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Work

Elderly person's hands

A human-centred approach to long term care for an ageing population

Like many urban centres in the developed world, Singapore faces a rapidly ageing population. In 2015, one in 10 Singaporeans was aged 65 and older. By 2030, that number is projected to rise to one in five. That poses challenges around how to provide quality long-term care services for an increasing number of older people who can be expected to experience multiple and chronic medical conditions and disabilities over their lifetimes.
Client
Singapore Ministry of Health
Service
Service design
Sector
Health
Project Team
Calvin Tan Kai En's profile'
Chia Yan Wei's profile'
Topics
stakeholder engagement
Singaporean people eat at a restaurant

To meet the needs of this ageing population, the Singapore Government has offered a number of schemes to make long-term care for older people more affordable, most notably ElderShield.

But, with these demographic challenges looming larger, the Government decided to explore how Singaporeans might best manage the costs of long-term care in old age.

ThinkPlace worked with the Ministry of Health as part of the ElderShield review, which ultimately reviewed, reshaped and rebranded the scheme – resulting in the recently launched CareShield. We took a human-centred approach, putting people and their families – and the carers, clinicians and allied medical professionals who support them – at the heart of the design process.

people wait for a bus

This meant exploring the views and experiences of 10 Singapore families – some of whom were already navigating long-term care for themselves or a loved one, and others for whom it remained a distant possibility. Using an ethnographic approach, we spent time with all 10 families in their homes to learn more about their lives, their caring experiences and their plans for ageing. This depth of insight allowed us to not only share insights with the review committee about the experience of families currently caring for a loved one and accessing ElderShield, but also to put into perspective the many competing priorities for financial and emotional attention that families face in Singapore today.

“We are very proud to have been a part of the ElderShield review journey,” says Erin McAuliffe, who led the project.

‘’We heard so many powerful stories in our research, both from Singapore families currently needing long-term care for their loved ones and from those too busy juggling the demands of today to think about and prepare for the future.

The experience caused many of us at ThinkPlace to start thinking about how prepared we and our families are for long-term care as we age.”

The resulting work will have a significant impact on the lives of generations of Singaporeans. The new CareShield Life scheme will be a significant improvement over the previous ElderShield policy, in part because it offers lifetime payouts to policyholders suffering from disabilities, said ElderShield Review Committee Chairman, Chaly Mah.

“Based on the statistics we’re seeing, in the future, as many as three in 10 of those who suffer disabilities may live longer than 10 years,” he said. “So, if you think about it, if you are disabled and you live for a long time, a lifetime payout is indeed a very significant assurance."

The Value Delivered

Over the course of the project, we gathered 10 diverse stories about how households plan, prepare for, finance and manage long-term care. 

These stories helped the project team to generate insights into how Singaporeans perceive disability and long-term care, how and why they plan for it, and how they view and engage with the broader aged care system. 

The insights were complemented by rich personas, helping the client and the review committee to better understand the experience, attitude, planning behaviours, barriers and needs of different users and their families towards long-term care, and the influence of different individual personas within family contexts. The report also identified opportunities to shift user behaviour to more proactively engage with planning and preparing for long-term care in old age.

The research was a key input into the ElderShield review process, and the findings were adopted by the review committee in their recommendations to government. This included the sufficiency and price anchoring of payments, the branding of the scheme to enhance its relevance to younger Singaporeans, and the role of government in administering premiums and claims.

HOW WE HELPED

The intent of the project was to understand how Singaporean families plan and prepare for the cost of long-term care in old age. The ethnographic research was commissioned as part of a government review of the ElderShield scheme.

The research was conducted through in-depth semi-structured interviews with 10 households in their home environments. The participants were diverse, representing different experiential (e.g. experience with ElderShield and long-term care), socioeconomic and demographic profiles (e.g. age, race, household composition).

ThinkPlace engaged with members of the family separately and jointly to understand their personal experiences with the health system, family experiences with care and ageing, their own attitudes towards ageing, appetite for risk and propensity to plan.

We used cultural probes and network mapping to elicit stories and better understand people’s experiences, attitudes and needs. As the interviews were conducted in people’s homes, we complemented the semi-structured interviews with observation, including key artefacts like medical and financial documents and resources.