18 Oct 2016
• Singaporeans are most concerned about being able to care for oneself and ageing in place
• Their top aspirations for old age are good health, financial readiness & having a sense of purpose
• Nearly half of respondents (47%) are willing to stay in assisted-living facilities; three in five (60%) think that residents in nursing homes should stay in single or twin-bedded rooms
• Income unveils Silver Secure in response to key insights to survey findings
SINGAPORE, 18 OCTOBER 2016 – In the latest figures released by the Department of Statistics Singapore, the city state has passed the half-way mark to hit 900,000 seniors (those above 65 years old) by 2030 . Currently, there are 487,570 people in Singapore who are 65 years old .
To better understand the needs of Singapore’s rapidly ageing population, Lien Foundation and NTUC Income (Income) collaborated on a research to gain insights to Singaporeans’ aspirations and concerns about growing old in Singapore.
Entitled ‘Supporting Singaporeans’ Aspirations in Aged Care’, this survey follows Lien Foundation’s recent release of “Safe but Soulless – Nursing Homes Need a New Narrative”, an in-depth study on the state of nursing homes today where aged care experts and professionals weigh in with their opinions and insights on possible solutions and improvements to better aged care.
Mr Gabriel Lim, Programme Manager of Lien Foundation, said, “We have heard from the experts in aged care, and now the ground-up sentiment tells us that close to half of those surveyed are willing to stay in assisted-living facilities. However, nursing homes remain the only dominant residential care option today for those whose care needs can no longer be met at home. This gap between Singaporeans’ aspirations and the lack of choice must close quickly, because there could well be 92,000 elderly living alone by 2030.”
He added, “We are glad to find a partner in Income as the private sector can play a greater role in aged care to meet the growing needs of aging Singaporeans with innovative and insightful services.”
Mr Ken Ng, Chief Executive of Income, said, “Increasingly, there is a recognition that we may be facing a silver tsunami as our population ages. Longer life expectancy come with health and aged care issues. This calls for more quality and affordable aged care models or solutions in Singapore. Similarly, the onus is on Income to meet the needs of the growing silver population with the right insurance products and services. To do this, it requires a change of mindset and approach to insurance targeted at older consumers.”
Concerns about ageing in Singapore
The research, ‘Supporting Singaporeans’ Aspirations in Aged Care’, surveyed 998 respondents between 30 and 75 years old in Singapore. Amongst them, 82% indicated that they were concerned about ageing here. Those between 30 and 44 years old (89% of them) were the most concerned compared to older respondents.
The top concern amongst respondents was the inability to care for oneself or perform activities of daily living (ADL). Amongst them, the seniors (60-75 years old) were most fearful. Respondents were next most concerned about their financial preparedness citing a fear of “running out of savings” and the inability to afford healthcare and medical expenses. In this regard, the younger respondents (30-44 years old) were the most worried about financing themselves as they age. For seniors, they were more concerned about becoming “a burden” to their families.
The survey also revealed that three in four respondents were concerned about ‘ageing in place’. This refers to the ability of an individual to live in one’s own home and community safely, independently and comfortably, regardless of age, income or ability level. Those aged below 60 years old were the most concerned about ‘ageing in place’ (80% of those aged 30-44 years old, 81% of those aged 45-59 years old, compared to their older (75% of those aged 60-75 years old) counterparts.
The respondents’ key concerns mirrored their aspirations for good health, being financially prepared and having a sense of purpose as they age.
Good health was defined as being free of critical or long-term illnesses and thriving physically. Respondents also aspired to have sufficient income and savings to maintain current living standards and to finance aged care and needs. For respondents who are caregivers, they aimed to afford medical and aged care expenses for themselves, while providing for their dependents. Respondents also expressed a desire to continue contributing to society and caring for their loved ones.
Living arrangements in old age
Running in tandem with the respondents’ concern about ‘ageing in place’, 78% of them preferred to stay in their own home, independently or with their spouses during their silver years. This preference was the strongest amongst the seniors (84% of them) compared to their younger counterparts (73% of those aged 30-44 years old and 77% of those who are 45-59 years old).
Alternative living arrangements such as a retirement village or a senior’s apartment were the preferred choices for the younger set (30-44 years old) while those aged 60 to 75 years old opted for a senior’s apartment (66% of them) and nursing home (58% of them).
Interestingly, while one in two respondents were willing to stay in a nursing home themselves, they were less prepared to send a family member to one. Nearly one in three were strongly against it.
Awareness and usage of aged care services in Singapore
Awareness amongst respondents about aged care services which include elderly day care centres, nursing homes, home care and respite service was high. More than eight in ten respondents were aware of such services with nursing home recording the highest awareness level (88% of respondents), followed by day care centre (86%), home care (62%) and respite service (30%). Amongst the respondents, two in ten had a relative staying (or stayed in the past) in either an elderly day care centre or a nursing home.
The lack of time, space at home, expertise and social support were key factors that respondents cited for the need of quality aged care services in Singapore.
Considerations for and expectations of aged care services
Focus group sessions with the respondents revealed that expectations for mainstream aged care services – home care, elderly day care and nursing homes – in Singapore were multi-faceted but could be grouped under the following four categories.
