Relevant studies on ageing – related issues

Participation and independence
- Financial security
 

ASHER, M. G., & BALI, A. S. (2013). FAIRNESS AND SUSTAINABILITY OF PENSION ARRANGEMENTS IN SINGAPORE: AN ASSESSMENT (SSRN SCHOLARLY PAPER NO. ID 2360405). Rochester, NY: Social Science Research Network. Retrieved from http://papers.ssrn.com/abstract=2360405 
Singapore’s pension system is based on two major premises. First, it is possible to finance retirement expenditure almost entirely by mandatory savings of households which are micro-managed and intermediated by the state. Second, the pension system should focus on mitigating absolute rather than relative poverty. The analysis in this paper suggests that fundamental rethinking of these premises is needed to enhance sustainability and fairness of Singapore’s pension system. This will require use of social risk pooling methods such as social insurance and budget-financed non-contributory social pensions linked to per capita income, whose value does not decrease over time in real terms; and a shift in policy focus from addressing absolute poverty to relative poverty. The paper also suggests improvements in the design and governance of the Central Provident Fund (CPF) system such as a shift away from administered interest rate to crediting members with full returns earned on ultimate deployment of CPF balances; and reforming age-based premiums for health insurance and CPF Life. The main constraints in reforming Singapore’s pension system towards fairness and sustainability are not fiscal, economic, institutional or capacity related, but arise from unwillingness of policymakers to reconsider pension system objectives, governance and design. More open and informed debate involving all stakeholders could facilitate public policy choices designed to enhance fairness and sustainability of Singapore’s pension system.

CHAN, M. L., GUSTAFSSON, L., & LIDDLE, J. (2015). MANDATORY RETIREMENT FOR OLDER PROFESSIONAL DRIVERS: AN EXPLORATION OF EXPERIENCES FOR OLDER SINGAPOREAN TAXI DRIVERS. AGEING & SOCIETY, 35(07), 1384–1409. http://doi.org/10.1017/S0144686X14000257 
ABSTRACT: Singapore has an age-based mandatory retirement policy for taxi drivers. In 2006, the upper age limit of mandatory retirement was raised from 70 to 73 years for healthy, older taxi drivers. Retirement from taxi driving in Singapore often results in simultaneous retirement from work and forced driving cessation due to limited private vehicle ownership. While both retirement from work and driving cessation have been found to have negative implications for health and wellbeing in Western countries, little is known about the effects of mandatory retirement and driving cessation for healthy professional drivers in an Asian context. This study aimed to explore the mandatory retirement experience of older Singaporean taxi drivers, aged 70–73 years. In-depth interviews were conducted within a descriptive phenomenological approach with 23 older Singaporean taxi drivers who were retired or retiring drivers. Findings showed the experience to be dominated by retirement from work issues rather than by driving cessation. Three themes described the experiences: ‘stories of taxi driving’, ‘feeling lost in retirement’ and ‘contradictions of growing old in Singapore’. Taxi driving was a valued role. Despite an expected retirement, most participants were not prepared for the retirement transition. They struggled with emotional adjustment, financial vulnerability, identity, reduction in life-space and meaningful activity participation. Participants felt under-valued despite having personal achievements and support from family and ‘successful ageing’ policies. Work remained a preferred activity despite limited re-employment opportunities. The unique context of expected but forced retirement, financial need in a non-welfare system, high cultural value on work, and limited options for productive or meaningful activities and roles, predisposed this sub-group of older Singaporean men to be vulnerable retirees in terms of identity and wellbeing issues. Support for a stressful late-life transition is indicated for continued health and wellbeing.
DO, Y. K., WU, T., & CHAN, A. (2014). INTENTION TO RE-ENTER THE LABOUR FORCE AMONG OLDER MALE SINGAPOREANS: DOES HEALTH STATUS MATTER? JOURNAL OF POPULATION AGEING, 7(4), 283–299.
The increasing old-age dependency ratio in Singapore poses a major challenge to the social security benefit for its ageing population. Providing older Singaporeans with more employment opportunities may then benefit individuals, families, and society—if older adults are willing and able to work. This paper investigates the intention of Singaporean male retirees to re-enter the workforce and how their health status may influence this decision. Using data from the Social Isolation, Health and Lifestyles Survey (2009) we model the intention to re-enter as the dependent variable and used both subjective and objective health measures as the main independent variables. A probit model accounting for sample selection was estimated. We found that poorer health status had a positive association with the probability of elderly men reporting having retired, and a negative association with the intention to re-enter the labour force. Health status may matter substantially in older adults’ labour market transitions, especially for occupations requiring physical labour. Perceived income adequacy in old age was also a contributing factor in the retiree intention to re-enter the labour force. These results suggested that poor health can be a substantial deterrent to older workers’ labour force participation through earlier retirement and lower likelihood of re-entering the labour force; investing in the health of older and middle-aged workers may have positive long-term economic effects.

