The Tsao Foundation is a Singapore-based non-profit organisation dedicated to aged care and ageing issues. It was chartered in 1992 by Dr Tsao's grandmother, who highlighted three basic principles for the foundation - that seniors should live in their own home; be surrounded by their loved ones; and be masters of their own destinies.
The initial years were tough - agencies catering to the elderly in Singapore were few, and Dr Tsao, a United States-trained paediatrician, relied on her own resources to kickstart the operations, including getting doctors from the US to help train the staff.
When asked how she measures the success of her philanthropic efforts, Dr Tsao said the foundation uses a "happiness scale" to gauge how happy its beneficiaries are.
Dr Tsao said: "We can no longer just depend on the family due to changes in family structures and longer lives. Therefore, community-run programmes by volunteers and patient-care managers are important in the long-term care of older people."
To companies considering eldercare philanthropy, her advice was: "Go and see what is happening on the ground."
2Cs of eldercare
Panellist Zulkifli Baharudin, a director at SymAsia Foundation, highlighted the success of Singapore's housing policy, which has made it possible for the elderly to live in their own apartments. These have an en-suite bathroom with lifts that stop on every floor.
But, he said, community support is still needed - such as the provision of nursing homes as an alternative for families that cannot cope with the elderly at home.
To provide higher quality community support for the elderly, Mr Zulkifli coined the term "2Cs" - "competency" and "capacity". He highlighted the need for better doctors and staff at nursing homes and eldercare facilities, and said philanthropists could help in getting the right talents and services.
He noted that besides orthopaedic care, the elderly also need help with other medical problems. In Japan, the use of technology such as robots has raised the capacity to care for the elderly, although its application in the Singapore context needs to be explored.
Dr Christopher Lien, senior consultant geriatrician and director of community geriatrics at Changi General Hospital, said that if philanthropy is to be sustainable and affordable, it is necessary to empower senior citizens.
He said that for the elderly, the ability to continue walking is important for their happiness. "Rehabilitation and exercise are key, and the elderly should have access to such facilities in the community," he said.
Dr Lien pointed out the need for an ecosystem with integrated support from the community, such as policemen and convenience store or coffee-shop staff who would recognise a registered elderly with dementia, for instance.
Such a system would promote independence and autonomous living, as well as allow the elderly to have a higher quality of life.
Professor Kua Ee Heok, senior consultant psychiatrist at the department of psychological medicine at National University Hospital, has spent 20 years researching dementia. He said it is possible to reduce the rate of dementia among the elderly through activities like choral singing.
A 10-year study he initiated in Jurong for elderly patients with a family history of dementia, diabetes and hypertension, successfully reduced their depression rate after three months of art and music therapy and mindfulness practice.
Additional grants have allowed for the study to be conducted at eight other centres across Singapore. The programme has expanded to include the use of traditional Chinese medicine and research on how food and diet can play beneficial roles in reducing depression.
Mr Paul Robertson, chair of St Vincent's Health Australia, said that there, the caregiver's role has been given greater support by the government and philanthropists. For instance, caregivers for dementia patients attend short courses or have access to helplines to find out what to expect in the coming weeks and months.
In his concluding remarks, he said that a top-down approach was insufficient; having a big picture with the involvement of various parties would help create a more inclusive space to embrace eldercare.