Against the backdrop of falling birth rates in Singapore, citizens’ life expectancies have continued to climb. In 2017, the country even edged out rivals like Japan in terms of life expectancy, with an average of 84.8 years.
An average Singaporean also spends about 74.2 out of 84 of those years living in good health. This confluence of factors has resulted in more Singaporeans working into their greying years in order to be financially self-sufficient and independent.
Statistics from the Ministry of Manpower in 2016 showed that the number of employed residents aged 70 and over surged from 16,000 in 2006 to 43,000. While these positive developments should be applauded, the country is also seeing the rise of a new troubling trend — a growth in the cases of elderly suicide.
Statistics provided by suicide-prevention agency, Samaritans of Singapore (SOS), showed that 129 people aged 60 and above took their own lives in 2017. This is the highest recorded number of suicides among members of this age group since records first began in 1991, and it signals a worrying trend.
To effectively address this, efforts need to be geared towards solving the underlying issues.
Lifting the veil on elderly suicide
Older adults typically have the highest suicide rates, especially in view of the likelihood of contracting physical illnesses, mental disorders and depression as the person ages. Other changes such as the loss of loved ones can be a significant source of stress for seniors too. They are also more likely to commit suicide if he or she possesses only a primary school education and lives either alone or with their spouse.
While staying employed in their greying years may eliminate feelings of isolation by turning them into active contributors in the workplace and society, it is just one part of the solution.
This approach only works if the senior possesses the requisite educational qualifications to be employed.
For this vulnerable group, there is a real danger of depression taking hold.
More attention needs to be paid to shore up preventative efforts in guarding our elderly against falling into a depressive state. To this end, the Singapore government and Volunteer Welfare Organisations (VWOs) have initiated active ageing programmes to offer greater support.
One example is the Seniors Sports Day event jointly organised by the Singapore University of Social Sciences (SUSS), St Luke’s ElderCare and SASCO Senior Citizen’s Home in 2018.
Lack of eldercare support
Besides helping the elderly embrace active ageing, a 2018 report by the Lien Foundation found that the quality of care and outcomes in the eldercare sector must be raised . The foundation also cited the lack of attention being paid to building facilities or providing subsidies for Singapore’s ageing population as a matter of priority.
In a separate report by the foundation, it was found that Singapore’s eldercare workers are the lowest paid compared to the post-tax salaries in four other ageing economies — Japan, Korea, Hong Kong and Australia.
These findings coupled with the high turnover rate in the sector can make it even more challenging for the country to meet its target of growing the long-term care workforce by at least 45% between 2017 and 2020.
High levels of attrition have resulted in what is called a ‘leaky bucket’ syndrome where high turnover rates are leaving an indelible impact on the standard of eldercare.
Besides low pay, many workers also cite the limited job prospects as another key challenge.
Building the eldercare ecosystem
One solution is to implement a Progressive Wage Model (PWM) for the sector. The PWM is a wage ladder which specifies wages according to skill and experience levels which can incentivise workers to upgrade their skills in order to receive higher wages.
Another approach which warrants exploration is increasing investments in improving human capital.
In the 2018 Budget, it was announced that a pilot Community Networks for Seniors Scheme which encourages active ageing and helps lonely seniors make new friends will go national by 2020. The community network will be made up of government bodies, VWOs and volunteers, who will team up to visit seniors, get them involved in community activities and care for them as they age and as any health issues emerge.
Once this community network is implemented, a primary goal should be to enable seniors to maintain their residence – or “age in place” – instead of having to resettle them into a new environment which may create unnecessary anxieties.
Such efforts must also be implemented in step with training family members to offer proper and effective care for their elders at home. For instance, Khoo Teck Puat Hospital has produced a handbook for caregivers on spotting the signs of depression and offering tips on what people can do to help their aged parents.
That said, proper intervention from trained professionals may still be needed in serious cases of depression. Short-term courses in eldercare should also be made available to adult learners to offer proper care for their aged parents at home.
These adult learners can also in turn play a crucial role as a volunteer in providing trained eldercare services as part of the Community Networks for Seniors Scheme.
It is also likely that technology will play a central role in the ecosystem of care for the aged, alongside existing solutions like medical providers and caretakers. University faculties should take the lead in partnering with private technology firms to show how innovative technology like the Internet of Things (IOT) can improve eldercare outcomes. As technologies mature, it is likely that its adoption rates will also soar.
Flexible work arrangements must also be made possible to encourage families to take on a greater responsibility in caring for their aged parents. At present, busy schedules coupled with caring for one’s own children can make adult children less available to care for their elderly parents. By reducing the time elders spend alone and isolated, it is possible to also reduce the risk of depression.
Free from being ‘sandwiched’
Such a multi-pronged approach to improving the service standards within the eldercare sector will go a long way toward resolving many of the existing challenges that Singapore will likely face in the years to come.
With life expectancy likely to increase, more families may find themselves ‘sandwiched’ — having to support both the young and the old. In fact, many middle-income families are already struggling to pay hefty caregiving bills.
As more ways to help strengthen families’ ability to care effectively for their aged parents, along with steps to set up a facility responsible for improving skills in the eldercare sector are put in place, they would bring about much welcomed relief and possibly reduce the scourge of elderly suicide.