LEE, W. K. M. (N.D.). INCOME PROTECTION AND THE ELDERLY: AN EXAMINATION OF SOCIAL SECURITY POLICY IN SINGAPORE. JOURNAL OF CROSS-CULTURAL GERONTOLOGY, 13(4), 291–307. http://doi.org/10.1023/A:1006541410391 
This article examines the impact of the aging population on social security policy in Singapore. The adequacies of public policy responses, specifically the Public Assistance Program and the Central Provident Fund (CPF), are explored. The Singapore government’s strategy of minimal approach to social security is challenged. Poverty among the elderly is on the rise. Members from the working poor, a group that disproportionately consists of women and Malays, have inadequate retirement income protection and are most likely to slip into poverty as they age.

MOHD, S., AZMAN, A., SULAIMAN, J., & BABA, I. (2010). FINANCIAL SECURITY PROTECTIONS IN MALAYSIA, SINGAPORE AND PHILIPPINES: A PERSPECTIVE OF TWO GENERATIONS. THE HONG KONG JOURNAL OF SOCIAL WORK, 44(02), 89–104.
The study investigated the formal and informal old age protections in the major cities of Malaysia, Singapore and Philippines. The role of family support as important source of old-age protection in Asian countries was also investigated. Data were collected using a survey-interview method. A total of 250 young population and 250 of the elderly population in Kuala Lumpur were interviewed. Similar number of young and elderly population was interviewed in Manila. In Singapore, data was collected from 206 and 161 young and elderly population respectively. A Venn diagram was constructed to analyse the overlapping of availability of the various old age protections for the two generations and their relative sizes among the three cities were compared. Given the many agreement on the inadequacy of the formal old-age benefits, many reverted to informal protections such as insurance, savings and family support. With the exception of Manila, reliance on the family support as perceived by the younger generations has lost its importance.

MUKHOPADHAYA, P., & VENAIK, S. (2014). OLD-AGE INCOME INSECURITY IN SINGAPORE: A PROBLEM OF NON-INCLUSIVE DEVELOPMENT. AUSTRALIAN ECONOMIC PAPERS, 53(3-4), 184–206. http://doi.org/10.1111/1467-8454.12035 
With a growing old-age population, ensuring income security for the elderly is becoming an increasingly important element of public policy worldwide. The World Bank report proposed a three-tier system to avert old-age crisis, which was extended into a five-tier system by Holzmann et al. Our analysis of Singapore’s old-age income security system in light of these two systems shows that it lacks the basic zero and first pillars of protection against old-age hardships. We show that a budget allocation of less than half a percent of national gross domestic product (GDP) can ensure that no elderly citizen suffers from poverty in Singapore. As Singapore occupies the status of a developed country, a government-financed pension system that is adequate, affordable, sustainable and robust is long overdue.

NG, K.-H. (2011). REVIEW ESSAY: PROSPECTS FOR OLD-AGE INCOME SECURITY IN HONG KONG AND SINGAPORE. JOURNAL OF POPULATION AGEING, 4(4), 271–293. http://doi.org/10.1007/s12062-011-9051-7 
This review shows that Hong Kong and Singapore face a distinct and serious challenge to old-age income security due to their mix of public pension provision and intergenerational family support. They are among the fastest ageing societies internationally and will be the oldest in Asia after Japan by 2030. Yet their public pensions remain weak. Defined contribution pensions, even for full-career workers, are projected to replace just 17% of net lifetime average earnings in Singapore and 41% in Hong Kong, compared to 70% across the OECD countries. Instead, older persons in Singapore and Hong Kong depend mainly on their adult children for income security in the form of co-residence and cash transfers. More than half of them live with adult children. In Singapore, more than two-thirds receive financial support from the younger generation, compared to just 5% on average in Europe. Current welfare theory would suggest that Singapore and Hong Kong portray an extreme variant of welfare regime where the state’s role is more limited than in the liberal regime and the family’s role more central than in the Southern European regime. The sustainability of current old-age income security arrangements is therefore particularly vulnerable to new social risks that threaten the stability of traditional family structures. Already co-residence and financial support from adult children are declining. A fuller assessment of the prospects for old-age income security must focus on the interaction of pension policy and family support for elderly persons in different gender and income groups.

