Longer life expectancies and declining fertility rates mean that the Western Pacific Region has one of the largest and fastest-growing older populations in the world. As a result, society and health systems are evolving to support people throughout their life through methods such as long-term care and community level social services.
In Singapore, SingHealth Community Hospitals (SCH) provides services for patients requiring sub-acute care, rehabilitation and palliative care. They draw from WHO’s Regional Action Plan on Healthy Ageing in the Western Pacific and support the nation’s older population by establishing partnerships between community services and its own community health team. Community services can include activities and programmes such as social time with peers at senior activity centres, therapeutic gardens, or online classes for skills like cooking or sports. The SCH team includes nurses, doctors, allied health staff, and community relations and engagement administrators.
Healthy ageing is influenced by social determinants of health, which are non-medical factors that affect health outcomes. Examples include housing environment, literacy, food security, social support and access to health and social care. These determinants can be more important than health care or lifestyle choices in influencing health, and numerous studies suggest they account for between 30–55% of health outcomes. SCH’s method of linking patients to non-clinical support services in their own community, known as social prescribing, aims to address these factors.
Social prescribing takes various forms, such as health care providers directing patients to community-based services or specialized in-house Wellbeing Coordinators. These coordinators address social determinants by designing personalized wellness plans based on the patient’s interests and engaging with them throughout their community hospital stay. They also routinely follow up on patients to monitor their progress.
During COVID-19, this programme has also helped teach older people how to use smartphones, QR codes, Wi-Fi and WhatsApp in order to stay connected.
Support for patients continues even after they complete social prescribing programs. As part of its continuing care efforts, SingHealth Community Hospitals launched the complementary Integrated Primary Care Programme for At-Risk Elders (iPCARE) to re-connect patients who are discharged from community hospitals back to medical practitioners in their neighbourhood.
By connecting individuals to resources in their community and providing holistic care, countries can achieve the vision of healthy ageing outlined by WHO. Adding years to life can offer individuals and society new opportunities, but only if we also add life to those years by encouraging and enabling older people to remain healthy and to continue to participate and thrive in their communities.