Why Singaporean Seniors Are Missing Out on Geriatric Medicine and Care?
By 2030, one in five Singaporeans will be aged 65 or older, placing immense pressure on the country’s healthcare system. However, despite the rising number of elderly individuals, many are missing out on essential geriatric care — care that could drastically improve their quality of life. Geriatric care is designed to address the unique medical, emotional, and social needs of seniors, but many in Singapore remain unaware of its importance and how to access it.
Research indicates that geriatrician-led care enhances outcomes and quality of life for elderly patients:
Comprehensive Geriatric Assessment (CGA):
A systematic review found that CGA interventions improve functional ability and reduce mortality in older adults[1].
An umbrella review concluded that CGA is beneficial in hospital settings, improving multiple health outcomes with high certainty of evidence[2].
Geriatrician-Led Care Models:
A study comparing outcomes of care by geriatricians and non-geriatricians found that geriatrician-led care was associated with shorter hospital stays, lower costs, and similar inpatient mortality and 30-day readmission rates. In fact, this study was done in a Singaporean patient population. [3]
Outpatient Geriatric Evaluation and Management (GEM):
Research on outpatient GEM programs indicates they can improve survival rates and reduce nursing home admissions compared to conventional care.[4]
These studies underscore the positive impact of geriatrician-led interventions on the health and well-being of older adults.
Seniors in Singapore face numerous challenges, from managing chronic diseases like diabetes and hypertension to dealing with frailty, memory loss, and mobility issues. These issues demand specialized medical attention that goes beyond what general healthcare services can offer. Yet, many seniors and their families continue to rely on standard healthcare, unaware that geriatric services could significantly enhance their well-being.
Why Geriatric Care Is Often Overlooked
Despite the increasing demand for geriatric care, a large portion of Singapore’s senior population remains underserved. One of the primary reasons for this is the lack of awareness about what geriatric care actually entails. Families often assume that regular healthcare services are sufficient for seniors, overlooking the need for specialized attention that geriatricians provide. These healthcare professionals are trained to handle the complexities of aging, from managing multiple medications to addressing issues like dementia and frailty, which are common in the elderly.
Accessibility is another reason for the lack in geriatric care. Most geriatricians are found in public hospitals or in nursing home. But not only older persons in nursing homes need geriatricians! Public hospitals have a high load resulting in stringent criteria to be seen by a geriatrician. Unfortunately, not everyone who needs geriatric care will get geriatric care.
Cultural factors also play a role in why seniors miss out on proper geriatric care. In Singapore, there is a strong expectation for families to care for elderly relatives. While this family support is invaluable, it can sometimes prevent seniors from seeking professional medical help, especially for complex health issues that require a multidisciplinary approach. As a result, many seniors end up receiving piecemeal care that doesn’t address their full range of health needs.
Additionally, concerns about cost and accessibility may prevent families from exploring geriatric care options. There is a misconception that specialized geriatric care is prohibitively expensive, leading some to delay seeking the care their elderly loved ones need. However, some private providers, like ours, allow utilization of various government schemes, such as the Community Health Assist Scheme (CHAS) and Medisave CDMP, which can significantly reduce the financial burden of geriatric care.
The Importance of Geriatric Care for Singaporean Seniors
As seniors age, their health needs become more complex. Unlike younger adults, older individuals often deal with multiple chronic conditions simultaneously, such as diabetes, high blood pressure, arthritis, and heart disease. Managing these conditions requires specialized attention, as seniors are more likely to experience complications from treatments or medications. Geriatric care focuses on addressing these unique challenges through a holistic approach that takes into account not only physical health but also cognitive, emotional, and social well-being.
A key component of geriatric care is managing frailty, which refers to the decline in physical and functional abilities that commonly occur with aging. Frail seniors are more prone to falls, injuries, and infections, all of which can lead to hospitalizations or even long-term disability if not managed properly. Additionally, conditions like dementia or Alzheimer's require a comprehensive approach that includes both medical and emotional support to maintain the senior's quality of life.
Geriatricians are trained to handle these complexities. They offer preventive care, rehabilitation, and ongoing support, helping seniors maintain independence for as long as possible. They also work closely with families and caregivers, offering advice and resources to improve caregiving practices.
Current Situation
Despite Singapore's rapidly aging population, many seniors are not receiving the specialized geriatric care they need. As the population ages, healthcare systems must adapt to address the specific challenges that come with it. However, many elderly individuals in Singapore continue to rely on general practitioners or hospitals that are not fully equipped to meet the multifaceted needs of seniors.
For example, a senior with both diabetes and dementia may receive care for each condition separately, but without a geriatrician's integrated approach, the treatment plan may not address how these conditions interact or how medications for one condition might exacerbate the other. In addition, without proper geriatric care, preventive measures like falls prevention and cognitive therapies may be overlooked, leading to avoidable health complications.
