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TRANSFORMING THE WAY WE CARE

The Ministry of Health (MOH) will shift the way it organises care in a few ways so that the healthcare delivery system will be better and more appropriate for older patients.

From disease-specific, fragmented care to person-centric care.
Seniors with more than one disease condition may need to make multiple visits to different clinics.

We need to reduce the number of doctors they need to consult and focus on treating the person as a whole and not the diseases in isolation.

From hospital to community care.
We need to build good models of care in the community, so seniors can be well supported where they stay, no matter their health condition.

From caring ‘for’ to caring ‘with’ patients.

From caring ‘for’ to caring ‘with’ patients.
We need to help Singaporeans prepare for a long and healthy life.

This includes understanding the motivation of seniors and their caregivers and empowering them with the knowledge and skills to take charge and manage their own health well.

TRANSFORMING HEALTHCARE SERVICE DELIVERY

Geriatric capabilities in acute hospitals will be enhanced.
- More inter-disciplinary Geriatric Care Teams (comprising doctors, allied health professionals and nurses) will be set up to provide holistic care for frail seniors.
- More Geriatric Resource Nurses will be trained to advise care teams in adult wards on what to look out for and how to better care for very old patients.
- More healthcare professionals will be trained to care for seniors’ needs.
Community hospitals provide short period of continuation of care for patients, usually after discharge from the acute hospitals.
Sub-acute care and rehabilitative care are provided in community hospitals to improve or optimise one's physical function so that one can better integrate back into the community or at home.
Community-based geriatric services will be piloted to bring care closer to older Singaporeans in the community.
A multi-disciplinary team of healthcare professionals will provide geriatric assessments, develop care plans and deliver team-based coordinated care for seniors to keep them well in the community.

Geriatric dental expertise and services will be developed to improve the oral health of seniors.

Geriatric dental expertise and services will be developed to improve the oral health of seniors.
Wheelchair bound patients and those confined to their trolley beds can be seen in new dental facilities such as the Geriatric Special Care Dentistry Clinic at the National Dental Centre Singapore (NDCS) and the upcoming National University Centre for Oral Health. We are working with education providers such as NUS and NDCS to equip healthcare professionals with the relevant skillsets and knowledge to better serve seniors as well as to undertake more research in disease trends in geriatric dentistry.

Community Nursing - Shifting care to the community
A pilot is being conducted where cluster-led, geographically-based community nursing teams see to the health needs and care for residents through the following:
- Preventive health - community nurses can reach out to residents in the community and coach them to manage their health better.
- Direct home care - community nurses can provide care in the homes of residents who have been discharged from hospital with complex medical issues. For example, the nurses can help them manage and care for their wounds.
- In end-of-life care, residents can be supported by community nurses trained in palliative care.

EXPANDING CAPACITY

Intermediate and long-term care services will be expanded between 2015 and 2020.
The number of community hospital beds will be more than doubled. Nursing home capacity will increase by more than 50%. Home and community care capacity will go up by 50% and 100% respectively.
A Masterplan on Home and Community Care will be implemented to support seniors to age-in-place.
A new care assessment framework will be piloted to better evaluate seniors’ needs so as to match them to appropriate services.

MOH has also worked with providers to develop more holistic Integrated Home and Day Care packages to meet the needs of seniors. For example, seniors can receive centre-based care on the days they feel well and receive care services at home on the days they do not feel well.

The Health Ministry (MOH) will introduce new aged care sector initiatives to support the sector’s efforts in quality improvement, manpower and organisation development and productivity.

Manpower development will be ramped up to ensure there is enough staff to support the expansion in aged care

Manpower development will be ramped up to ensure there is enough staff to support the expansion in aged care
MOH will step-up the recruitment of Singaporeans into the aged care sector through job fairs, training and retention incentives.

MOH will work with aged care providers to re-design more jobs so as to offer Singaporeans more flexible work arrangements in the aged care sector.

We will also help aged care providers to increase manpower productivity through automation, adoption of technology and improvement of business processes.

Community support for seniors with dementia will be expanded.
MOH and the Agency for Integrated Care (AIC) have reached out to residents, businesses and community organisations in different localities to form “dementia friendly communities”, where residents and staff of businesses can be trained to recognise and assist seniors with dementia. This will give peace of mind to seniors and their caregivers. Seniors with dementia can remain active and move around in the community with less worry, because there will be helpful “dementia friends” in their neighbourhoods to look out for them.
Dementia care support at home and in the community will be enhanced.
AIC has expanded the pool of elder-sitters to look after seniors with dementia at home and engage them in activities, while giving their caregivers a break.
Nursing homes of the future will be piloted.
MOH has experimented with new nursing home designs to create more dementia-friendly spaces and more comfortable environments without compromising the affordability of care. We will continue to improve our designs as care needs of seniors grow and evolve. New technologies will also be tested in these homes to improve productivity.

MOH will also work with nursing home providers to pilot new programmes to support residents in their recuperation so that they can return home to their loved ones.

TAPPING TECHNOLOGY

Tele-health solutions will be test-bedded to better care for older patients.

We will test technologies, such as video consultation, tele-rehab, and remote vital signs monitoring, to bring care to the homes of seniors while making the delivery of healthcare more manpower efficient.

ENHANCING PALLIATIVE CARE

Capacity, quality and affordability of palliative care will be enhanced to support an ageing population.
By 2020, MOH will increase the number of inpatient palliative care beds from 182 (in 2015) to 360, and we will be able to serve 6,000 home palliative care patients per year.

To enhance the quality of palliative care, MOH has been working with the Singapore Hospice Council (SHC) to develop and implement a set of National Guidelines for Palliative Care. MOH is also working with AIC, SHC and community partners to increase awareness and uptake of Advance Care Planning (ACP) in Singapore.

MOH has raised the Medisave withdrawal limits for both inpatient and home-based palliative care, and lifted personal Medisave withdrawal limits for home-based patients with cancer or end-stage organ failure.

Additionally, MOH has improved funding for home palliative care providers by moving away from funding based on the number of visits made to patients to funding based on a fixed amount for every patient under their care each month.

Subsidies for day hospice services, which provide healthcare and social support in a day care setting to meet the needs of palliative care patients, have also been rolled out.