Summary
The Community for Successful Ageing (ComSA) is a Tsao Foundation initiative in Singapore which takes a community-wide approach to delivering comprehensive programmes and services with the aim to promote health and wellbeing over the life course, and to enable ageing in place. The initiative has four areas of focus: self-care development; community development; health and social care systems; facilities and infrastructure. The comprehensive system which is housed in one building pulls together multiple services, disciplines, branches of policymaking and civic participation, to build environments where people thrive as they age. It seeks to improve the quality of life of older people and to reach those most marginalised. The Foundation was requested by the Ministry of Health to engage in the remote area of Whampoa, yet unknown to them. They used an array of creative approaches based on fun activities such as Parties to mobilize older people and motivate them to promote self-care and peer support. Given the success of the ComSa, other initiatives took root such as the SCOPE training on self-care and well-being, with a catalyst theme song, and ‘Sharing Wellness and Initiative Groups’ (SWING). In these groups, older people work together to identify local issues in their residential areas. The focus for most of the SWING groups was on actions needed to ensure housing and local environments were more age-friendly. The initiative has grown organically and has had positive impact on the motivation of older people to engage in other activities.
Planning and Implementation
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What was the challenge you were trying to address?
The main challenge of the holistic approach of the Tsao Foundation for this initiative is to overcome ageist attitudes and create an age-friendly primary care service integrated with the wider health and long-term care systems.
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Who were you trying to impact?
Older people in general
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What sectors were you targeting?
Health, Long-term care
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Who else was involved?
Government, Civil Society Organization, Older People's Association
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How did older people participate?
Older people were part of the process at multiple or all stages
Lessons learned
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Please describe how collaboration worked in your initiative.
The Foundation was asked to work in the Whampoa constituency by the Ministry of Health because of its demographics and the lack of available services and support for older people from other NGOs. Whampoa was a new area for the Foundation. In spite of being located within the central part of Singapore, it is a relatively isolated community. Around 18% of the population in Whampoa is older, higher than the national average of 11%.
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What was the impact of your initiative on older people, their families, and/or their communities?
Engagement in the community development activity has had a positive impact on older people and has often led to them engaging in other types of activities or services offered under the ComSA initiative. The initial self-care and development approach taken in the Community Development work, which involves nurturing older people’s engagement in a slow and personal way, has resulted in older people being more motivated and willing to take part and also to recognise the value of their engagement. The Community Development work also promotes intergenerational engagement that increases older people’s visibility and participation with wider groups in the community. This has helped others to see older people as active community members. It has also helped to address issues of social isolation, highlighted as an issue for more than half of all older people in Whampoa, by a study undertaken by the Foundation. This increased social interaction has been welcomed by older people. An evaluation of the ComSA work also showed that older people who engaged in a guided biography process, undertaken at the start of the initiative and linked to the longevity parties, or the SCOPE project, were the most likely to stay engaged with the community development activities and were found to have experienced the most positive outcomes from their engagement. Many of the groups have also developed sub-groups known as ‘Sharing Wellness and Initiative Groups’ (SWING). In these groups, older people work together to identify local issues in their residential areas.
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What issues did you face, and how did you address them?
The Foundation had not worked in Whampoa before, and was not known to the community. Therefore, it wanted to find a fun and innovative way to start to engage with older residents. It took the decision to organise ‘Longevity Parties’ to bring older people together. The Foundation worked with the leaders of these RCs to identify and invite older people to the parties.
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What lessons did you learn from implementing this initiative?
(1) Use fun engaging approach to provide safe and self-care spaces: The ‘Longevity Parties’ to bring older people together provided a space for older people to participate in group learning on health, through the Self-Care on Health of Older Persons in Singapore programme (SCOPE). The parties also allow the older people to be engaged with a series of ‘self-discovery’ workshops, including ‘life reviews’ and ‘guided biography’ (a socio-emotional process providing older people a space for reflection). The Foundation observed that older people in Singapore are often reticent about engaging in such activities, so creating the right environment was essential. Facilitators supported older people to identify their own resilience and become motivated to take part in community development and develop their own leadership. (2) Use innovative approaches to value lived experience and dispel ageism: The Foundation wanted to use the idea of a community museum as a way of highlighting the positive aspects of ageing in Whampoa. Older people hold the history of the areas in which they live and often want an opportunity to share and pass on this history to the younger generations. To enable this, the Tsao Foundation trained older people as community curators. The curators have worked with other older people to hold two exhibitions. One was focused on Whampoa as a home and place to live. High school students and students from art schools worked with the older people to develop the exhibition, leading to increased solidarity between generations.
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Do you have any other reflections you would like to share?
Self-care helps improve and extend life: however, it does take time to train older people! Training is provided to group members using the SCOPE programme. This aims to improve the health and wellbeing of older people with relatively good levels of functional ability. SCOPE aims to increase the efficacy of self-care among older people to support the maintenance of health, to control chronic disease and improve functional ability and quality of life. The training is a 16-week programme, with sessions of two hours per week. In three years, 579 group members were trained.