Self-Care on Health of Older Persons in Singapore (SCOPE)

A Story

Mr Soh is 66 years old. For many years he sold chicken rice in a hawker centre but he retired when he could no longer withstand the back-breaking work. His wife passed away a few years ago due to an accident. Nowadays he lives all alone in his flat. His two children and their families visit him occasionally on weekends.

Mr Soh has a simple lifestyle. He meets his friends for breakfast at the nearby hawker centre and lingers on for a few hours of chatting until it is time for lunch. Whenever he is at home, he is mostly pre-occupied watching his favourite shows on television. Sometimes he wanders around the neighbourhood or sits on the park bench watching the world go by.

He looks fit. There are times he will feel some pressure on his chest, some pain on his knee and has difficulty breathing. But he dismisses all these as “part of ageing.” He doesn’t go for health screenings and thinks he cannot “bother” his children about these “little ailments.”

Mr Soh’s story is typical among the increasing number of older persons in Singapore. They continue to be unaware of the effects that their inactive lifestyle and unhealthy choices have on their bodies. More and more are ageing with higher risk of having chronic diseases and depression.

5W and 1H on SCOPE

The Self Care on Health of Older Persons in Singapore (Project SCOPE) is a community development programme that combines research and training components. It aims to improve the health and wellbeing of well and mildly disabled older persons aged 55 years and above. The project is funded by the Ministry of Health and the Ministry of Education. Project SCOPE is a pilot project that will test and evaluate the efficacy of self-care approach in maintaining health, controlling chronic disease and improving functional status and quality of life of older persons.

In Singapore, 1 in 4 older persons has at least one chronic condition such as chronic obstructive pulmonary disease (COPD), diabetes and hypertension. However, most have poor knowledge of self-care practices that can prolong active ageing. By the year 2030, 1 out of 5 Singaporeans will be 65 years old and above. That means there will be about 1 million older persons.
Given this scenario, all sectors in society need to start preparing for the challenges of an ageing population. Most importantly, every individual, especially those at high risk of chronic illnesses, should learn how to manage their health and lead a more healthy and active life.

Tsao Foundation, through the International Longevity Centre Singapore, have implemented Project SCOPE together with the National University of Singapore-Faculty of Arts and Sciences. They have also partnered with 8 Seniors Activity Centres & Family Service Centres to reach out to older Singaporeans in a randomized controlled trial process. This is designed in order to effectively validate the impact of the project.

The project will work with 400 older persons randomly selected from Senior Activity Centres & Family Service Centres located in Ang Mo Kio and Tiong Bahru. Older persons who have been selected will be divided into 2 groups: 200 will be in the intervention group and another 200 will join the control group. All activities related to Project SCOPE participants will be conducted in their respective Centres.

The project has started in June 2011 and will be completed in May 2013.

Both control and intervention groups will receive a baseline assessment of physical and mental health status, and follow-up assessments at 8 and 18 months. In addition to this, the intervention group will also undergo a structured training programme that will be conducted weekly over a period of 7 months (56 hours in total). Each intervention group will be composed of 15 -20 older persons and their training will be led by 2 Community Health Trainers. The content of training materials will focus on health promotion, disease prevention, and health seeking behavior, chronic disease management and anti-stigmatization.

Basic Core Program

  • Life review
  • Overview of common chronic disease and health problems
  • Physical care – dental, skin, foot, eye, vital organs
  • Happy mind – stress management, positive thinking, managing anxiety, emotions and fears
  • Health systems – understanding health systems, assessing good medical care, asking doctors the right questions.

Lifestyle Core Program

  • Management of chronic disease
  • Nutrition and eating well
  • Exercise
  • Understanding health and social resources
  • Revisiting healthcare action plan

During the training, the Older Persons will nominate their Health Partners. They can be family members or friends or basically someone who can continue on positively influencing the Older Persons when they are in their own homes or communities. The Health Partners will also undergo training to effectively help the Older Persons achieve their health plans.

A support group will also be set up after the Older Persons have completed their training. They will meet for support group sessions over a 28-week period. The aim is to provide a sustained initiative and continuously motivate the Older Persons in realising life-changing decisions and living a more healthy and active life. Click to view article on the Aging Center.