“Geriatric care is not just about addressing current illnesses but improving quality of life through preventive care, rehabilitation, and support services.”
The Impact of Neglecting Geriatric Medicine
When seniors miss out on specialized geriatric care, the consequences can be severe. Without proper management of chronic conditions, seniors may experience frequent hospitalizations, leading to a diminished quality of life and increased healthcare costs. Neglecting geriatric medicine often results in untreated or poorly managed conditions that worsen over time, leading to premature deterioration in both physical and mental health.
For instance, untreated frailty can lead to falls that result in fractures or immobility, further weakening a senior’s ability to live independently. Similarly, undiagnosed cognitive issues can progress more rapidly without the right interventions, robbing seniors of their autonomy. Beyond the individual impact, neglecting geriatric care can place a heavy burden on family caregivers and the healthcare system, as more resources are required for emergency treatments or long-term care.
Ultimately, geriatric care is essential to maintaining the health, dignity, and independence of Singapore’s aging population, while also helping to prevent hospitalizations and improve overall quality of life.
Why Are Singaporean Seniors Missing Out on Geriatric Care?
A major reason why many Singaporean seniors are missing out on geriatric care is simply a lack of awareness. Many seniors and their families are not fully informed about the specialized services available for the elderly. They may not realize that geriatric clinics and services exist, offering comprehensive care tailored specifically to seniors. This includes services like falls prevention programs, memory clinics, and home-based care services, which can significantly improve the quality of life for seniors with chronic conditions or mobility issues.
For instance, a family may continue bringing an elderly relative to a general practitioner for routine checkups without realizing that a geriatrician could provide more specialized and targeted care. Without awareness, families miss opportunities to access services that could help their elderly loved ones remain healthier and more independent for longer.
“Many families may not know that specialized clinics for seniors exist or that they can access home-based services tailored to elderly care.”
Cultural and Social Factors
In Singapore, cultural norms and expectations play a significant role in how seniors access healthcare. Many families believe that it is their duty to care for elderly family members at home, which often leads to informal caregiving rather than seeking professional help. In many cases, seniors themselves may feel reluctant to ask for external help, believing it is the family's responsibility to look after them.
This cultural mindset, while rooted in respect and family solidarity, can prevent seniors from receiving the specialized care they need. Family members may lack the knowledge or resources to handle complex medical conditions or provide the necessary rehabilitation, leading to untreated or poorly managed health issues. While family support is critical, professional geriatric care can complement this by addressing medical issues that family caregivers are not equipped to handle.
Accessibility and Cost Concerns
Accessibility and perceived cost concerns are also significant barriers preventing Singaporean seniors from accessing geriatric care. Many families may believe that geriatric care is expensive and beyond their financial reach. This perception often stems from a lack of understanding of the subsidies and financial support schemes available, such as the Community Health Assist Scheme (CHAS) and Medisave, which can help reduce the financial burden.
Additionally, some seniors may not live near specialized clinics or hospitals offering geriatric services, making access difficult. Public transportation may not be convenient for seniors with mobility issues, and families may not always have the means to transport them to appointments. These accessibility challenges, combined with the fear of high costs, discourage many from seeking geriatric care even when it is needed.
Misconception About Geriatric Care
Another significant issue is the misconception that general healthcare services are sufficient for seniors. Many people believe that a visit to a general practitioner or specialist for a specific condition is enough to address the health needs of an elderly person. However, geriatric medicine goes beyond treating individual conditions—it focuses on the overall well-being of seniors by considering their unique vulnerabilities, such as frailty, cognitive decline, and the interaction of multiple medications.
General practitioners may not have the specialized training needed to provide comprehensive geriatric care, which often requires a holistic approach that includes managing mental health, mobility issues, and social needs. Seniors treated by general healthcare providers may receive fragmented care, where conditions are treated in isolation without considering how they affect the individual as a whole. Geriatricians, on the other hand, are trained to look at the bigger picture, ensuring that all aspects of a senior's health are managed in an integrated way.
By addressing these misconceptions, raising awareness, and making geriatric care more accessible, Singaporean seniors can greatly benefit from specialized medical attention that helps them live healthier and more fulfilling lives.
Common Myths About Geriatric Medicine — Debunked!
Myth 1: “It’s Only for Very Old People”
A common misconception is that geriatric care is only meant for the "very old" or frail individuals over 80 years of age. However, geriatric care is not just for seniors in advanced age but is appropriate for anyone over the age of 60 who may be dealing with complex or chronic medical conditions. This specialized care addresses the unique challenges that come with aging, such as managing multiple health conditions, cognitive decline, frailty, and mobility issues, which can begin to affect people even in their early 60s.
Geriatric care goes beyond treating illness—it focuses on maintaining a senior's overall quality of life and independence. Early intervention with geriatric care helps prevent more severe issues down the line, such as hospitalization or significant loss of mobility. Therefore, seniors in their 60s with health conditions like diabetes, high blood pressure, osteoporosis, or early-stage dementia can benefit immensely from specialized assessments and care plans designed specifically for older adults.