SCHWINGEL, A., NITI, M. M., TANG, C., & NG, T. P. (2009). CONTINUED WORK EMPLOYMENT AND VOLUNTEERISM AND MENTAL WELL-BEING OF OLDER ADULTS: SINGAPORE LONGITUDINAL AGEING STUDIES. AGE AND AGEING, 38(5), 531–537. http://doi.org/10.1093/ageing/afp089
Objective: to examine the effect of late life engagement in continued work involvement or volunteer activities during retirement on mental well-being. Methods: two waves of data from the Singapore Longitudinal Ageing Studies were analyzed for 2,716 Singaporeans aged 55 or above at baseline and 1,754 at 2-year follow-up. Trained research nurses interviewed participants (non-volunteering retiree, volunteering retiree, and working seniors) on mental health status (geriatric depression scale, Mini Mental State Examination, positive mental wellbeing and life satisfaction). Results: about 88% of seniors were retired (78% non-volunteering, 10% volunteering) and 12% were still working in paid employment or business. At baseline and 2 year follow up, and regardless of physical health status, volunteering retirees and working seniors gave significantly better MMSE cognitive performance scores, fewer depressive symptoms, and better mental well-being and life satisfaction than non-volunteering retirees. Conclusion: the results of this study suggest that continued work involvement or volunteerism provides opportunities for social interaction and engagement and may be associated with enhanced mental well-being. Future research should clarify which specific aspects of volunteerism are related to long-term mental well-being.

TAN, M.-E., SAGAYADEVAN, V., ABDIN, E., PICCO, L., VAINGANKAR, J., CHONG, S. A., & SUBRAMANIAM, M. (2016). EMPLOYMENT STATUS AMONG THE SINGAPORE ELDERLY AND ITS CORRELATES. PSYCHOGERIATRICS, n/a–n/a. http://doi.org/10.1111/psyg.12206 
Aim: It has been hypothesized that working beyond retirement age may have a protective effect on various aspects of well-being in the elderly. This paper aims to examine the relationship between employment status of elderly Singaporeans and indicators of well-being.  Methods: As part of the Well-being of the Singapore Elderly study, data relating to sociodemographics, social networks, medical history, physical activity, cognitive function, and disability were collected from 2534 participants aged 60 years and older. Participants included full-time workers (n = 483), part-time workers (n = 205), the unemployed (n = 32), homemakers (n = 808), and retirees (n = 1006). The data were analyzed by multiple logistic regression.  Results: Likelihood of being employed decreased with age, and employment was higher among men. Paid workers had significantly higher levels of physical activity, more extensive social networks, better cognitive function, less disability, and lower risk of dementia than retirees and homemakers. Paid workers had significantly lower chronic disease burden than retirees and rated their health to be better than retirees and the unemployed.  Conclusions: These findings show that meaningful employment is associated with better psychological and physiological well-being among the elderly, highlighting the importance of studying likely protective effects of employment and creating employment opportunities for elderly Singaporeans.

THANG, L. L. (2011). POPULATION AGING, OLDER WORKERS AND PRODUCTIVITY ISSUES: THE CASE OF SINGAPORE. JOURNAL OF COMPARATIVE SOCIAL WELFARE, 27(1), 17–33.

VIVIEN K.G. LIM. (2003). AN EMPIRICAL STUDY OF OLDER WORKERS’ ATTITUDES TOWARDS THE RETIREMENT EXPERIENCE. EMPLOYEE RELATIONS, 25(4), 330–346. http://doi.org/10.1108/01425450310483361 
This study examined the attitudes of older workers towards work and retirement, retirement planning and their willingness to continue working after retirement and to undergo retraining. Data were collected via questionnaire surveys. Respondents consisted of 204 individuals aged 40 and above who attended courses at a local institute of labor studies. Findings suggested that work occupied a salient part of the respondents’ lives. In general, respondents also held rather ambivalent attitudes with regard to the prospect of retirement, i.e. while they did not view retirement negatively, they were nevertheless anxious about certain aspects of retirement. Results also suggested that majority of respondents preferred to remain employed in some ways even after they have officially retired from the workforce, i.e. partial rather than full retirement was preferred. Implications of findings for organizations and policy makers were discussed.

