This discussion is based on literature review of studies pertaining to successful ageing, home care support and institutionalization in Singapore. The Singapore government adopts the "Many helping hands" approach, in which the government advocates three tiers of assistance (self, community, state), and heavily rely on the Asian concept of filial piety for support to the seniors. Unique to Singapore, is 1)the different forms of support rendered by the chinese, malays and indians, and 2)the employment of Foreign Domestic Helpers (FDH) to look after seniors and allow them to age at home. Even though home care services is available, employment of FDH is a cheaper option. In the past, large multi-generation families look after their elders. However, the increasing population of singles, divorcees, childless married couples and small nuclear families in Singapore, meant that greater support services is needed in place of the absence or lack of "children". Against this backdrop, we argue that the decision for institutionalization cannot be easily made by rational reasons, but are constrained by unique cultural factors. The decision on institutionalization can also be based on individual preferences, and articulated through Advance Care Planning. We also argue that institutionalization by rational deliberation may not always be the preference of the individual.Possible permutations and models based on common profiles of seniors are then proposed as a recommendation for decision making on institutionalization. These permutations will factor in individual preferences, availability of family support and support services for example.
Amberyce Ang, Singapore University of Social Sciences, Singapore
Stream: Aging and Gerontology
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