A guidebook compiling the various initiatives and experiences of 16 towns in Singapore has been launched, in hopes of encouraging other towns to get onboard and care for their elderly residents. According to a newspaper article, the guidebook will be distributed to all constituencies by December.
In Singapore, hospices tend to have a negative image due to the society’s certain beliefs and avoidance on the topic of death. Despite hospices’ skillful and compassionate efforts to care for end-of-life patients, its services are not regarded as integral in Singapore’s healthcare system, and are commonly shunned by families as an option to care for their loved ones.
In collaboration with the Lien Foundation and Ang Chin Moh Foundation, healthcare specialist design consultancy, Fuelfor, embarked on a nine-month long research project with Assisi Hospice, Dover Park Hospice and St Joseph’s Home and Hospice to find out how the hospice experience can be delivered differently.
Ageless Voice chats with Laszlo Herczeg from the Fuelfor team, on his findings:
Can you share how you embarked on this project?
I was representing Fuelfor to give a public talk about design thinking in the area of radiation therapy, when the CEO of Lien Foundation, Lee Poh Wah, approached me afterwards. He was intrigued by how our team carefully considers the experiences of the healthcare staff, doctor, patient and family when designing an overall better healthcare service. He felt that the growing demands of an ageing population in Singapore makes it necessary to relook at the issues within the current hospice care model and evolve fresh perspectives for future hospices.
As a healthcare design company, it is also interesting for us to delve into the topic of end-of-life. This is because we are always striving and designing for improved life and living, but we have never actually looked at the topic of death and dying. Now coming to think of it, death and dying is always in the backdrop of what we do.
What perceptions does Singaporeans and healthcare staff have towards hospice care and end-of-life matters?
The topic of death and dying is taboo in Singapore society. Singaporeans shun discussing about death, looking at funerals, visiting the hospice, or anything linked to death and dying.
Being a multi-faith country, Singapore has different religions that practise their own rituals and hold certain beliefs about death. For the Chinese in the 1960s, ‘death houses’ were known as a place where the dying sought comfort care. Today, the older generations harbour resistance towards death houses and view today’s hospice as their equivalent. Hence, the superstition that hospices and funerals bring ‘bad luck’ and are things not to be associated with, have been passed onto the younger generation today. Such superstitions foster further ignorance towards the issues of end-of-life and the role of hospices in society. Even healthcare professionals can be affected by the depressing perception around hospice because it influences how they may consider working there.
Singapore is also a ‘vocally conservative’ society where people do not easily open up about their personal or sensitive problems. So there is stigma placed upon people who receive any form of therapy, because accepting help means they are somehow a ‘failure’ in society. Receiving therapy has been regarded as something to be ashamed of.
Associate Prof Albert Teo, director of the National University of Singapore’s (NUS) Chua Thian Poh Leadership Programme, spoke at the recent Temasek Polytechnic’s School of Humanities & Social Sciences, Diploma in Gerontological Management Studies (GEM) (the only diploma in Singapore specialising in the business of ageing) forum about impactful community development with seniors and six guiding principles he has learnt from doing this work:
1) Before doing interventions, you need to talk to the community to find out the challenges.
2) Find out the dreams and aspirations of the community – “We cannot impose our own aspirations onto a community as it doesn’t work. We always think we know what is best but that is the wrong approach,” said A/Prof Teo.
There are many areas of merit as well as many sources of angst with regard to our current CPF model (in Singapore). Both perspectives have been articulated vividly and passionately recently (including at the Institute of Policy Studies’ forum on CPF and retirement adequacy), with many suggestions being put forward for consideration. As a stakeholder myself, I thought I should contribute to this process by proffering some ideas as well.
To me, the main gripe over our CPF regime revolves centrally around the general lack of autonomy over our own CPF monies due to the imposition of arbitrary limits or barriers. Currently, we possess most control only at the age of 55 (when we can withdraw the bulk of our CPF, less the Minimum Sum of S$155,000 as of today) and at 65 (where we can begin to draw down the Minimum Sum).
With our increased life expectancy and cost of retirement, cold math suggests there will be perennial pressure to revise these milestone figures upward. As many have rightfully asked, “but to what end?” Will we one day only be able to withdraw our CPF monies and Minimum Sum at the ages of 70 and 80 respectively? Will the Minimum Sum be S$300,000 then? Will I actually be able to get anything?
I read “Today” newspaper recently and saw a reader comment about using the term “mature citizens” instead of the more common “elderly”. He shared, “… we should change our perceptions to elevate their position. They should not be viewed as weak, in constant need of assistance and handouts, and treated with pity.”
I couldn’t agree more that we need to change our perceptions but I wonder does using a term really matter that much in doing so. There is also the term “senior citizens” and “older persons”. Sometime back, someone shared with me yet another term “good lifers”, where yes, it sounds positive but you can’t quite distinguish between whether you are referring to seniors (sorry) or to those below 50. Is that what we want? Or, maybe we shouldn’t use a term at all.