Mr Alex Chong has picked up a new skill — and he loves it. At 68, Mr Chong has learnt to make lattes, long whites, americanos, cappuccinos — and serving them — in true barista style at Goodlife Makan. More than brewing and serving coffee, Mr Chong goes to the community kitchen run by social service agency, Montfort Care, daily to enjoy the camaraderie of other seniors.

Having Goodlife Makan is an important aspect of Montfort Care’s aim for seniors to live healthily and age well at home. While ablebodied seniors are able to walk from nearby Marine Terrace flats to the centre, those who are not able to move on their own are helped to the centre in wheelchairs by Montfort Care assistants for lunch.

“For our seniors to age well, social and health integration is very important. Our healthcare assistants will bring eight to 10 wheelchair-bound seniors for their community lunch Mondays to Fridays. It could be as short as 45 minutes, but the time is very meaningful and impactful for our seniors who are not able to walk down to meet their neighbours and friends by themselves,” said Ms Ong Boon Cheng, Assistant Manager, Goodlife Makan, Montfort Care.

Indeed, an important lesson on social isolation was learnt during the early days of the COVID-19 pandemic, when circuit breaker measures were implemented and many seniors, particularly those who were single, became isolated and lonely at home, said Associate Professor Low Lian Leng, Chairman, Division of Population Health and Integrated Care, Singapore General Hospital (SGH). “The health impact of social isolation is as bad as for someone who is obese, who smokes, and can lead to higher blood pressure (and other long-term issues),” he said, adding that older people who engage socially with both friends and family, and not just family or friends, have a low mortality risk.

While material needs like housing and food of single elderly residents might be met relatively easily, questions hang over their social and mental health needs. How can they continue to age and live well at home without the important support of family and friends? How can they overcome social isolation? How can they avoid hospitalisation and care homes that seem to be synonymous with ageing? How can they be integrated into the wider community and society?

Under Healthier SG, healthcare institutions and social welfare organisations have been stepping up to meet this need in boosting preventive health among residents.

As the Population Health Manager for Singapore’s southeast precincts, SGH works with community partners like Montfort Care, as well as general practitioners (GPs), to support the more than 300,000 residents living in its Healthier SG neighbourhoods like Bukit Merah, Chinatown and Katong. SGH’s Healthy, Empowered and Active Living (HEAL) Fund — made possible by the Low Tuck Kwong Foundation for supporting these efforts — can be used to finance promising early community projects to support needy patients and residents. One involves SGH dietitians conducting in-depth interviews and focus group discussions to understand senior residents’ nutritional needs and knowledge at Goodlife Studio (Bukit Purmei) and Goodlife Studio (Marine Parade), active ageing centres run by Montfort Care. Underscoring the challenges of the project, Ms Joycelyn Er, Principal Dietitian (Clinical), SGH, found different levels of understanding of nutrition and other food-related knowledge among seniors at these centres. “Perhaps, it’s due to the differences in socio-economic status and education level of the seniors between the two centres,” she said. Such findings enable dietitians to better design a series of handson interactive nutrition activities to meet the needs of these seniors. There are also plans to pilot these activities with Montfort Care, which can potentially be extended to other active ageing centres in the southeast region of Singapore.

Montfort Care has transformed five other studios under different themes — carpentry in Bukit Purmei, digital media in Tiong Bahru, community theatre in Telok Blangah, bike kitchen in Yishun, and tea bar in Bedok. “We’ve had to think a little out of the box about what might inspire our younger seniors to visit these active ageing centres in the coming years. What might inspire and motivate them? Bingo or Teresa Teng songs might no longer be a draw,” said Ms Ong.

In addition to the nutrition programme, Montfort Care is working with SGH to evaluate the effectiveness of its Goodlife studios by answering questions like the effectiveness of thematic centres versus conventional ones in meeting the demands of ageing Singapore, the elements that have been successful, and the inclusion of intergenerational programmes. Having students from nearby CHIJ Katong Convent visit Goodlife Makan to interact with and energise the seniors can help replace the negative stereotype of the elderly with the idea that they are valuable assets to society, given their wealth of experience, added Ms Ong.

<<Mdm Lin Yan Qing, 84, (flanked by Montfort’s Ms Ong Boon Cheng and SGH’s Ms Jocelyn Er) is a volunteer cook at Goodlife Makan kitchen.>>

Frailty increases chance of falling and illness

More than half of 403 seniors who were recruited for a SingHealth baseline pilot physical assessment were found to be frail, including 10 per cent who were severely frail.

Physical frailty does not just increase the chances of falling, but also the risk of illness and poor recovery from diseases. Thus, if the assessment that more than half of seniors are frail holds true for the general population, this means that, to age and live well in the community without the need to go to a nursing or care home, changes would have to be made to support them.

“The physical environment is very important, while technology is also increasingly important to support initiatives such as telehealth to allow remote monitoring of residents at home,” said Associate Professor Low Lian Leng, Chairman, Division of Population Health and Integrated Care, SGH.

To find out what the elderly need in their neighbourhoods, another project involved giving disposable cameras to 25 seniors to document places and activities in Marine Parade that they did over the course of a week. The Photovoice Identification project found that outdoor benches were important to the elderly, who might become breathless as they walk to the market, active ageing centres, or bus stops and MRT stations. Benches allowed them to rest and chat with their neighbours, or just to sit and watch people go by. Importantly, residents said the benches encouraged them to go out more often. Going out every day boosts not only their physical health, but social interactions benefit their social and mental health.

In these community projects, SGH partners social agencies, schools and other organisations. For the First On Frailty screening and integrating health and social care, it partnered Thye Hua Kwan Moral Charities, Montfort Care, and Agency for Integrated Care, and with Singapore University of Technology and Design students for Photovoice. These projects were aided by SGH HEAL Fund, which is supported by Low Tuck Kwong Foundation, for advancing academic and population health in SGH and SingHealth, said Assoc Prof Low.

Since its launch in 2021, HEAL has helped finance needy SGH patients, startups with promising health and social impacts, and those awaiting national-level funding. Other projects that HEAL funded include outreaches to over 3,000 elderly residents for vaccination during the early days of the COVID-19 pandemic when community nurses and social workers could not visit homes.

Another was Project Wire Up to promote digital and health literacy among the elderly from June 2020 to August 2022. SGH worked together with telcos and community partners from Infocomm Media Development Authority’s Seniors Go Digital programme to offer smartphones and data plans to needy seniors, who were also taught to use the devices and avoid falling prey to scams. More than 170 seniors benefited from Project Wire Up.

HealthStart was then established to support residents on their health journey through initiatives such as goal setting and social prescribing, where there was an increase in follow-up rates with primary care from 42.7 per cent to 84.5 per cent after a few runs of the programme.

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