The eldercare ecosystem: It takes a village

Above (from left): Mr Vincent Schoon, management committee member of the Eurasian Association, Singapore; Mr S Devendran, CEO of Sree Narayana Mission, Singapore; Ms Jiaming Ju, associate director of SMU Centre of Research for Economics of Ageing (CREA); Madam Rahayu Mohamad, president of Persatuan Pemudi Islam Singapura (PPIS, or the Singapore Muslim Women’s Association); Ms Lim Chiu Loo, manager (family and worker support) at the Chinese Development Assistance Council (CDAC)

By Sim Shuzhen

SMU Office of Research & Tech Transfer – In Singapore, Confucian teachings still resonate with many Chinese families, such that parents place a high priority on providing for their children, and children in turn feel a strong obligation to show filial piety towards their elderly parents.

But the reality of modern life is that family roles, in particular those of the elderly, are constantly evolving alongside societal changes, said Ms Lim Chiu Loo, manager (family and worker support) at the Chinese Development Assistance Council (CDAC). For example, in single-parent families where the parent is also the sole breadwinner, elderly grandparents may have to take on the role of main caregiver to their grandchildren, she explained.

“The financial stresses which arise from changing family circumstances have put pressure on the elderly to assume a significant responsibility in taking care of their families. By doing so, some aspects of their quality of life have been adversely affected,” said Ms Lim, who was speaking on 14 March 2018 at a panel discussion organised by the Singapore Management University’s (SMU) Centre for Research on the Economics of Aging (CREA).

The panel, convened to discuss the challenges faced by the elderly in Singapore’s major ethnic communities, also comprised Madam Rahayu Mohamad, president of Persatuan Pemudi Islam Singapura (PPIS, or the Singapore Muslim Women’s Association); Mr S Devendran, CEO of Sree Narayana Mission, Singapore; and Mr Vincent Schoon, management committee member of the Eurasian Association, Singapore.

“The function of an organisation like CREA is not only to provide academic insight, but also to gather together people like the panellists today, so that we can learn from the community perspective in combination with the academic and policy perspectives,” said Ms Jiaming Ju, associate director of CREA, who moderated the panel. “That’s how we can come up with the most holistic approach to solve any concerns.”

Filial piety—a changing concept

Intergenerational support is also highly valued in Singapore’s Malay-Muslim community, said Madam Rahayu. According to surveys of the community, older Malays prefer to live as part of an integrated family unit, where they can receive financial and emotional support; in return, they are happy to contribute to the family by helping to care for the grandchildren.

At the same time, however, notions of filial piety are always in flux, said Madam Rahayu, noting that PPIS has seen cases of families sending elderly relatives to nursing homes in Malaysia, partly because of the lower cost of residential care there.

Understanding these changes, she added, will be critical for the community to adapt. “This is where we need to figure out what to do with these changing values, where people have a different sense of nuance in terms of how they look at filial piety. For example, what do the statistics indicate? Is the definition of filial piety cast in stone? Is it attached to cultural values or religious beliefs?”

For Sree Narayana’s Mr Devendran, filial piety is a core Asian value that families should strive not to lose. But he also noted that the role that filial piety plays in caregiving arrangements is bound to be affected by Singapore’s low total fertility rate, which has resulted in fewer working-age citizens for every elderly person. This is where community organisations and networks can step up to help elderly people who have fallen through the cracks, Mr Devendran added. “There’s the pithy statement that it takes a village to raise a child. In this scenario, what will it take to look after the elderly?” he asked.

Not just about the money

While the discussion around the elderly is often focused on financial aid and financial security, the panel agreed that the conversation needs to go beyond money, and into the realm of emotional and social needs. “How can the elderly be supported in terms of having a function and purpose, or in terms of redefining their contribution?” asked Madam Rahayu.

For the Eurasian Association, providing the elderly with a sense of hope is an important priority that has become part of the mission statement of the organisation’s Family Support Service. “We can’t give them 100 percent of their needs, but we want to give them sufficient assistance, service and hope. Hope is a magical ingredient that we have to give people at all times,” said Mr Schoon.

“There is nothing so sad as when we visit houses and see what we call an amputated spirit,” he added later in the discussion. 

Efforts to strengthen emotional and social support networks for the elderly can also start with the younger generation, said CDAC’s Ms Lim. “When the elderly can no longer contribute, they worry about the negative impact that this may have on their family members, and this can actually affect their mental health. At CDAC, we hope that by helping the younger generation move up the social ladder, and by fostering family and social ties, older members of the household can be supported in the future as well.”

Plugging in

From financial aid to befrienders schemes and skills upgrading courses, each community has no shortage of services targeted at the elderly. But there is also a need to better integrate such community services into the wider national eldercare ecosystem, said the panel.

“When we talk of the challenges facing the elderly, these really cut across ethnicities,” said Mr Devendran. “Issues like financial security and healthcare are the concerns of anyone who is an elderly person. It doesn’t matter if you are an elderly Malay, Chinese, Eurasian, or Indian.”

For his part, Mr Devendran regularly encourages Indian religious, community and grassroots organisations to work in concert with national programmes, such as the recently announced Community Networks for Seniors and the Senior Cluster Networks, he said.

“If we do it alone, we’re going to be isolated and resources are going to become an issue. But if we are plugged into this ecosystem, we can have interlocking webs of befrienders, who will be able to go out and work in a coherent manner,” said Mr Devendran.  

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