Participation and independence
- Leisure in later life
 

ANG, S. (2016). SOCIAL PARTICIPATION AND MORTALITY AMONG OLDER ADULTS IN SINGAPORE: DOES ETHNICITY EXPLAIN GENDER DIFFERENCES? THE JOURNALS OF GERONTOLOGY SERIES B: PSYCHOLOGICAL SCIENCES AND SOCIAL SCIENCES, gbw078. http://doi.org/10.1093/geronb/gbw078 
Objectives: Social participation has been consistently associated with lower risk of all-cause mortality, but studies have been ambivalent about how this association differs between men and women. The present study investigates if ethnicity accounts for gender differences in (a) the types of social activities older adults participate in and (b) the association between social participation and 4-year mortality. Methods: Data from 4,482 Singaporean older adults who participated in a nationally representative longitudinal survey were analyzed. Stepwise logistic regressions and Cox proportional hazard models with inverse probability of treatment weights were used. Results: Men were more likely to engage in social activities compared with women, but this gender difference varied by ethnicity for three activities. Whereas going out to eat was associated with a lower risk of mortality for men only, playing sports was found to be protective for women only, but these associations did not vary by ethnicity. Discussion: Findings suggest that although ethnicity may account for gender differences in the content of social activity participation, it does not explain gender differences in the association between social participation and mortality. More consideration should be given to whether each activity provides an appropriate milieu for the social interaction of each gender.
KRISHNASAMY, C., UNSWORTH, C., & HOWIE, L. (2011). THE PATTERNS OF ACTIVITY, AND TRANSPORT TO ACTIVITIES AMONG OLDER ADULTS IN SINGAPORE. HONG KONG JOURNAL OF OCCUPATIONAL THERAPY, 21(2), 80–87. http://doi.org/10.1016/j.hkjot.2011.12.002 
Background: Engagement in occupations is important, and appropriate transportation modes are necessary for continued activity participation in the community. The aim of this study was to explore the patterns of activity and transportation methods used by older adults and the links between their transport use and activity engagement in Singapore. Methods: Fifty-six participants aged 50 years and older recorded in a time diary (in English or Mandarin) their activity participation over 24 hours on a weekday or weekday and weekend day. Data on the participants’ out-of-home activities were analyzed using parametric statistics, including Student t-tests and analyses of variance, along with visual inspection of the data. Results: No significant difference was found between time spent out of the house on weekdays and weekends on the variables of sex, age, and self-reported health status, and between living situation and time spent out of the house for drivers and nondrivers. The participants undertook a wide variety of activities including work, singing with friends, and shopping, and most frequently left their house to shop, exercise, or meet family/friends or participate in leisure activities. The participants were found to be able to use several transportation methods to access these activities, and they were satisfied with how they traveled to them. Conclusion This study contributes to the understanding of the activity engagement of older adults in Singapore. It has highlighted participants’ engagement in neighborhood activities and the importance and preference to walk or use public transportation to access activities. Additionally, this study has highlighted the need to consider the issues surrounding occupational performance in older adults.

LUYT, B., & ANN, H. S. (2011). READING, THE LIBRARY, AND THE ELDERLY: A SINGAPORE CASE STUDY. JOURNAL OF LIBRARIANSHIP AND INFORMATION SCIENCE, 43(4), 204–212. http://doi.org/10.1177/0961000611418813 
Singapore is now one of the fastest aging societies in the world. By 2030 those over 65 years old are expected to number 1.41m strong, 26.8 percent of the country’s entire population. Given these numbers, it is not surprising that aging is a key concern in Singapore. This article reports on a qualitative study of 32 individuals over the age of 55 who frequented one branch of Singapore’s public library system. It sheds light on the current views of the elderly on their reading and some of the facilities that the library currently offers them. In particular it argues that attention needs to be paid to four issues: gender disparities, class differences, the effects of ageism, and an instrumental view of reading.

LUYT, B., CHOW, Y. H., NG, K. P., & LIM, J. (2011). PUBLIC LIBRARY READING CLUBS AND SINGAPORE’S ELDERLY. LIBRI, 61(3), 205–210. http://doi.org/10.1515/libr.2011.017 
The public library system of Singapore has taken an interest in developing programs for the elderly, an increasing component of the nation’s aging population. One of these programs involves the establishment of reading clubs. This article reports on a qualitative study of one of these clubs, the Seniors’ (Chinese) Reading Club. Club members were asked to describe their reading behaviour, how they learned about the club, why they decided to join, what they felt they gained from the club, and why more elderly people did not participate. Three themes emerge from the responses: an instrumental view of reading or, in other words, a notion that reading is done for utilitarian purposes rather than intrinsic enjoyment; gender issues, in so far as club membership appears to have created a public space for elderly women, but not men; and social exclusion in that word of mouth is the main way that people learn about the club, and that its members appeared to be from a specific socio-economic group.

