To grow old in good health in body and mind and happiness is what everyone would wish for as a fulfilling life but it is a goal that has eluded many the world over. The blessing of attaining ripe old age is clearly reflected in Chinese culture and the Holy Bible where to live to “three scores plus ten” would be what mankind should strive for, albeit not easy to accomplish.
In the 16th century, most people would have a life span of between 38 and 48, and beyond that would be regarded as a long life. However, life expectancy did increase during the following centuries with improved health care and better standard of living. In the last century, to live to the biblical age was well within the reach of more and more people, with envy and admiration from those struggling with unending ill health. At the present time, especially in the more developed counties in the West and Asia, the average person can now live well beyond the biblical milestone.
Take my native Singapore as a case in point. With its present day world standard healthcare, high standard of living and growing health consciousness of its citizenry, life expectancy has gone up significantly in the past five decades. Put it simply, men now approaching the age of 80 in reasonably good health can aspire to live to 85 or beyond and more for women. Current Government statistics show that the number of people now in their 90s has increased and also those reaching 100, many still in good shape!
With people in more countries living longer nowadays than ever before, many countries in Asia and the West are now settled with more older folks and a declining younger ones. This will become more acute with each passing year. Asian countries facing this dilemma include especially Japan, China and Singapore. In the West, the same problem also confronts Italy, Greece, Germany and a number of other European nations. China now has more than 200 million people aged 60 and this will increase to 65 by 2050. In Japan, which has the highest aging population worldwide, those reaching the compulsory retiring age of 65 are being recalled to work up to 70, if medically fit to do so. Singapore, too, is most likely to increase its retiring age from 65 to 70 in the near future in order to ease the expected acute shortage of experienced workforce. By 2030, one in five workers here will be aged 65 and above. What all this aging population means is that the younger people will have to work much harder in future in order to support the older non productive fellow citizens and a declining population. The more affluent countries affected are increasingly resorting to employing cheaper foreign workers to overcome such shortages but this can bring with it many attendant social problems as evident in such countries if these are not tackled timely and effectively. They also resort to using robots in certain industries to help ease worker shortages.
To cater to these aging folks, one of the most important measures is for governments to have firm plans to build more old age homes, dementia homes, hospitals and improving existing medical and social welfare benefits catering to the poor and needy as well as augmenting their existing such facilities and programmes. I am glad to note that my own country has already formulated or implemented tangible plans to better cater to the anticipated needs of these growing older folks. The charitable and other welfare organisations are also lending their support in this national endeavour.
It is beyond the scope of this article to discuss how best these and other urgent measures need to be implemented by governments and other institutions so as to alleviate this pressing problem in those affected countries. My aim is to call attention to this reality of life in the hope that this will create greater public awareness to it which will eventually be confronted by each and every one of us when we or our parents reach old age.
I will mention three cases affecting people I know and how they endeavour to cope with it as best they can in their separate ways. The first case concerns a rich Malaysian couple in their late 70s living with a domestic helper in a large bungalow with spacious garden. They have four successful tertiary-educated sons and daughters with families living in US and Canada. They used to enjoy visiting them regularly and their children would come home at regular intervals too. As time went on, these reciprocal visits became less frequent as the parents found it too tedious physically to undertake such long journeys and their children and families too came home less and less due to work commitments and other factors. This eventually affected their hitherto very close family ties. The old couple became more and more lonely in their big house and gradually cut off contacts even with a handful of close relatives and friends. They then spent most of their time watching TV, tending their garden and reading newspapers. Their health too is no longer what it used to be in their happier times. It suddenly dawned on them that it is a truism that money may not bring you happiness but may certainly bring you a chain of miseries. They finally decided to turn to their lapsed religion for comfort and now spend much of their time doing voluntary church work and find fulfilment doing so. They intend to bequeath the bulk of their wealth to their church and other charitable homes for the relief of the poor and needy, as their children have adequate means to live well.
