Lonely seniors in Singapore: Who cares for them when they're all alone?

SINGAPORE — As Singapore's population ages, the number of seniors living alone is a growing concern, presenting significant challenges to their well-being and mental health.

The Department of Statistics has projected a worrisome trend, estimating that the number of elderly persons living alone will increase from 47,000 seniors aged 65 and above in 2016 to 83,000 by 2030.

Navigating loneliness and rejection

This troubling reality is exemplified in the case of AB (not his real name), a 73-year-old divorcee who was living alone in a two-room Flexi unit.

Without the presence of his ex-wife and son, he experienced a profound sense of loneliness and feelings of rejection, leading to challenges in managing his well-being and mental health.

Despite regular visits to his ex-wife's workplace, his attempts at reconnecting with her were met with a restraining order.

Concerns about his non-compliance with medications, missed doctors' appointments and suboptimal living conditions led Thye Hua Kwan Moral Charities (THKMC) to refer him for home care services upon discharge from hospital.

A Singapore-based charitable organisation since 2011, THKMC is dedicated to providing social and community services to those in need, including seniors, children, and families.

It has 18 active ageing centres spread across the island, and these centres serve as essential day facilities for needy and vulnerable seniors.

A wide range of activities are offered, aimed at keeping the seniors active and socially engaged. The centres also extend support services to frail and homebound elderly individuals.

These include befriending services, emergency alert response calls, and information and referrals for eldercare-related concerns.

For AB, the support provided by THKMC staff during their visits brought moments of gratitude and happiness. However, during the challenging times of the COVID-19 pandemic when visits were being reduced, his mental health began to deteriorate rapidly.

His condition worsened, ultimately leading to his hospitalisation at the Institute of Mental Health (IMH), where he died.

Challenges in balancing independence and family support for seniors

Norsila Hamid, assistant nurse manager (clinical) at THKMC, has witnessed many cases like AB's.

"Living alone can lead to feelings of loneliness, social isolation, and depression, which can adversely impact the mental health (of seniors)," she told Yahoo Southeast Asia.

While some seniors prefer the privacy and independence of living alone, Norsila said it can be challenging for those with physical or cognitive impairments to manage daily tasks like personal hygiene, meal preparation, housekeeping and transportation.

Family support can be crucial in such cases, as they provide companionship, a sense of belonging, and assistance with daily activities and medical follow-ups.

However, maintaining this balance can sometimes lead to tensions and strained relationships between seniors and their families, said Norsila.

Various organisations and government initiatives have stepped in to address these challenges and promote seniors' well-being.

For instance, Active Ageing Centres provide opportunities for seniors to engage in social activities, foster connections among peers, and access support services and healthcare facilities. Meanwhile, Seniors' Community Services offer essential home care services, including medical and nursing care, personal care, meals on wheels, and transportation for medical appointments.

Lions Befrienders' AI-driven mental health intervention

A social service agency that has made a significant impact is Lions Befrienders (LB). Since its establishment in 1995, it has supported over 86,000 seniors.

It runs 10 Active Ageing Centres in various HDB residential estates, providing active ageing programs, befriending, and referral to care services for seniors regardless of their income and housing type.

Since 2020, LB has been using artificial intelligence (AI) through a software program developed by Opsis Emotion AI to enhance the quality of intervention for seniors' mental health concerns.

The technology measures facial expressions in real-time during video calls, allowing counsellors to accurately diagnose conditions such as anxiety, stress and depression in senior citizens.

This enables them to organise personalised care planning for seniors and refer severe cases to medical centres for further consultation.

Meeting the growing complexity of senior mental health

Karen Wee, executive director of LB Service Association, emphasised the growing complexity of cases encountered by the organisation.

"Nowadays, 70 to 80 per cent of cases are complicated, meaning it's not just one showcase of depression; there will be a lot of issues as well," she explained.

To address this, they have "Wellness Befrienders" who receive specialised training from the IMH to identify and handle mental health issues among seniors effectively.

"These volunteers undergo training by IMH, where psychiatrists teach them do's and don'ts, how to identify issues, what to look for in conversations, and other essential skills," she said.

"The training includes case studies and group work, spanning about three sessions, typically lasting one to two or three days."

As Singapore continues to address the challenges of an ageing population, eldercare providers stress that the well-being of seniors is a collective responsibility.

They believe in fostering a society where seniors are valued, included and cared for, so that they can create a future where ageing is not a burden but a journey filled with dignity, joy and purpose.

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