RAWTAER, I., MAHENDRAN, R., YU, J., FAM, J., FENG, L., & KUA, E. H. (2015). PSYCHOSOCIAL INTERVENTIONS WITH ART, MUSIC, TAI CHI AND MINDFULNESS FOR SUBSYNDROMAL DEPRESSION AND ANXIETY IN OLDER ADULTS: A NATURALISTIC STUDY IN SINGAPORE. ASIA-PACIFIC PSYCHIATRY, 7(3), 240–250. http://doi.org/10.1111/appy.12201 
Objectives: Subsyndromal depression (SSD) and subsyndromal anxiety (SSA) are common in the elderly and if left untreated, contributes to a lower quality of life, increased suicide risk, disability and inappropriate use of medical services. Innovative approaches are necessary to address this public health concern. We evaluate a community-based psychosocial intervention program and its effect on mental health outcomes in Singaporean older adults.  Method: Elderly participants with SSD and SSA, as assessed on the Geriatric Depression Scale and Geriatric Anxiety Inventory, were included. Intervention groups include Tai Chi exercise, Art Therapy, Mindfulness Awareness Practice and Music Reminiscence Therapy. The program was divided into a single intervention phase and a combination intervention phase. Outcomes were measured with the Zung Self-Rating Depression Scale (SDS) and Zung Self-Rating Anxiety Scale (SAS) at baseline, 4 weeks, 10 weeks, 24 weeks and 52 weeks. The program had ethics board approval.  Results: A hundred and one subjects (25 males, 76 females; mean age = 71 years, SD = 5.95) participated. There were significant reductions in SDS and SAS scores in the single intervention phase (P < 0.05), and these reductions remained significant at week 52, after completion of the combination intervention phase, relative to baseline (P < 0.001).  Conclusion: Participating in these psychosocial interventions led to a positive improvement in SSD and SSA symptoms in these elderly subjects over a year. This simple, inexpensive and culturally acceptable approach should be adequately studied and replicated in other communities.

THANG, L. L. (2006). EXPERIENCING LEISURE IN LATER LIFE: A STUDY OF RETIREES AND ACTIVITY IN SINGAPORE. JOURNAL OF CROSS-CULTURAL GERONTOLOGY, 20(4), 307–318. http://doi.org/10.1007/s10823-006-9010-6 
In a society faced with rapid aging and extended life expectancy, older persons in Singapore are just beginning to see retirement as a new era in their lives that can be quite different from the later life experiences of their own parents. Presenting an ethnographic case study of one of the first retiree activity centers in Singapore, this article will examine (a) how older persons cope with retirement, social, and cultural norms, and (b) the strategies older adults adopt in order to stay relevant in a fast-paced society. The ethnographic study shows that extrafamilial social support and opportunities for new experiences in learning and leisure contribute significantly to positive and active living in old age. Although the discussion of aging in Asia usually focuses on the problems of health, finances, and caregiving, the present study suggests the need for policy makers to pay equal attention to issues such as activity participation in old age. Participation in leisure activities may act as a preventive measure to delay the onset of aging-related problems, while at the same time enhancing life satisfaction among seniors.

WONG, C., WONG, S., & SHEN, L. (2003). CORRELATES OF HABITUAL WALKING AND SPORTS/LEISURE-TIME PHYSICAL ACTIVITY IN OLDER PERSONS IN SINGAPORE: INTERACTION EFFECTS BETWEEN EDUCATIONAL ATTAINMENT AND GENDER. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE, 32(6), 801–806.
INTRODUCTION: We examined for demographic and psychosocial correlates on the participation of habitual walking and sports/leisure-time physical activity (LTPA) among older persons in Singapore.  MATERIALS AND METHODS: In an observational study, 177 Chinese, community/urban-dwelling, ambulant, non-disabled participants > or = 50 years old were recruited from a health promotion programme. The main outcome measures were self-reported participation in habitual walking and sports/LTPA. Variables examined include highest educational attainment, demographic and health characteristics, social contact and health knowledge. Interaction between gender and educational attainment was also examined.  RESULTS: The mean age of participants was 62.5 +/- 7.8 years. The effects of educational level were significant on habitual walking (P = 0.02), while that of age, self-rated health and interaction between gender and educational level were significant for sports/LTPA (P = 0.012, P = 0.002 and P = 0.019, respectively). Men with higher education had a higher self-reported sport/LTPA, while in women; those with lower education attainment had a higher participation.  CONCLUSION: Unlike findings from Western developed nations, previous studies done in Japan and Singapore found that educational level and health behaviours may not be positively associated. In this study, there is a negative correlation between educational attainment and participation in habitual walking and sports/LTPA, especially among older Singaporean women.

