SINGAPORE - Mr Nar Swee Kim and his wife Lee Lan came from Malaysia to Singapore in 2011 to be with two of their six children.
Mr Nar, now 91, and Madam Lee, 86, have both been bedbound for the past three years. He had suffered multiple strokes and has dementia, while she is battling developed peripheral artery disease (PAD), a condition in which narrowed arteries reduce blood flow to the legs.
Their care is managed by two foreign domestic helpers at their flat in Bukit Batok, with additional support from a home nursing service provided by St Luke's Hospital, which visits every two months.
Ms Priscilla Yeo, 68, retired after working at Changi Airport for 30 years, hoping for a fresh start in life after retirement.
However, she was hit by recurring health issues, making frequent trips to the hospital inevitable and resulting in her feeling down.
But since joining St Luke's Hospital's Western Silvercare programme - a community initiative which promotes screening, preventive health and active ageing for seniors living in Bukit Batok - she has regained her strength, energy and self-confidence.
Associate Professor Tan Boon Yeow, the chief executive officer of St Luke's Hosptial told The Straits Times that the hospital, which was established in 1996, has been working for decades "to put 'community' back into healthcare".
"It was and still is a ground-up effort," he said.
The hospital works with community partners like social service agencies New Life Community Services and St Luke's ElderCare, the Agency for Integrated Care (AIC) and the different healthcare clusters to provide comprehensive care, enabling more seniors to age comfortably at home and within their communities.
This was what Prime Minister Lawrence Wong had planned for Toa Payoh, one of Singapore's oldest towns, as well as in "one or two other places" with a higher concentration of seniors.
In his National Day Rally on Aug 17, the PM said that Singapore will be rolling out
Age Well Neighbourhoods
, a scheme to provide the older Singaporeans and residents with the support to age at home and within the community they call home.
"Many seniors choose to live independently, in order not to burden their children. We have been studying how to better support seniors in Toa Payoh and other older towns," PM Wong said during his rally speech.
He also said the Government will make "physical touchpoints more accessible to seniors" to enhance convenience, something St Luke's Hospital had been working towards since 1999 with the establishment of St Luke's ElderCare.
Prof Tan said St Luke's Hospital has created its own ecosystem of care with home-based services, home nursing, and community programmes to empower those in the community to age actively.
It is also working with another healthcare provider in providing furnishing community healthcare services to Harmony Village @ Bukit Batok, the first Community Care Apartments (CCA) in Singapore.
Drawing insights from the Grant Study - the world longest study, conducted by the Harvard Medical School and Massachusetts General Hospital since 1938 - Prof Tan said individuals who were happiest, stayed healthiest as they grew old, and who lived the longest, were those who had the warmest connections with others.
"That was what our Western SilverCare (WSC), launched in 2019, was designed to be. Apart from a personalised intervention plan developed for each senior with the goal of supporting their physical, mental, and social well-being, we designed the Wow (Working Out to Wellness) programme, which are exercise sessions led by fitness coaches to focus on enhancing strength, endurance, and balance," he said.
The Wow programme played a significant role in helping Ms Yeo overcome her depression and loneliness. She discovered their activities while attending the Active Ageing Centre a part of the WSC programme.
She now participates in the sports activities at the Renci Active Ageing Centre, and even leads cooking classes every Monday.
Prof Tan said the home nursing service at St Luke's Hospital, which started in 2012, has become an integral part of the hospital's holistic approach to providing eldercare and ensuring continuity of care for patients in and outside the hospital.
"Home nursing is a part of our home-based services to provide care for patients living mainly in Bukit Batok. Other types of services include home medical and home therapy. They are managed by a dedicated team that provides complete care, and improve the health and well-being of our patients," he said.
According to Prof Tan, there are three groups of patients who need home care services - those who are not able to visit the hospital, those who choose not to go and those dealing with invisible health issues.
"Often these patients have complex care needs such as multiple medical conditions, functional issues and social issues," he said.
Using the example of a patient who repeatedly experienced falls, it wasn't until a home visit to his flat revealed the cause - a leaky pipe under the kitchen sink - that the issue was resolved. After the pipe was fixed, he stopped falling.
Home care staff nurse Katie Tan, 32, who joined St Luke's Hospital in 2021, often helps bridge communication between patients, caregivers and the care teams.
"With one care team communicating regularly with the patient's caregiver and family, it helps to easily identify care gaps and challenges faced by the patient and family members as this is crucial in medical care," she told The Straits Times.
"The population is rapidly ageing and many seniors want to age where they live," Ms Tan added.
Ms Tan, along with either Prof Tan or another doctor from the team, visits the Nars once every two months to ensure that things remain stable for them and to help optimise the care provided at home by foreign domestic helpers Satur Nina Sarmiento, 44, and Eh Shee Than, 39.
Daughter Nar Lay Choo, 57, a part-time teacher, shared that she relocated her parents from Malaysia to Singapore to provide better care for them.
"My siblings are all married and have moved abroad. My elder sister and elder brother are in Canada, a sister lives in the capital KL (Kuala Lumpur), another sister in Sabah. Both my youngest brother and I are in Singapore with our families, so it made sense to move mum and dad here," Ms Nar said.
Since moving to Singapore, Mr Nar had suffered multiple strokes and is now bedbound.
"They used to live in Woodlands and we would call for transport to take him to St Luke's for his rehabilitation, but he got motion sickness travelling the long distance," his daughter said.
"Since the second stroke, he developed aphasia, and he lost his ability to walk. Getting a wheelchair-friendly service van to take him around was not only difficult but also expensive, so we moved them to Bukit Batok to be nearer the hospital."
"With Katie and the doctors only a stone's throw away, we can rest assured that my parents, though frail, especially when emergencies arise, will be well taken care of," Ms Nar said.