As an ageing population, the government has come up
with many initiatives to support the elderly in the country. However, news articles
reported elderly suicide rates being at an all-time high last year (Mahmud,
2018). It might be easy to blame the government or society in general for not doing
enough, but it is another thing to take personal responsibility for this issue.
In order to know how to help, one needs to take the time to find out what the
elderly actually face on a day-to-day basis, and why they face those issues.
1.
Living Alone
The proportion of elderly living alone has been
increasing over the years, and it is estimated that 83,000 elderly persons will
be living alone by 2030, compared with 47,000 aged 65 and above in 2016 (Singapore
Ministry of Health, 2016). Such arrangements are either by choice, due to the
elderly’s own desire for more independence and personal space away, or a result
of circumstances such as having no living family members, or difficult family situations
(Tai, 2015).
Among those
living alone, a large fear is dying without anyone knowing. Cheong (2016) interviewed
an elderly man, and he recounted that two of his elderly neighbours died alone in
the house without anyone realizing it, and their bodies were only discovered
due to the smell. Other social service workers also concur that the lack of dignity
in death is a prevalent fear amongst those who live alone (Lee, 2016; Heng,
2016).
Apart from deaths or injuries going unnoticed, the elderly
living alone are also more prone to depression, and this is especially so in
the absence of social support (Ng et al., 2015). Studies show that elderly who
do not live with their families were less likely to receive monetary, time, and
emotional support. However, those actively involved in community activities conducted
by the Residents’ Comittees (RCs) had people checking in on them and
accompanying them to doctor visits, and this strong social support compensated
for the lack of family support, thus allowing for more healthy ageing even for
those who live alone (Gubjahu and Chan, 2016).
2.
Loneliness and Disconnect
It should be acknowledged that living alone does not mean
that the elderly face loneliness, and living with others does not mean that the
elderly does not experience loneliness. While loneliness and living alone are highly
correlated, the presence of social and family support is a stronger predictor
of constant feelings of loneliness. With Singapore’s fast-paced culture, many
elderly report feeling lonely despite living with their children and grandchildren.
It is common for their children to come home late after a long day of work,
only to say a few words to their parents or be too tired to engage in extended
conversations with the elderly in the house.
Coupled with health problems and common joint issues,
the elderly may also find it difficult to leave their homes to socialize with
others. Low moods and feelings of helplessness tend to cause the elderly to
withdraw further, having negative attitudes towards themselves and others, further
leading to poorer health outcomes. Such a vicious cycle has negative implications
on elderly wellbeing, as studies have associated loneliness with poor sleep
quality, depression, anxiety, cognitive decline, high blood pressure, and even
premature death (National Institute of Ageing, 2019).
As such, while actual social isolation is an issue
amongst the elderly that lead to feelings of loneliness, subjective feelings of
distress arising from social disconnect can arise in elderly regardless of the number
of people they are surrounded with. The lack of concern showed to them by
family members, and the lack of time and emotional support by family and friends
result in a social disconnect. The elderly feel out of touch with the lives of
those around them, and are afraid of reaching out to their family members for
help, for the fear of being a burden (Mahmud, 2018). This can lead them to feel
that their lives are “empty and meaningless”, and such mindsets have large implications
on an elderly’s mental health and wellbeing, and can serve as a springboard to more
serious physical and mental
health conditions.
3. Depression and Dementia
One in ten elderly in
Singapore suffer from dementia, and one in five elderly aged 75 and above show
signs of depression (Institute of Mental Health, 2015; NUS Medicine, 2012).
While dementia is largely
a result of age, those who have had a stroke at least once in their lives, or had
low levels of education were the most likely to be diagnosed. Housewives and
retirees were also 25 times more likely to have dementia, compared to those in
paid employment (Institute of Mental Health, 2015). Given caregiving for demented
elderly is highly draining and difficult since these individuals need care “much
of the time) (IMH, 2015), these elderly tend to be stigmatized, and it is
common for caregivers to resent their role (Brodaty, 2009). Implicit attitudes
and feelings from caregivers are likely to show in conversations, adding to the
elderly’s feelings of being a burden to the family. On the other hand, elderly
depression in Singapore tends to be a result of being diagnosed with illness,
loss of spouse or close family members, the lack of social or family support,
or being single, widowed, or divorced (Singhealth, n.d.). If left unmanaged, depression
can lead to suicide.
