Consider elderly patients' social needs too, Singapore docs urged

SINGAPORE - Doctors treating the elderly need to be more aware of their patients' social and psychological needs, a new report has found.

They should take a holistic view - instead of drawing a distinction between medical and social care - said the study commissioned by the Lien Foundation and developed by consultancy firm KPMG.

The research aims to draw ideas from other countries on how they have addressed their challenges. It is based on interviews with 46 eldercare experts in 14 nations. Four were from Singapore while others came from countries including Japan and the United States.

Dr Gerald Koh, a National University of Singapore associate professor and one of those interviewed for the report, said: "We're very good at building hardware and infrastructure, and that's not a bad thing, but we could do more in the 'heartware' area.

"Traditionally, doctors focus more on cures and treatment. I think we're training them to be more patient-centred, to be aware of the patient's social and psychological needs. But we could move beyond awareness and get them to take these needs into consideration when planning the management of the patient."

Doctors should work more closely with social workers and therapists in an "interdisciplinary team", added Dr Koh, from the university's Saw Swee Hock School of Public Health.

And there should not be "a sharp demarcation between the different roles". For example, in the United States, multidisciplinary teams provide services ranging from medical care to occupational therapy and diet monitoring - all at an adult day health centre.

The report - An Uncertain Age: Reimagining Long-term Care In The 21st Century - recommended providing more training and support to informal caregivers, and introducing more sustainable funding models. For instance, one pool of money could be used to fund institutional care and home-based or community-based services. This would avoid having two separate budgets.

Ageing Asia managing director Janice Chia said health-care facilities had been integrated to some extent, but more could be done to help the elderly age within the community.

"There have been collaborations between hospitals and nursing homes, but these focus more on medical care...

"We should have more activities in the area of preventive care, such as strength training and mental training, or other communal activities to draw them out from these homes and prevent them from being socially isolated."

And Singaporeans are likely to expect more, said Lien Foundation chief executive Lee Poh Wah. He added: "Is our current system more geared towards serving the poor, versus the middle- and upper-income groups?

"Having visited some nursing homes in Asia, most of our nursing homes today resemble Class C hospital wards that lack the homely feel. That's why few people would welcome the thought of spending old age in such an environment."

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