Participation and independence
- Living in the community

CATTAN, M., WHITE, M., BOND, J., & LEARMOUTH, A. (2005). PREVENTING SOCIAL ISOLATION AND LONELINESS AMONG OLDER PEOPLE: A SYSTEMATIC REVIEW OF HEALTH PROMOTION INTERVENTIONS. AGEING & SOCIETY, 25(01), 41–67. http://doi.org/10.1017/S0144686X04002594
Preventing and alleviating social isolation and loneliness among older people is an important area for policy and practice, but the effectiveness of many interventions has been questioned because of the lack of evidence. A systematic review was conducted to determine the effectiveness of health promotion interventions that target social isolation and loneliness among older people. Quantitative outcome studies between 1970 and 2002 in any language were included. Articles were identified by searching electronic databases, journals and abstracts, and contacting key informants. Information was extracted and synthesised using a standard form. Thirty studies were identified and categorised as ‘group’ (n=17); ‘one-to-one’ (n=10); ‘service provision’ (n=3); and ‘community development’ (n=1). Most were conducted in the USA and Canada, and their design, methods, quality and transferability varied considerably. Nine of the 10 effective interventions were group activities with an educational or support input. Six of the eight ineffective interventions provided one-to-one social support, advice and information, or health-needs assessment. The review suggests that educational and social activity group interventions that target specific groups can alleviate social isolation and loneliness among older people. The effectiveness of home visiting and befriending schemes remains unclear.

CHAN, A., MALHOTRA, C., MALHOTRA, R., & ØSTBYE, T. (2011). LIVING ARRANGEMENTS, SOCIAL NETWORKS AND DEPRESSIVE SYMPTOMS AMONG OLDER MEN AND WOMEN IN SINGAPORE. INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, 26(6), 630–639. http://doi.org/10.1002/gps.2574
Objectives: To examine the association of living arrangements and social networks outside the household with depressive symptoms among older men and women, ascertain if these relationships differ between older men and women, and investigate whether the association of living arrangements with depressive symptoms varies by strength of social networks. Methods: Data for 4489 community-dwelling Singaporeans, aged 60 years and older, from a recent nationally representative survey were analyzed. Depressive symptoms were assessed using the 11-item CES-D (Center for Epidemiologic Studies) scale, social networks through Lubben’s revised social network scale, and living arrangements through household composition. Analysis was stratified by gender, and descriptive and multivariate statistics were used to assess the risk of depressive symptoms by living arrangements and social networks, adjusting for age, ethnic group, education, housing type, functional status, number of chronic diseases and involvement in social activities. Results: Women had higher depressive symptom scores than men. Living alone and living with at least 1 child (no spouse) (relative to living with spouse and children), and weak social networks outside the household were associated with higher depressive symptom scores among both men and women. Men living alone with weak social networks outside the household had higher depressive symptom scores than those with strong networks. Conclusion: The findings have implications regarding the importance of strengthening non-familial social networks of older adults, particularly for those living alone. Copyright © 2010 John Wiley & Sons, Ltd.

EMLET, C. A., & MOCERI, J. T. (2012). THE IMPORTANCE OF SOCIAL CONNECTEDNESS IN BUILDING AGE-FRIENDLY COMMUNITIES. JOURNAL OF AGING RESEARCH, 2012. http://doi.org/10.1155/2012/173247 
The purpose of this paper is to further elucidate the importance of social relationships and social connectedness with aging in place and in developing elder-friendly communities. The process used in this study was inclusive of younger adults (age 40–65) as well as older adults (65+) in order to further understand how they envision a community that could support their own aging in place. A community forum, using the World Café format, was conducted in order to engage community members, 40 years and older, in conversation about the importance of social connectedness in elder-friendly communities. A second purpose of this forum was to obtain data on what would keep aging boomers in their community as they age. Three major themes emerged from qualitative analysis of the forum: social reciprocity,  meaningful interactions, and structural needs/barriers. The results of this study reinforce the importance of social connectedness in creating and maintaining elder-friendly communities for older adults, as well as soon-to-be retired individuals, wishing to maintain life connectedness to their community. The study suggests the possibility of using more non-traditional research techniques (such as the World Café process) for gathering community level data.