The second case relates to an elderly Singaporean retired couple who live harmoniously and happily with one of their three married children in a five-room HDB flat built by Government. All their three sons have stable jobs with middle level incomes. They are a close-knit family and meet up regularly at each other’s homes for weekend meals. The couple have five grandchildren. At these family gatherings there would always be good food and much laughter and an unfailing atmosphere of family cohesiveness and bliss. The parents have savings of their own as the father was a supervisor in a well established multinational firm before retirement. He and his wife spend a great deal of their time at the local community centre, which has good facilities and social activities suited to the elderly people. In the late afternoon, they would enjoy spending some leisure time with two of their grandchildren in a nearby park. The entire family usually have dinner together and enjoy watching Media Corp Chinese television programmes. To keep fit, the old couple would rise early and go for their regular morning leisurely walks or do Taiji exercises with friends, followed by breakfast in a local hawker centre in the company of their friends or neighbours. Weekends are family time with all their children and their family members at their respective homes. Their five grandchildren are a great joy to them as they lovingly watch them growing up healthily. To them, this is a happy and fulfilling life indeed, and they would not trade it with any other lifestyle.
The last case is, unfortunately, a rather sad and tragic one. A devoted Singaporean retired widower, who has only one son married with wife and two teenage children, out of love and trust for him was persuaded by the latter to add his name as joint holder to his substantial bank account. The son assured the father that he would undertake to look after him throughout his life time. The son even invited the father to move into his own apartment so that he and his wife can better take care of him. The father lovingly declined this thoughtful gesture, as he was more used to living alone in a rented apartment after his wife passed away some years earlier. All went well for some years and the family tie seemed firm and deep-rooted. Then the son got into dire financial difficulties and was hounded by a couple of “loan sharks” as he was unable to repay the unlawfully high monthly interest rate due to them. To solve his seemingly unsolvable financial predicament, he decided to migrate to a foreign country with his family hurriedly. He then withdrew the bulk of his father’s bank account, leaving a smaller portion for his living expenses. He has since made no contacts with his father, perhaps out of shame or remorse for what he had done. Fortunately, the father has not withdrawn his rather substantial CPF (Central Provident Fund) money set up by the Government for his retirement needs. The father is not in good health now and decided to move into a low cost old age home for the rest of his life. This happened when he was in his mid 70s. I hope he will not become destitute if he lives a very long life with his savings gone.
Old age can bring with it a variety of problems, some of which have been alluded to earlier. The more complex ones are mental illnesses like dementia, serious long term illnesses and loss of mobility, among others. For older people especially, accidental falls can lead to permanent disability and there are more such mishaps occurring in one’s home than elsewhere. It is therefore prudent for old folks to take necessary safety precautions such as installing a shower facility in place of a long bath, fixing grab bars where needed, making sure floor areas are always kept dry and non slippery and staircases and bathrooms are dimly lighted throughout the night for their safety, exercising regularly, watching one’s diets and have regular medical check ups. Apart from health matters, its prudent for old people to preserve their financial independence during their life time and their children will benefit from their estate when both of them have passed on. These measures can go a long way to help you enjoy your old age as the golden years of your life. At the same time, it will reduce the burden of your loved ones to care for you under difficult circumstances out of filial piety which might impose considerable financial and other miseries upon them.
In most Asian communities, especially in China which has been greatly influenced and shaped by the ancient Confucianism, the children, especially sons, are expected to look after their parents in their declining years. This means that it is the bounden duty of the male children to care for them in their old age. In traditional societies, this was the norm as the entire extended family would live in the same location or within easy access of each other. Failure to comply with this would make the children an outcast of society even with extenuating circumstances. In our own time, this traditional heritage is still highly valued and quite commonly practised in Singapore and rural China, but changing circumstances have made it much more difficult to comply with it in its pure form. For instance, with economic expansion and industrialisation, family members may be living apart from their parents in a different far away location or foreign country and may not be available in their hour of need to be by their side. Those brought up with love will invariably render financial help to their parents to make them well cared for, if not able to be physically present to offer them comfort and personally take care of them.
