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Preparing for the silver tsunami

Four experts share their views on how best to improve eldercare in the face of ageing populations

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Panellists at the 7th Credit Suisse Philanthropists Forum, from left: Dr Kua Ee Heok, professor and senior consultant psychiatrist, Department of Psychological Medicine, National University Hospital; Dr Christopher Lien, senior consultant geriatrician; director, community geriatrics, Changi General Hospital; Laura Lee, senior philanthropy adviser, Credit Suisse; Zulkifli Bin Baharudin, board member, SymAsia Foundation Limited; Paul Robertson, chair, St Vincent’s Health Australia.

COUNTRIES around the world are bracing for a 'silver tsunami' of rapidly ageing populations and an impending spike in demand for long-term eldercare. On hand to discuss the key issues of this dilemma - which include dementia, active ageing, as well as end-of-life care - were four experts on a panel at the Credit Suisse Philanthropists Forum 2017.

Zulkifli Bin Baharudin, who sits on the board of the Ang Mo Kio - Thye Hua Kwan Hospital, spoke of the challenge of getting families to bring their elderly home from the community hospitals where they can age in dignity.

"The length of overstaying in the community hospitals is growing everyday. The patients should be in their homes, which is the best place they can age," said Mr Zulkifli, who is also Singapore's Non Resident Ambassador to the Republic of Uzbekistan and Kazakhstan.

That said, he noted that Singapore's high standards of public housing - which feature lifts that stop at every floor, for instance - has played a big part in helping the elderly to age in place, or the ability to live in one's own home independently.

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"There is no place far more ready to help our elderly age in place. However, there is still a high concentration of people who can't move up from the rental flats that don't have these facilities. This is an area we can focus on to help this group," he said.

Dr Christopher Lien, senior consultant geriatrician; director, community geriatrics, Changi General Hospital, touched on the related issue of discharging elderly patients successfully from hospitals.

"Elderly patients end up staying a long time in hospitals. Discharges tend to be unsuccessful; one in five older patients come back within 30 days," he said.

"If this is an unavoidable consequence of age it will lead to a burden so immense I'm not sure how any society can bear it." To tackle this challenge, Dr Lien proposed that "rehabilitation" and "enablement" needed to be part of the solution.

Meanwhile, Dr Kua Ee Heok, professor and senior consultant psychiatrist, Department of Psychological Medicine, National University Hospital, shared with the audience the details of a wide-ranging study of ageing and dementia in Singapore. Prof Kua leads the Dementia Prevention Programme (DPP), collaboration between NUS and the People's Association.

The DPP is an extension of the NUS-led, 10-year Jurong Ageing Study started in 2013, which showed that activities like music, art, mindfulness therapy and taiji reduced anxiety levels and symptoms of depression. This is relevant because studies have shown that there is a link between depression and the risk of dementia.

A perspective from Down Under was brought to the discussion by Paul Robertson, who is the Chair of St Vincent's Health Australia, the largest non-profit, non-government diversified health care provider in the country.

Mr Robertson said that the role of caregivers to dementia sufferers is significantly underestimated, and that this group of people needs more support to carry out their roles effectively. "The closer you are to someone with dementia the worse the health outcome," he said.

To overcome this problem, short courses are offered to caregivers who can hear from more experienced carers, who can give them an idea of the challenges ahead and how to deal with them. He said: "These programmes are partly funded by the government, but a lot by philanthropy."

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