KEATING, N., OTFINOWSKI, P., WENGER, C., FAST, J., & DERKSEN, L. (2003). UNDERSTANDING THE CARING CAPACITY OF INFORMAL NETWORKS OF FRAIL SENIORS: A CASE FOR CARE NETWORKS. AGEING & SOCIETY, 23(01), 115–127. http://doi.org/10.1017/S0144686X02008954
Population ageing and constraints on public sector spending for older people with long-term health problems have led policy makers to turn to the social networks of older people, or the ‘informal sector’, as a source of long-term care. An important question arising from this policy shift is whether these social networks have the resources to sustain the high levels of care that can be required by older people with chronic health problems. In the face of both dire warnings about the imminent demise of the informal sector, and concurrent expectations that it will be the pillar of community long-term care, it is timely to undertake a critical analysis of the caring capacity of older people’s social networks. In this paper we argue that the best way to understand the caring capacity of informal networks of frail older people is to establish their membership and caring capacity. It is useful to make conceptual distinctions between ‘social’, ‘support’, and ‘care-giving’ networks. We argue that transitions of networks from social through support to care roles are likely to show systematic patterns, and that at each transition the networks tend to contract as the more narrowly defined functions prevail. A focus on ‘care networks’, rather than the more usual ‘care dyads’, will move forward our understanding of the caring capacity of the informal sector, and also our ability to forge sound social and health policies to support those who provide care.

LIM, L. L., & KUA, E.-H. (2011). LIVING ALONE, LONELINESS, AND PSYCHOLOGICAL WELL-BEING OF OLDER PERSONS IN SINGAPORE. CURRENT GERONTOLOGY AND GERIATRICS RESEARCH, 2011, e673181. http://doi.org/10.1155/2011/673181 
Studies of the psychological well-being of elderly living alone have yielded inconsistent results. Few investigators have distinguished living alone from loneliness in the same study. Thus, the present study examined the independent and interactive effects of living alone and loneliness on depressive symptoms (GDS score) and quality of life (SF-12 MCS score) in a prospective 2-year follow-up cohort study of 2808 community-dwelling older adults (aged ≥55 years) in Singapore, controlling for baseline covariates. In cross-sectional analysis, loneliness was a more robust predictor of GDS score than living arrangements; living alone, when controlled for loneliness, was not associated with GDS score. GDS score associated with living alone was worse for those who felt lonely than for those who did not feel lonely. Similar patterns of association were found in longitudinal analyses and for SF-12 MCS score, although not all were significant. Thus, though living alone predicted lower psychological well-being, its predictive ability was reduced when loneliness was taken into account and loneliness, a stronger predictor, worsened the psychological effects of living alone.

SOON, G. Y. (SAMUEL), TAN, K. K., WANG, W., & LOPEZ, V. (2015). BACK TO THE BEGINNING: PERCEPTIONS OF OLDER SINGAPOREAN COUPLES LIVING ALONE. NURSING & HEALTH SCIENCES, 17(3), 402–407. http://doi.org/10.1111/nhs.12203
Singapore has an aging population that is projected to increase by 32% in 2100. The majority of older couples live alone. ‘Aging in Place’ is an initiative that is widely promoted by the government, in which older people are supported to live in their own homes. In this qualitative study, we explored the perceptions of older people living with their spouse in Singapore. Fifteen community-dwelling older participants were interviewed. Four themes emerged from the thematic analysis: (i) maintaining health and mobility; (2) maintaining relationships with spouse; (iii) maintaining relationship with others; and (iv) living the last leg of the race. The older people living on their own were generally content about maintaining their interdependence and complementary roles. Insights gathered from this study have relevance to implementation of the Aging-in-Place policy to ensure that older people receive the support they need to maintain their physical and psychosocial well-being while living on their own.

TAN, K.-K., HE, H.-G., CHAN, S. W.-C., & VEHVILÄINEN-JULKUNEN, K. (2015). THE EXPERIENCE OF OLDER PEOPLE LIVING INDEPENDENTLY IN SINGAPORE. INTERNATIONAL NURSING REVIEW, 62(4), 525–535. http://doi.org/10.1111/inr.12200 
Background: Globally, older people are living independently either alone or with their spouse, population continues to age. In Singapore, some may live with an unrelated older person in a public rental apartment. In Asia, these older people are associated with increased risks of poor health and social isolation, have poorer social support and a poor quality of life. Few studies have explored why these older people choose such living arrangements, the challenges they encountered and what has helped or may help them overcome these challenges.  Aim: To explore older people’s experiences of living independently or with an unrelated older person.  Methods: This descriptive qualitative study involved face-to-face interviews with 25 informants, 65 years or older in Singapore. Thematic analysis was adopted. Results: Five themes emerged: (1) making own choice – participants decided to live apart from their families, (2) contending with concerns – the availability of external resources for participants was shrinking, (3) coping with the available assistance – depending on available external resources from the community, (4) holding on to their values – participants rely on their internal resources to manage, and (5) preparing for the inevitable – participants were planning for their final years of life and for their death. Conclusion: Older people have such living arrangements for many reasons. They attain well-being and quality of life by devising strategies, tapping on their limited external resources and relying on their values to manage their diminishing resources and the foreseeable death.  Implications for nursing and/or health policy: Understanding older people’s experiences may help nurses and health professionals to develop health promotion programmes that support older people’s everyday needs and help them to stay healthy. Public health policy must support older people to live in a safe environment near their extended family to reduce their need to relocate.

