Silver tsunami: Homes meeting elderly needs

EdgeProp Singapore |

June 26, 2018 9:00 AM SGT

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The grounds of Kampung Admiralty are buzzing with activity — children are running about, while grandparents and helpers look on, seated on concrete benches. The community plaza is cool even on a hot day. Ventilation comes from a large eight-blade ceiling fan and an air well, which also lets light in. Surrounded by eateries, the plaza is a gathering place for people.

This sets the tone for Singapore’s first public retirement village, where childcare and senior centres are co-located. Kampung Admiralty is the first of 10 such HDB housing precincts that the government intends to roll out over the next decade. It is part of a $3 billion plan unveiled in 2015 to prepare the nation for the rise in an ageing population, covering more than 70 initiatives, including housing, employment, health and wellness.

Phua Kai Hong, health policy professor at the Lee Kuan Yew (LKY) School of Public Policy, believes that a crucial problem faced by an ageing population is the lack of social support. “When families get smaller and adult children live farther away from their parents, it’s harder for them to take care of their elderly folks,” he says. This is why designing facilities that will promote social integration is vital in a retirement village, he points out. “Facilities such as void decks and support services such as medical clinics, childcare and eldercare would promote interaction between those of different generations,” he says.

The government’s effort to create common spaces in Kampung Admiralty has worked. In the activities hub on the sixth floor, for instance, a small crowd of elderly people utilise the space to play board games, while some pack their own food to eat with friends. The childcare centre is also located on the sixth floor, alongside the rehabilitation and elderly activities hub.

Yishun Health Campus runs a two-level medical centre and pharmacy in Kampung Admiralty (Credit: Albert Chua/The Edge Singapore)

Ageing in place

“As you age, you have to modify the home environment so that it’s conducive for ageing,” says Phua. “In the past, HDB’s priority was to build homes as fast as possible and at the lowest cost, to make them affordable,” he says. The government has now realised the importance of adopting elderly-friendly features in public housing.

A whole range of facilities that cater to retirees has been introduced at Kampung Admiralty, including a two-level medical centre and a pharmacy, both run by Yishun Health Campus under the National Healthcare Group; a rehabilitation, activities hub and a day-care centre, all targeted at the elderly and managed by NTUC Health; as well as a 900-seat NTUC Foodfare hawker centre, where half of the dishes conform to health standards set by the Health Promotion Board.

Residents began moving into their flats in Kampung Admiralty last October. All the units were snapped up in HDB’s July 2014 build-toorder exercise. Of these, 60% were purchased by existing residents in Woodlands and neighbouring towns, HDB said.

The NTUC Foodfare hawker centre at Kampung Admiralty can sit up to 900 people, and half of the dishes conform to health standards set by the Health Promotion Board (Credit: Albert Chua/The Edge Singapore)

At Kampung Admiralty, there are 104 flats housed in two residential blocks of 11 storeys each. The units are a mix of studio apartments and two-bedroom flexi flats that range from 36 sq m (387 sq ft) to 45 sq m (484 sq ft). The apartments run on a 30-year lease. Design features include support bars in washrooms and along the walls leading to the units’ front doors; induction cookers in place of gas stoves; and retractable clothes drying racks, a move from the practice of slotting laundry poles in pipe sockets outside older HDB flats.

With an ageing population, healthcare costs will balloon, rising faster than that in less labour-reliant industries. Elderly healthcare expenditure in Singapore is projected to increase 10-fold over the next 15 years, hitting more than $66 billion annually, according to a 2016 report by the Asia Pacific Risk Centre. Phua reckons that by allowing seniors to age actively in a community, this would minimise the period of intensive and high-cost medical care. “It makes economic sense to shorten that period,” he says. “Only at the tail end of their lives, when they have acute illnesses, will they need to be based in homes.”

Kampung Admiralty is the first out of 10 HDB housing precincts that the Singapore government will roll out in over a decade, co-locating childcare and senior centres (Credit: Albert Chua/The Edge Singapore)

Nursing homes or integrated communities?

UOB Bank economist Francis Tan warned in a Dec 6 report last year that the city state is facing a “demographic time bomb”. This year will mark the first time in Singapore’s history that the number of citizens below 15 years matches the number of people exceeding 65 years, with each group comprising 14% of the population, he said. By 2030, Singapore’s demographics will mirror Japan’s in 2016, when 26.6% of the population exceeded the age of 65.

Currently, there are more than 60 nursing homes in Singapore; as at 2016, 32 of them were privately run. Bernie Poh, CEO of Allium Healthcare, believes that there is still room for more privately run nursing homes that cater to the high-end market. Allium Healthcare — a wholly-owned subsidiary of investment holding company GK Goh Holdings — is targeting to open its first nursing home on Venus Drive, off Upper Thomson Road, in 2019. The project, slated for completion in December, will have 129 beds across four storeys.

The upcoming nursing home on Venus Drive is designed to emulate that of private residences. Seniors have a choice of single or double en suite rooms, and the flexibility to plan their daily schedule. With an emphasis on privacy, groups of 10 to 12 residents will share living, dining and kitchen areas, replacing the large communal dining halls common in most nursing homes, says Poh.

The community garden on the eighth floor of Kampung Admiralty features elderly-friendly features like a wheelchair ramp for the disabled (Credit: Albert Chua/The Edge Singapore)

Creating strong communities for the elderly is a priority for both the private sector and the government. For Allium Healthcare, the company is looking at a model where the nursing home could act as a medical and community resource centre for its neighbours. Residents could, for instance, share pool facilities with with non-residents from the neighbourhood. The government has also introduced Senior Activity Centres since the 1990s, targeting elderly folks living in HDB flats. It has since planned for 58 SACs in various HDB estates to serve 48,000 elderly folks by 2020.

There is undeniably more room for the aged care industry to grow. In an ageing population, situations change as a spouse may pass on, and living needs will change as health deteriorates. “The whole concept centres around different strokes for different folks,” Phua says. “In the end, it is about figuring out the best way to live out the remaining years of our lives.”

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