In normal circumstances and given a choice, most old people would inevitably prefer to spend their final days in their own homes or that of their loved ones’ and being lovingly comforted by their presence rather than dying in a hospital, hospice or old age home by themselves. This cherished wish might not always be fulfilled due to factors rendering it difficult for family members to comply even though there is strong bond of love between the parents and their offsprings. For instance, ailments like loss of mobility and becoming bed-ridden and mental illnesses like acute cases of dementia may require continuous professional medical care which most families, except the affluent, would be unable to provide outside a hospital, hospice or a well-run old age home. Those critical of families resorting to placing their ailing parents in these public institutions must be realistic and understand their predicament and not condemning their painful decisions by using the traditional yardstick in the vastly changing circumstances now prevailing. Each case must be judged on its own merits or lack of it.
Growing old healthily and happily are personified by the two aunts of my wife and mine. My wife’s aunt Dr Oon celebrated her 100 birthday last year with a family lunch attended by four generations of Oons and their family members. She is still enjoying excellent health, mentally alert, physically strong and can walk without aid that would be the envy of those younger than she is. She still goes for occasional early morning walks at the Singapore Botanical Garden with a friend and plays the Chinese mentally stimulating game of mahjong regularly which helps to keep her mind mentally sharp in old age. She has endowed charitable, medical and educational projects, including founding Singapore’s first dementia home, Apex Harmony Lodge.
My aunt, Mrs Cheong, will be 103 soon, and will be the first in the Lam family to attain this rare milestone. She worked as a nurse in Singapore’s General Hospital and Ministry of Health. After her retirement, she emigrated to Australia in the 1970s to join her son and family in Sydney. She was completely mobile until a few years ago due to a fall and used to visit her siblings in Singapore and could go about in public transportation everywhere by herself without any difficulties. Living in Australia has taught her to be independent, self-reliant, outgoing and social. She later decided to reside permanently in a paying and well run old age retirement home-built by the Catholic church, of which she is an active member. She lovingly declined her son and family’s invitation to live with them. She assured them that she would be very happy there with her own friends. She was allocated a single room with ensuite bathroom facility. Her new home has access to good medical service, its own recreational and canteen facilities. Some of her fellow residents have since become her constant companions sharing same interests such as music. The residents there are free to go out at any time they choose for a change of environment including spending weekends with their own family members. She is happy and contended in this comfortable retirement home and lives each day to the full.
The United States has pioneered the well-run and comfortable retirement home or village concept, some of which are so luxurious with facilities approaching those of a five-star hotel. They cater to the rich and are in great demand, especially in those states blessed with sunny weather and mild winter including Florida and parts of Southern California. The residents there live in what is referred to as “gated communities”.
Like the US, the retirement home or village model is also becoming very popular in Australia and some more affluent Western countries catering to those who can afford to live there after a long working life. In Asia, this concept is beginning to appeal to some people who prefer to lead a more independent life after retirement, rather than depending on their children to take care of them. These include richer countries like Japan and increasingly the rising China too.
In the case of newly affluent Singapore, there are also a growing number of people, especially those who are single or married without children and some with children but prefer the freedom of living on their own and still be close to their family families, who would like to reside in a comfortable retirement home with good facilities. The first small scale retirement home with reasonably good facilities to be launched was enthusiastically received by the target groups and the limited accommodations were fully taken up by them within a short time. One constraint for large scale retirement homes or villages like those in the US and other affluent Western countries is the very limited land available in the Republic for such projects and the very high cost of running them in order to make it viable commercially. The rich in Singapore would inevitably already have spacious homes of their own with foreign domestic helpers to add to their comfortable lifestyle. They would also be members of prestigious social and country clubs to cater to their social and recreational needs. The Singapore retirement home or village’s target groups would therefore be mainly the upper middle-income business or professional classes who favour this mode of living. For the above reasons such homes will need to be sited in Johore State of Malaysia where land and building costs are substantially lower than in Singapore and is within easy access from it. For various reasons and factors briefly mentioned above, I am convinced that retirement homes or villages will increasingly appeal to many financially independent Singaporeans and this trend will grow in the years to come.
Lam Pin Foo