TAN, K.-K., VEHVILÄINEN-JULKUNEN, K., & CHAN, S. W. C. (2014). QUALITY OF LIFE AND PSYCHOSOCIAL HEALTH OF OLDER PEOPLE WHO WERE LIVING ALONE OR WITH ANOTHER OLDER PERSON IN SINGAPORE. RESEARCHGATE, 40(2), 16–33.
As the proportion of older people in the world continues to rise, many older people are living apart from their immediate and extended families. Their ability to continue to live independently and...

WILES, J. L., & JAYASINHA, R. (2013). CARE FOR PLACE: THE CONTRIBUTIONS OLDER PEOPLE MAKE TO THEIR COMMUNITIES. JOURNAL OF AGING STUDIES, 27(2), 93–101. http://doi.org/10.1016/j.jaging.2012.12.001 
Older people are often positioned as passive recipients of care and dependent on resources or as overly productive and active. In this paper, we seek a more nuanced, middle ground between such stereotypes, by exploring the question: what contributions do older people make to the places they live in? Drawing on qualitative research from Aotearoa New Zealand, involving focus groups and interviews, we examine the varied and active ways many older people are involved in and contribute to their neighbourhoods and communities, or what we term ‘care for place’. In particular, we identify the different forms of older people’s care for place, including volunteering, activism, advocacy, and nurturing, and consider how these efforts positively impact on older people and the communities in which they live. Whilst we caution against assumptions that all older people should be productively involved, we argue that greater understanding of older people’s care for place is central to challenging stereotypes of older people as either passive and dependent, or highly active.

WONG, Y.-S., & VERBRUGGE, L. M. (2008). LIVING ALONE: ELDERLY CHINESE SINGAPOREANS. JOURNAL OF CROSS-CULTURAL GERONTOLOGY, 24(3), 209–224. http://doi.org/10.1007/s10823-008-9081-7
Asian societies maintain the norm that older people should live with their children. Yet some older people live alone. This is the first study to explore social isolation, strategies of coping, and preferences about living arrangements among Chinese Singaporeans aged 65+ who live alone. Data from 19 semi-structured interviews were analyzed. The elderly people who live alone either have no other alternative, or they choose it despite opportunities to live with others. Regardless of the initial reason, solo-dwellers in Singapore succeed at living alone by developing behavioral and psychological strategies that help overcome social isolation. Their main link to the ‘outside’ world is access to medical and social services. Despite some hardships, many prefer living alone because it has become familiar and personally comfortable.

WU, T., & CHAN, A. (2012). FAMILIES, FRIENDS, AND THE NEIGHBORHOOD OF OLDER ADULTS: EVIDENCE FROM PUBLIC HOUSING IN SINGAPORE. JOURNAL OF AGING RESEARCH, 2012, 659806. http://doi.org/10.1155/2012/659806 
Introduction. This empirical paper examines how the Housing Development Board (HDB) public housing neighborhood influences older urban Singaporeans’ social interactions and ameliorates social isolation. Methods. Using 4,542 observations of noninstitutionalized urban adults aged 60 and above, ordered logistic regressions are run to determine the predictors of isolation while controlling for physical health and demographics. Results. 87% of older Singaporeans reside in public housing apartments while 13% reside in private market housing. The main predictor of social isolation is living alone and the second main predictor is coresidence with adult children. The relationship between coresidence with adult children and isolation is mediated when controlling for older adult functional limitations. The public apartment neighborhood and daily participation in public neighborhood events have substantial effects on reducing the risk of isolation. Older adult contact with friends alleviates isolation more than contact with non-coresiding relatives. Conclusion. Findings suggest that the public neighborhood-built environment in Singapore plays a positive role in the social interactions of the elderly. Knowledge of the factors that decrease the risk of social isolation will have implications for studying morbidity and mortality among the elderly.