4 days ago
Home alone, but loneliness doesn't have to be a constant companion for Singapore's seniors
Lions Befrienders executive director Karen Wee said Singapore has made significant strides in building senior-friendly infrastructure, but noted that there are limits to how much more can be built.
She said there needs to be more of a "human element" – not in the form of more case workers, but rather for the community to come forward.
"If every three people check in on one senior, and each person spends 10 minutes, that is sufficient. You're looking at about 30 minutes a day for that senior, and that is enough," said Ms Wee.
On the ground, social workers from 4S Active Ageing Centre @ Eunos Crescent agreed that strong neighbourly camaraderie should also be encouraged so that seniors can help one another.
They added that seniors have diverse needs, so engagement has to be "flexible and person-centred" as some seniors may not be comfortable in a large group, or unable to participate in robust activities.
Assoc Prof Chan suggested Singapore could take a leaf out of Japan's Hyogo Prefecture's book on how community-driven efforts can make a tangible difference to seniors' lives.
In Hyogo, rural communities such as Sasayama City have implemented a grassroots "Happy Yellow Flag" initiative to check in on seniors living alone.
Launched in January 2019, the scheme invites participating households to display a small yellow flag each morning to signal that they are safe, and take it down at night. If a flag isn't seen, neighbours or volunteer welfare officers will follow up.
Prompted by a case of kodokushi (a lonely death) in the area, the initiative has strengthened community vigilance and fostered a sense of shared responsibility. Residents say it brings peace of mind, especially for elderly individuals living alone.
Dr Ad added that while the expansion of active ageing centres is a positive step, addressing loneliness remains difficult, as building meaningful connections takes time and is highly personal.
"Active ageing centres are premised upon being very activity-centric," he said. "The cure to loneliness is not giving people things to do. That is the cure to boredom."
He suggested that a way to tackle loneliness is by leveraging "weak ties", such as neighbours, shopkeepers and others in the neighbourhood, as these ties can help a person feel a sense of belonging and connection.
We need to normalise ageing as a basic facet of life, rather than medicalise it, said Dr Ad.
"The less we treat older people as fragile populations, the more confident seniors would feel about co-existing in the community."
WHY SOME SENIORS END UP SOCIALLY ISOLATED
Not all seniors who live alone are isolated, but for those who are, the roots often run deeper than their current living arrangements and can have significant consequences.
Studies have shown that living alone can cause psychological distress and lead to feelings of loneliness, which then contributes to the risk of mortality and depression – hence the general stereotype of living alone being sad and lonely.
But as the seniors and experts pointed out, living alone is not a definite indicator of loneliness. In fact, studies show that older adults living with their families can feel lonely too, said Assoc Prof Ghoh.
One factor that contributes to isolation is when frailty sets in, she said. It becomes difficult to perform activities of daily living, and this can limit the ability to live life as fully as before.
Assoc Prof Ghoh added that some older adults suffer from chronic illnesses in their younger years and, as they age, the deterioration of these medical conditions can lead to limitations in living well and managing life independently.
Another concern for seniors is fall risk, which increases exponentially when the senior becomes frail and has difficulty moving around freely, experts noted.
Fall risk increases when the home environment is not safe, for example, slippery floors, no grab bars and wires, carpets and objects on the floor that hinder safe mobility.
"Some seniors become homebound as they fear that they may fall if they move too much. This in turn may lead to social isolation and loneliness," said Assoc Prof Ghoh.
Assoc Prof Chan said that compared to their American counterparts, Singaporean seniors tend to stay at home after a fall, which can lead to depression, and then to lower muscle mass, with deterioration potentially occurring quite rapidly.
As such, she suggested that community health programmes, active ageing centres and community centres conduct more fall screenings and provide more education on this front.
Although there has been a proliferation of services for seniors, a gap remains in the area of screening for depression and suicide risk in older adults, said Assoc Prof Ko.
Even if the government increases its range of senior services, Asst Prof Ang said more fundamental changes are necessary if Singapore wants to tackle the risks of social isolation in old age.
"There is no quick fix, because people do not suddenly become older adults overnight. They are a culmination of decades of life experiences and circumstances," he said.
This means that people have to be able to make the best decisions for themselves at every stage of life, so that they are able to reap the benefits and enjoy a good life in their silver years, he added.
