Enabling and Caring for the Elderly in Our Community

Raymond Leong, Christina Tiong

As Singapore's life expectancy increases and its people live longer, we have all become acutely aware of the growing medical needs of the ageing population. Here, we feature two organisations, the Tsao Foundation and Home Nursing Foundation, that have dedicated decades of attention and efforts to improving the quality of life of the seniors in our community, bringing medical care and support to those in need.


Raymond Leong, Tsao Foundation

Nestled within the dynamic landscape of Singapore lies a beacon of support and empowerment for the elderly – the Tsao Foundation. Founded in 1993 and currently led by Dr Mary Ann Tsao, the foundation has been steadfast in its commitment to improving the quality of life of seniors and their families.

More about us

Central to the Tsao Foundation's ethos is a vision of a society where ageing is embraced as a natural and fulfilling phase of life. This vision entails a future where seniors are not only supported in their continuing life journey, but also actively engaged in shaping their own well-being and contributing to the broader community.

Also guided by a multifaceted mission encompassing advocacy, education and comprehensive healthcare services, the Tsao Foundation promotes active ageing. We empower seniors to remain physically, mentally and socially active, challenging stereotypes and combatting ageism to ensure every individual receives rightful support and opportunities as they age.

As life expectancy increases, the foundation continues to evolve its initiatives to address the diverse needs of seniors. I share here some of our key initiatives.

  • ComSA

Serving as the cornerstone of the foundation's efforts, the Community for Successful Ageing (ComSA) project is a conceptual framework that supports a comprehensive array of services tailored to the unique needs of older adults. From preventive healthcare and rehabilitation to social engagement and lifelong learning opportunities, ComSA serves as a vibrant community hub where seniors can thrive and foster meaningful connections.

  • Integrated home and day care services

Recognising the importance of enabling seniors to age gracefully in their own homes, the Tsao Foundation provides integrated home and day care services. Through a dedicated team of multidisciplinary professionals, we deliver personalised care and support to seniors, empowering them to maintain their independence and dignity.

  • Caregiver support and education

Acknowledging the challenges faced by family caregivers, we offer a range of educational programmes, resources and support services for caregivers. We strive to alleviate their burdens and ensure they receive the necessary assistance to fulfil their caregiving roles effectively.

  • Research and advocacy

Through collaborations with academic institutions and governmental bodies, we also actively engage in research and advocacy initiatives aimed at advancing knowledge in the field of ageing and influencing policy at the national level.

The way forward

Through its comprehensive approach to community health, the Tsao Foundation continues to make a significant impact, enriching the lives of seniors and their families across the nation. As Singapore's population continues to age, the work of the Tsao Foundation serves as a testament to the transformative power of compassion, innovation and solidarity in building a more inclusive and equitable society for individuals of all ages.


Christina Tiong, Home Nursing Foundation

Following a Home Nursing Foundation (HNF) nurse on a home visit during my community medicine posting, the sharp smell of ammonia permeated the home of a bedridden patient. Although the infected sacral wound emanated a foul smell, the dedicated nurse did not flinch when dressing it carefully yet confidently. On that day, my olfactory senses imprinted an indelible memory of the needs of the frail and forgotten.

Our purpose and work

Forty-eight years after its founding, HNF still serves the frail and vulnerable in their homes. Medical capabilities have advanced since – our nurses provide multi-layer compression bandage for venous wounds and negative-pressure wound dressings, and are trained in continuous ambulatory peritoneal dialysis, percutaneous endoscopic gastrostomy changes, male catheterisation and 24-hour telephonic support for end-of-life care. HNF now serves close to 5,000 patients island-wide each year. During the COVID-19 pandemic, we had a patient (an amputee) who lived in Pulau Ubin, and our nurse would wait for the once-a-day ferry ride to dress his infected stump wound.

Home-based medical doctors work in tandem to do comprehensive geriatric care plans, unlock insurance and drug subsidies through disability assessments, and conduct acute-on-chronic consultations, empowering patients to live comfortably to the end without unnecessary admissions to the hospital.

Rehabilitation therapists add to the suite of services to support patients in ageing well in the community. These therapists, including occupational therapists, physiotherapists and speech therapists, do home rehabilitation, which is effective for cases of post-hospitalisation functional decline, joint replacements, strokes and returning to oral feeding after enteral feeding.

Healthcare professionals who work in inpatient settings may take simple patient transfers and their activities of daily living for granted, sometimes hurrying the family to bring the patient home or labelling some reluctant families as "social over-stayers". But the stress and adjustment difficulties that caregivers experience are real and often underestimated. An aged spouse, a fatigued unmarried child contemplating becoming a full-time caregiver, a homesick helper – these are all people with critical issues that our social workers handle. Averting suicide or neglect, handling runaway helpers and seeking financial assistance to support "sandwiched" caregivers (those with both young and elderly dependents) are actions just as needful as prescribing standby antibiotics and dressing the persistent wound of a malnourished elderly patient. We work as a team, bringing in volunteers to run errands or take the patients on excursions sponsored by corporate organisations.

Caring for the person within the community

What about our preventive efforts? HNF runs two senior care and community rehabilitation centres, one in Hougang and Buangkok each. These centres provide day care services for patients with dementia or impaired mobility who require supervision and assistance in their daily activities, thus providing meaningful social engagement and functional maintenance to patients and respite to families.

Active ageing centres are new go-to resources where seniors can seek help and support from, whether for their loved ones with dementia, learning a new skill, joining a regular exercise, or having an active social network in a safe and nurturing environment.

To sum up, this is the landscape of community care for the elderly in Singapore, and HNF's mission is to empower our patients and caregivers to live with joy.

Angklung choir at HNF Wellness Club (active ageing centre)

Raymond Leong is currently working as Medical Director in Clinical Affairs at the Tsao Foundation. In this role, he provides strategic healthcare advice, as well as leadership in healthcare operation and policy governance in the organisation.

Christina Tiong Trained in public health, Dr Tiong's career spanned from geriatrics, primary care, surgery, emergency medicine, to management roles in policy and planning, hospital operations, clinical innovations, hospital infrastructure and healthcare information technology implementation. She endeavours to build a vibrant home healthcare charity that empowers patients to age well and live joyfully in the community.

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