The future of elderly wellbeing: A survey of Singaporean adults

Introduction Singapore has one of the fastest aging populations in the world. Health and social needs will increase and evolve as the current cohort of middle-aged Singaporeans enter the latter halves of their lives. This study aimed to explore Singaporeans’ views on successful aging and what they desire for Singapore’s health and social care in the future. Methods We conducted an online survey of 567 respondents (aged 45 to 65 years old) from January to March 2019. Topics included: knowledge and experience of health and social services, technology use in daily life, social life, financial health and employment, and conceptualization of successful ageing.  We performed descriptive and bivariate analyses of the data and thematic analysis for qualitative data. Results The mean age of survey respondents was 54.2 ± 5.0 years. 72% of respondents had contact with the healthcare system at least once a year, and 68% were satisfied with their care experience. Top concerns with healthcare were accessibility, high cost, and lack of sympathy and interpersonal skills among healthcare providers. Almost all (97%) of respondents had some knowledge of available social services but only one-third used the services. Suggestions for future social services included: greater social connection, better access to elder support facilities and financial assistance. On social connection, 83% hope to spend more time with friends or families in the future. Social interaction was viewed as both intra-generational and inter-generational. Despite all respondents reporting having an online social network, the majority desired face-to-face interaction (92%). 40% wanted to work beyond retirement age not only for financial independence, but to keep themselves active and to meet people. Two-thirds used technology to manage their health. The three most commonly used technologies were mobile/tablet apps (28%), wearable technology (23%) and health monitoring devices (13%). Respondents envisaged using technology in future for physical activity and diet, better diagnostic capabilities and better sharing of health and social data across providers. Definitions of successful ageing were wide-ranging. Apart from good physical health, the majority of respondents explained that financial independence, meaningful work, autonomy, social connectedness, and mobility were important. Discussions Singaporeans have high expectations for the future of health and social services. Basic health and social services were still important, but Singaporeans have a more expansive view of factors contributing to overall wellbeing. The need for purposeful living and meaningful social interactions extends traditional views of healthy aging. Conclusions There is a need to broaden the scope of health and social policies for the future generation of older Singaporeans.  Lessons learned The current range of healthcare and social services may not be adequate to meet the multifaceted needs of future elders. Limitations Respondents were primarily English-speaking ethnic Chinese and from higher income groups. Future research The next phase of this study will gather views from non-English speaking Singaporeans, particularly those from lower socio-economic backgrounds. The final phase will be an in-depth exploration of survey results through a series of focus group discussions leading to future policy recommendations.