Consider elderly patients' social needs too, docs urged
Study says a holistic view of care should be adopted
By Priscilla Goy, The Straits Times, 22 May 2013
DOCTORS treating the elderly need to be more aware of their patients' social and psychological needs, a new report has found.
They should take a holistic view - instead of drawing a distinction between medical and social care - said the study commissioned by the Lien Foundation and developed by consultancy firm KPMG.
Released yesterday, the research aims to draw ideas from other countries on how they have addressed their challenges. It is based on interviews with 46 eldercare experts in 14 nations. Four were from Singapore while others came from countries including Japan and the United States.
Dr Gerald Koh, a National University of Singapore associate professor and one of those interviewed for the report, said: "We're very good at building hardware and infrastructure, and that's not a bad thing, but we could do more in the 'heartware' area.
"Traditionally, doctors focus more on cures and treatment. I think we're training them to be more patient-centred, to be aware of the patient's social and psychological needs. But we could move beyond awareness and get them to take these needs into consideration when planning the management of the patient."
Doctors should work more closely with social workers and therapists in an "interdisciplinary team", added Dr Koh, from the university's Saw Swee Hock School of Public Health.
And there should not be "a sharp demarcation between the different roles". For example, in the United States, multidisciplinary teams provide services ranging from medical care to occupational therapy and diet monitoring - all at an adult day health centre.
The report - An Uncertain Age: Reimagining Long-term Care In The 21st Century - recommended providing more training and support to informal caregivers, and introducing more sustainable funding models. For instance, one pool of money could be used to fund institutional care and home-based or community-based services. This would avoid having two separate budgets.
Ageing Asia managing director Janice Chia said health-care facilities had been integrated to some extent, but more could be done to help the elderly age within the community."There have been collaborations between hospitals and nursing homes, but these focus more on medical care...
"We should have more activities in the area of preventive care, such as strength training and mental training, or other communal activities to draw them out from these homes and prevent them from being socially isolated."
And Singaporeans are likely to expect more, said Lien Foundation chief executive Lee Poh Wah. He added: "Is our current system more geared towards serving the poor, versus the middle- and upper-income groups?
"Having visited some nursing homes in Asia, most of our nursing homes today resemble Class C hospital wards that lack the homely feel. That's why few people would welcome the thought of spending old age in such an environment."
Innovative practices overseas
- Rewarding volunteers with "time credits"Non-profit organisations can give people rewards based on how much time they spend helping one another.
In Japan's Hureai Kippu scheme - which was created in the 1990s and is translated literally as "caring relationship tickets" - those who help the elderly earn "time credits".
They can use these credits to claim assistance for themselves when they fall ill, or use them for another person of their choice.
Non-monetary rewards like these could attract more people to volunteer in their communities.
- Giving the elderly a "village" to lean onPioneered by Beacon Hill Village in the United States in 2001, this approach involves recruiting elderly residents and other volunteers who live in an existing community to help one another with basic services such as transportation, household tasks and health care.
Although many of these "villages" rely almost exclusively on volunteer help, some also include paid staff or contracted service providers.
Having one team to offer all-inclusive careDeveloped in 1973, participants in the Programme of All-Inclusive Care for the Elderly in the US attend an adult day health centre, where they receive services that are provided by a multi-disciplinary care team.
These services include speciality medical care, therapy, transportation and help in making minor modifications to their houses to make them handicapped-friendly.
Coordinating services in this way reduces costs by delaying nursing home care for the elderly, as well as shortening hospital stays.
Last year, the US state of Wisconsin piloted a "virtual" version of this scheme, which offers more flexibility over where the care is provided.
Health Ministry on track to meet needs of elderly
By Vimita Mohandas, Channel NewsAsia, 22 May 2013
The Ministry of Health (MOH) has said it is on track to meet the needs of the elderly under its Healthcare 2020 Masterplan.
By Vimita Mohandas, Channel NewsAsia, 22 May 2013
The Ministry of Health (MOH) has said it is on track to meet the needs of the elderly under its Healthcare 2020 Masterplan.
Minister of State for Health Amy Khor gave this update a day after a study was published by the Lien Foundation on areas of concern in Singapore's long-term eldercare system.
Among the issues raised are better integration of medical and social care, and a relook at the current financing model.
Dr Khor said the current healthcare financing model is already undergoing a major review, and the ministry is also working to expand capacity and enhance capabilities.
She stressed that no one will be denied the care they need, adding that steps are being taken to ensure there is an integrated care model for the elderly.
Dr Khor said: "Recently we have integrated the policy as well as the service delivery functions related to the social and healthcare aspects of aged care within the Ministry of Health and the Agency for Integrated Care (AIC).
"Previously some of the social support and care needs of the elderly were taken care of by the Centre of Enabled Living (CEL). This has been transferred under the purview of AIC and that is to integrate care for the elderly -- not just the healthcare (aspects) but (also the) social aspects.
"We have also enhanced the various care options for the elderly in terms of bringing care for the elderly nearer into the community, so we've expanded day rehab services within the community through the development of senior care centres."