1) Value and affordability;
2) Customer experience, which included quality of staff, access to professionals, personalised service and quality of volunteers;
3) Quality of life offered, which encompassed environment and facilities, standard of food, programmes and activities, as well as level of autonomy; and
4) Convenience of these facilities which referred to location, accessibility, and visiting hours.
Across all respondents, well-trained healthcare professionals were listed as the most important criteria for home-care services, with older respondents (45-75 years old) expressing the need for doctors who could make home visits and care assistants that were trained in eldercare as the next most important factors.
Respondents also expected facilities at elderly day-care centres to be well maintained and clean, conveniently located (in every residential estate) and to provide well-trained staff. They also expected activities, therapy sessions, healthy food and training to be provided to caregivers of the aged.
Nursing homes expectations mirrored those cited for elderly day-care centres, with seniors (60-75 years old) expecting homes to have adequate numbers of well-trained staff that can provide personal attention to residents.
Privacy featured high in the expectations of Singaporeans. For respondents willing to stay in assisted-living facilities, 90% of them preferred single or twin-bedded rooms. With regard to nursing homes, 60% of them agreed that residents should stay in single or twin-bedded rooms rather than six to eight-bedded wards. Close to half of the respondents indicated that it was unacceptable to stay in six to eight-bedded rooms for the rest of their lives. For the younger set aged 30-44 years old, their wish for privacy in nursing homes emerged as the second most important consideration.
When considering quality of life rendered by aged care services, respondents differed in their expectations. Compared to the young who prioritised privacy, those aged 45-59 years old cited mentally engaging activities and counselling for both the aged and their caregivers as crucial. Seniors aged 60-75 years old desired most for healthy food and therapy sessions.
“To future-proof upcoming nursing homes, aged care facility providers can take heed of the varying preferences shown by the different age groups. Younger Singaporeans used to having their own rooms are likely to reject the restrictions that come with six to eight-bedded wards,” said Mr Lim of Lien Foundation.
“We have to honestly question what is being built right now and if these facilities meet the aspirations of tomorrow? Are our aged care solutions future-centric and sustainable? This is the time to be open to innovative options and to explore different possibilities so that Singaporeans’ aspirations in their old age can be realised,” he added.
The future of aged care facilities
Against this backdrop, the study also surveyed respondents on the concept of assisted-living facilities, which are defined as a housing alternative for seniors who do not require intensive medical and nursing care as provided in nursing homes.
Amongst those surveyed, close to half (47%) were willing to stay in assisted-living facilities, with those below 60 years indicating a preference for a shared room with their spouses while seniors preferred to share a room with a roommate. Those aged 30-44 years old were willing to pay the highest for assisted-living facilities at $1,745, with the seniors being the least willing.
Respondents also expected assisted-living facilities to provide preventive screening and health checks, personalised choices for food and activities, open spaces and gardens as well as mentally-engaging activities for the elderly.
Financing Silver Aspirations
When it came to financing their silver aspirations, two in three of those below 60 years old were found to be actively saving for their retirement, with savings and investments being the most common options.
Among seniors aged 60 and75 years old, the top three financing options were savings (57%), salary (45%) and relying on financial support from their children (40%).
While four in five below 60 years of age were financially prepared or are in the process of preparing to deal with future healthcare expenses, the same cannot be said amongst the seniors, with nearly one in three relying on government subsidies or relying on support from their children and/or spouse.
When considering aged care, majority of the respondents were not aware of how much it would cost and were many not confident of being able to afford aged care services. Amongst the respondents, those aged 30-44 years old were the most aware of the cost required (32% of them) and confident of financing aged care services (28% of them). The seniors were the least aware.
Though dependent on government schemes like CPF, MediSave and ElderShield, almost half of those below 60 years old would still like to be able to purchase insurance for long-term care to finance their future aged care expenses. Amongst respondents aged 30-59 years old, nearly one in two rated long-term care insurance to be among the top three instruments that they would prefer to finance aged care services with.
Respondents also indicated a fixed monthly pay-out and coverage for chronic elderly conditions such as diabetes as top expectations from a long-term care insurance plan. Other expectations included premium discounts and other incentives, free health screenings and coverage for dental care and lifestyle aids (e.g. mobility aids). They also indicated a willingness to pay around S$180 monthly to finance a long-term care insurance plan.
Mr Ng, Chief Executive of Income, said, “We are keen to deliver a suite of offerings to meet the diverse needs of the ageing process. Currently, we offer Silver Care to protect seniors against personal accidents and Silver Protect to protect against cancer. Today, I am happy to announce Silver Secure as the new addition to our suite of silver products to provide protection against old age related ailments. Silver Secure is an insurance plan that provides benefits pay-out upon diagnosis of senior diseases such as Parkinson’s disease, dementia or Alzheimer’s disease, blindness, major head trauma and paralysis amongst others.”
“Coming down with these conditions significantly increases the level of care required. As such, we are glad to be able to take into consideration the key research findings on respondents’ top concerns about ageing in Singapore, including their preference for benefit pay-out options and cost, when designing Silver Secure.”
Silver Secure will be available from 28 October 2016.
The Lien Foundation would like to invite the public to give their feedback on their experiences with nursing homes and/or the improvements they wish to see there, as well as their aspirations for residential aged care by emailing firstname.lastname@example.org.