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.
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.
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.
HOW WE DID IT
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.”
Over the course of the project, we gathered 10 diverse stories about how households 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.
ThinkPlace's 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.
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."