1) How can we help the elderly, especially home-alone elders, fight loneliness and age with dignity?
Being alone is not necessarily a bad thing. Not all ‘home alone’ elders need our help and attention.
We come across a lot of elders who live alone but are resilient and capable of independent living. Some might need physical help such as house-cleaning, medication monitoring and/or an escort to accompany them for their medical appointments. These can be arranged with the relevant social agencies that provide these services, and be incorporated into the lives of these elders, thus enabling them to age successfully in the community. There is no need to intervene or to move older persons into group housing just because they live alone.
Some elders could be experiencing loneliness, social isolation of different degrees and even depression – but these syndromes aren’t exclusive to older people, nor to one type of living arrangement. Elders living with their families aren’t necessarily less lonely and isolated.
However, we do know that loneliness negatively impacts physical and mental wellbeing. To help elders in that situation, we find that we need to build a closer relationship with them so as to better understand the reasons and causes for their experience, before effective counselling and related action plans can be made. From past experience, some of the more common reasons are:
– lack of a sense of life purpose or meaning as old age sets in
– loss of loved ones/friends
– so-called ‘unfinished business’: (aspirations and issues that have yet to be achieved, resolved or accepted)
To fight loneliness, we encourage elders to participate in social activities, such as those conducted by senior activity centres and other social service organisations. Sometimes, we see this leading to improvement in their social engagement, and some elders would even start to lead group activities or volunteer in the service agency. What is important is that the activities should meet the interest and aspirations of the elders themselves, and there is no one solution for all.
Helping elders fight loneliness and age with dignity has a lot to do with understanding their aspirations and yearnings in life. It involves helping them build on their strengths and empowering them to deal with goals, issues, and expectations to reclaim meaning in their life. We have to dispel the misperception that being old means there is no need or scope to actualise one’s yearnings in life.
2) How can we strengthen family bonds in Singapore and inculcate the value of looking after our elderly?
To build strong family bonds, we need to encourage family members to recognise and appreciate one another’s contributions and individualities, and to manage their own expectations and judgement.
In a typical strained relationship, we observe a general lack of appreciation from and for one or some family members. This can sometimes lead to harsher judgements made of one another, to misunderstanding and even abuse.
For example, if someone in the relationship thinks that another family member is too young, or too old, to make his or her own decision, then there is stereotyping here which prevents sharing and appreciation among the family – this affects future communications and understanding as well.
This issue of strong family bonds and appreciation for one another has a great impact on caring for the elderly in the family. If the caregiving child has never appreciated his/her ageing parent and has never shared a strong family bond with him/her, the caregiving can be more challenging than it already is.
Likewise, elders who are always picking on their caregiver and complaining about what has been done for them are in reality adding more stress on their fatigued caregiver. It is best not to have a one-directional perspective on any family relationship as it’s always a dynamic interaction between individuals.
3) What efforts can the government take to help seniors live more fulfilling lives?
A lot of intervention is focused on medical care and social assistance. Perhaps more can be done for psycho-emotional health, for example, by means of introducing gerontological counselling and coaching for elders that focus on realising and appreciating their potential, achievements and personhood. These can be conducted on a group or individual basis.
4) Would you consider it more important to empower the elderly than to help them with everything? How can we empower them to have a sense of control over their lives?
It is usually more sustainable and fulfilling to teach a man how to fish instead of handing him a fish. We believe that elders love their sense of empowerment and independence as well. Empowering the elderly is about helping them to discover their own potential and using their potential to achieve what they identify as their needs.
Most of the time, the tendency to take over and make decisions for elders is a quicker solution, as opposed to the lengthy process of empowering them to do something on their own. Take the example of a caregiver who simply goes ahead to manage his aged parents’ money, without explaining how much has been spent and on what items, what is the balance currently, where the parents can get emergency funds, or how to pay attention to potential scams and cheats.
It would have been more empowering for the parents, if the caregiver had spent more time engaging and explaining to them about managing their own money. Instead, his quick solution might have mystified the whole financial situation, leaving his parents with a sense of loss, helplessness, and total dependence on the caregiver. This can have great impact on their sense of self-worth, loss of aspiration, uncertainty, and depression.
Time spent on engaging and guiding elders on important day-to-day matters is vital in recognising and appreciating them. It reiterates the family’s love and belief in the elders’ ability and potential too. We often become guardians and caregivers for our elders without realising that they have more than 50 years of life experience that we can tap on as well.
Established in 1993, the Tsao Foundation is a not-for-profit organisation dedicated to transforming the ageing experience.
The foundation pioneers and provides community-based, primary healthcare and social services for mature adults, builds capacity in self- and eldercare, and forges multi-sector partnerships to generate ideas and systems that enable the actualisation of the physical, social and mental well-being of people as they age.
The three core programmes of the Tsao Foundation include:
i) The Hua Mei Centre for Successful Ageing enables ageing-in-place by pioneering community-based, integrated health and psycho-social eldercare service models grounded in person-centred principles. We currently have eight services providing comprehensive and integrated bio-psycho-social healthcare across the life course for mature adults.
ii) The Hua Mei Training Academy is dedicated to capacity building in self and family care, community action as well as professional development in successful ageing and community aged care through practitioner-driven training, education and consultancy services.
iii) The International Longevity Centre-Singapore supports policy, practice and community development through initiating high impact research and collaborative platforms for key stakeholders.