Government Efforts
A report by the Samaritans
of Singapore (2018) showed that amongst the elderly who called the suicide
hotline, common struggles were social disconnect, the fear of becoming a burden
to family and friends, as well as impairments to daily functioning due to physical
challenges and deteriorating mental health. As such, recent years have seen a
large increased in concerted efforts by the Ministry of Health, Agency for
Integrated Care, schools, mental health agencies, and social service
organizations to prevent elderly suicide by providing support to high-risk
elderly, and linking them up to various organizations and communities for long
term care and monitoring.
My Role
That said, reading
the article made me feel rather sad that the government and social service
organizations are taking up so much responsibility for elderly care in Singapore,
as the families and other social circles were not active in providing monetary,
time, and emotional support to these elderly. Given that loneliness and the fear
of being a burden to their extremely busy children and grandchildren are one of
the main struggles of the elderly, I am motivated to take an intentional effort
in slowing down to care for the elderly in my own home.
This mini research
has also made me think about the way I want to look after my parents in the future,
when I get older. If I am not mindful about intentionally making time for family,
and investing care and love into our relationship now, it would be even harder
to do so next time, when I get even busier and when they get sick. I believe
that taking care of the elderly needs to be a communal effort, as it might be a
large load to carry for one individual. Given that the government has already
by stepping up on their efforts to care for the elderly in the country, I, too,
believe that much more can be done on an individual and family level to ensure that
my grandparents (and parents, in the future) know that they are valued, and loved.
References
Gubhaju, Bina, and Angelique Chan. 2016. Helping Across Generations:
Families in Singapore. Singapore: Centre for Ageing Research and Education.
Holwerda TJ, Beekman AT, Deeg DJ, Stek ML, van Tilburg
TG, Visser PJ, et al. Increased risk of mortality associated with social isolation
in older men: only when feeling lonely? Results from the Amsterdam Study of the
Elderly (AMSTEL). Psychol Med. 2012;42(4):843–53.
Mahmud, A. H. (2018, July 30). Number of elderly
suicides at all-time high: SOS. Channel News Asia. Retrieved from https://www.channelnewsasia.com/news/singapore/suicides-elderly-singapore-all-time-high-sos-10565002
National Institute on Ageing. (2019, April 23). Social
isolation, loneliness in older people pose health risks. Retrieved from
https://www.nia.nih.gov/news/social-isolation-loneliness-older-people-pose-health-risks.
National University of Singapore
Medicine Faculty (2012). Singapore Longitudinal Ageing Study.
Researchers at Institute of
Mental Health Detail Findings in Dementia (Prevalence of Dementia in People
Aged 60 Years and Above: Results from the WiSE Study).(Report). (2016). Mental
Health Weekly Digest.
Samaritans of Singapore (2018). Suicide Rate Lowest, but Number of Elderly
Suicide Highest Recorded. Retrieved from https://www.sos.org.sg/pressroom/suicide-rate-lowest-but-number-of-elderly-suicide-highest-recorded
Singapore Ministry of Health (2016). I feel young in my Singapore!
Action Plan for Successful Ageing. Singapore: Singapore Ministry of Health.
Singhealth (n.d.). Elderly Depression:
Signs and Causes. Retrieved from https://www.healthxchange.sg/seniors/ageing-concerns/elderly-depression-signs-causes
Tai, J. (2015, August 17). Old and home alone in
Singapore. The Straits Times . Retrieved from
https://www.straitstimes.com/singapore/old-and-home-alone-in-singapore
Well researched piece. Thank you.
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