In fact, the earlier you or your loved one seek geriatric care, the better equipped you’ll be to maintain good health, manage chronic conditions, and age gracefully. Early engagement with geriatric professionals can delay or prevent the development of serious age-related complications.
Myth 2: “Geriatric Care Is Too Expensive”
Another widespread myth is that geriatric care is too expensive, deterring many seniors and their families from seeking professional help. While healthcare costs can be a concern, in Singapore, there are several government subsidies and healthcare schemes that make geriatric care more affordable and accessible than people may think.
For example, schemes like the Community Health Assist Scheme (CHAS) provide financial support for lower- and middle-income seniors, allowing them to receive subsidized treatment at participating GPs and specialist clinics. Additionally, seniors can use Medisave for a range of outpatient treatments, including geriatric services, and MediShield Life covers basic hospitalization needs, reducing the financial burden on families.
Furthermore, specific packages like the Pioneer Generation Package and Merdeka Generation Package offer additional subsidies for older Singaporeans, ensuring that their healthcare costs are manageable. Seniors who require long-term care or are severely disabled can also benefit from CareShield Life, which provides financial support for those in need of assistance with daily activities.
With these subsidies and schemes in place, seniors and their families can access quality geriatric care without overwhelming financial strain. It's crucial to understand and take advantage of these available resources to ensure that seniors get the care they deserve.
Myth 3: “We Can Manage Care at Home”
Many families believe that they can handle the care of their aging loved ones at home without needing professional geriatric services. While it’s admirable that families want to take on caregiving roles, managing care for seniors, especially those with complex medical needs, can be challenging and exhausting. Caregivers may quickly become overwhelmed when dealing with the demands of chronic illness management, mobility issues, and cognitive decline. This can lead to burnout and even unintended neglect of important healthcare needs.
Geriatric care complements home-based care by providing professional medical expertise that ensures seniors receive comprehensive and appropriate treatment. Geriatric specialists can develop personalized care plans, monitor medication management, conduct regular health assessments, and provide necessary rehabilitative services that are often beyond the capacity of family caregivers. For instance, if a senior is prone to falls, a geriatric care team can offer physical therapy and home safety modifications to prevent injuries. Similarly, managing conditions like dementia often requires professional interventions, such as cognitive stimulation therapy, which family members may not be equipped to provide.
In addition, professional geriatric care helps ease the burden on family caregivers by offering them guidance, emotional support, and respite care when needed. Families do not have to bear the weight of caregiving alone. Geriatric services are designed to work hand-in-hand with family support to ensure the best possible outcomes for seniors while preventing caregiver burnout.
By integrating professional geriatric care into the caregiving routine, families can ensure their loved ones receive holistic and high-quality care that keeps them healthy and independent for as long as possible.
As Singapore's aging population grows, the importance of geriatric care cannot be overstated. Seniors require specialized care to manage chronic conditions, improve their quality of life, and prevent serious health complications. Unfortunately, many Singaporean seniors are missing out on these vital services due to a lack of awareness, cultural factors, and misconceptions about cost and accessibility.
By understanding the value of geriatric care, recognizing the available services, and navigating healthcare schemes and subsidies, you can ensure your loved ones receive the best possible care. With options ranging from home-based services to specialized clinics, now is the time to take proactive steps toward securing quality geriatric care.
Don’t wait until it’s too late.
Start exploring geriatric care options today and ensure a better quality of life for your aging loved ones. The earlier you take action, the better the outcomes will be for their health and well-being.
At Alami Clinic, we are committed to providing exceptional geriatric care services tailored to the unique needs of seniors. Our experienced team works with families to create personalized care plans, ensuring that your loved ones receive the support they need. With available government subsidies and expert guidance, we make it easy for you to access affordable, high-quality geriatric care. Reach out to Alami Clinic today and start the journey toward better health and a dignified life for your loved ones.
[1] Chen, Z. et al. Effectiveness of comprehensive geriatric assessment intervention on quality of life, caregiver burden and length of hospital stay: a systematic review and meta-analysis of randomised controlled trials. BMC Geriatr 21, 377 (2021).
[2] Nicola Veronese et al. Comprehensive geriatric assessment in older people: an umbrella review of health outcomes, Age and Ageing, Volume 51, Issue 5, May 2022, afac104, https://doi.org/10.1093/ageing/afac104
[3] Merchant RA et al. (2022) Outcomes of Care by Geriatricians and Non-geriatricians in an Academic Hospital. Front. Med. 9:908100. doi: 10.3389/fmed.2022.908100
[4] Yen, PC. et al. Effectiveness of outpatient geriatric evaluation and management intervention on survival and nursing home admission: a systematic review and meta-analysis of randomized controlled trials. BMC Geriatr 23, 414 (2023). https://doi.org/10.1186/s12877-023-04036-4