Death and dying, life and living in long-term care facilities in Singapore

Building a dignified system where Singaporeans can choose how we want to live and how we want to say goodbye

The loss of freedom, dignity and respect in places with 11 to 25 bedded wards, lacking in privacy, with staff being paid SGD$350 a month without food and accommodation were reported in a Channel NewsAsia program known as Talking Point. In addition, it was also mentioned by author and research Ms Radha Basu one staff member can be observed responsible for 20 to 32 residents in the night, and residents live with bare necessities such as a toothbrush, bed and a cabinet. The lifestyle was found to be highly regimented with the journalist sharing that there are were only 2 options for times for showers at 6 am or 7 am.  “it was like a hospital for the rest of your life” stated television host Anita Kapoor. She also states that “it’s not a criticism of the facilities themselves, it’s a criticism of the system. You cannot approach eldercare the way you approach hospital visits. It can’t just be a means to an end need. It is a life. You have to think in terms of life and end of life.”

I was really exhausted by the environment  

– television host, Anita Kapoor, 45 years of age.

I applaud Ms Kapoor for taking a stand and putting herself in the resident’s place, experiencing the environment literally for a fortnight first hand, living as residents lived.

Like my previous article about Singapore nursing homes, our story of the wooden bowl? I questioned how we want to care for our older adults, our parents, our grandparents, given the state of the nursing homes in Singapore. How do we care for our loved ones in Singapore with dementia without dementia enabling built environments?

My thoughts have constantly been being echoed in this programme. Pushing for better environments for people with dementia. I dare to say that I can dream for a day when Singapore will be able to have facilities that advocate for independence, dignity and respect for residents. Seeing an assisted living facility in the heart of Bukit Timah, it’s heartwarming and inspiring to see the St Bernadette Lifestyle village, assisted living facility that is just like a home.

It is with a flicker of hope that one day we can have facilities like intergenerational nursing homes inspired from our HDB designs (Taking a leaf from HDB flats for Pocket Gardens & Intergenerational Nursing Homes) which we call home.

In the meantime, I will keep working on a dementia enabling environmental audit tool for Singapore in the hope that we will be able to create dementia enabling long-term care facilities that Singaporeans can call home.

Watch the full episode here


Living Tiny & the Psychological Issues that go with it

In Asia, it is not uncommon for us to be living in tiny living space. From Tokyo, Singapore, China and even Thailand, we’ve all heard, know or even are living in very tiny homes in a very overcrowded city. Cost of living is high, we pay a mint for our homes and we end up living in little shoeboxes in the sky. In a recent article by the Atlantic. The issues of micro apartments were discussed and the question is “how small can our living spaces get before it starts to impact on our physical and psychological health?”

The article talks about how these apartments serve their purpose for young, childless couples who had just started out in the world and wish to live close to the city or work or play. However, for people with children or living in a multigenerational family unit, how do people cope?


Looking back in Asia, for many in the sandwich generation, working long 10 to 14-hour shifts, caring for children and our parents. The home is suppose to be a safe haven, but when overcrowding occurs some people may feel a sense of dread befalling on them when it is time to go home. Trapped between the tortures of work and the stress of  claustrophobic home.


The article talks about how living in small apartments can affect the concentration of children and in turn, impact on their studies. The article also talks about the lack of privacy and how it may cause children to become withdrawn. If these housing conditions can have such fundamental impacts on children the implications for older adults living in such apartments with cognitive impairment and dementia must be very challenging.


However, in Japan, despite the overcrowding and challenging living conditions, strong community initiatives have risen to help support the physical and mental well-being of older adults living in these housing conditions. The Dementia Support Caravan (DSC), founded a decade ago help apartment managers to work with older tenants who may be living with dementia and require support from the community. As the number of people with dementia

The Dementia Support Caravan (DSC), founded a decade ago help apartment managers to work with older tenants who may be living with dementia and require support from the community. As the number of people with dementia continue to grow in Asia and housing conditions continue to remain unchanged; initiatives such as the DSC can help older adults with dementia age in place in their units within the community. It is in hope that more urban regions in Asia may develop similar programmes to support the people with dementia and their family living in the high-rise communities.


Source: The Health Risks of Small Apartments – The Atlantic

Source: Hand for dementia – Japan Times