At ACCESS Health International, we like to feature good examples of community and elder care. A recent visit to the South Central Community Family Service Center in Singapore reveals a thriving space where different generations of neighbors visit, work, and play with one another.
The South Central Community Family Service Center is just one of many other Family Service Centers in Singapore. Family Service Centers are an important part of the “Many Helping Hands” approach of the Singapore government toward social services. The Many Helping Hands approach emphasizes the involvement of multiple sectors in providing for the social welfare needs of people. Family Service Centers are run by Voluntary Welfare Organizations and are supported by the Ministry of Social and Family Development, the National Council of Social Services, Community Chest, or the Singapore Totalisator Board . This is one way the government supports and encourages care provision by nongovernmental entities.
The South Central Community Family Service Center is unique in one respect. In January 2013, the Center became an independent entity with its own board of directors. The mission of South Central Community Family Service Center remains the same: to promote the wellbeing and self reliance of families. The main focus is supporting lower income individuals and families in the Bukit Ho Swee, Henderson, Redhill, and Indus Road neighborhoods. Between 2013 and 2014, the Center managed an average of four hundred cases. Casework involves counseling or referral to specialized services. For example, children from families lacking in basic necessities may face challenges in schoolwork or dealing with classmates. Center staff can counsel children or their parents on managing these problems. Where necessary, families are referred to other services, such as specialized psychiatric help or financial aid.
Besides casework, another focus of the Center is community engagement. To this end, Center staff organize events to involve nearby residents and create community spirit. As the Center is located on the ground floor of a block of residential flats, it is accessible and open to residents in the neighborhood. Our visit took place during the Lunar New Year period. As seen in the photo, festive decorations lining the entrance created a welcoming and friendly atmosphere.
Outreach worker Erwin showed us around the Center. Erwin explained to us that a guiding principle for the Center and staff is community cooperation and participation. This principle is informed by the Asset Based Community Development approach to community work. This approach ensures sustainability because initiatives are driven by the residents themselves. Residents volunteer to help care for their neighbors’ elderly relatives or children. Residents worked together to plant a community garden full of useful medicinal herbs.
The Center is a collaborative environment. The community garden is a visible fruit of this collaborative environment. The garden had been an empty space in front of the Center. Center staff wanted to galvanize residents to work on a common project. Residents contributed ideas and voted for the winning project: a medicinal herb and vegetable garden. Because the idea came from residents, the garden has been adopted and cared for by residents.
In the picture above, one can see a board where residents can vote on the next plant type. At the time of visit, sweet potato leaf was the leading candidate. The board itself was constructed by hand by a resident who is a carpenter by trade.
Inside the Center hangs another board, where residents can request items or services they need, or post offers of items or services they can give. The platform helps match community resources to people who need them most.
Residents streamed in and out of the Center throughout our visit. Erwin pointed out a pair of young siblings playing games on the couch. Erwin told me the siblings come to the Center after school ends to wait for their parents to get off work. I also saw groups of elderly chatting with one another at tables and chairs. The open space created by the South Central Community Family Service Center helps with informal child and elder care as residents look out for and engage with one another.
Near the end of our visit, there was a briefing for a large group of about twenty five volunteers, both young and old. They were preparing to give out yusheng packs to shop owners and residents at the Lengkok Bahru neighborhood. This showcased lower income families and children as goodwill ambassadors as part of this “Lo Hei Outreach”. The yusheng salad is traditionally eaten during the Lunar New Year, and Lo Hei is the dialect term for tossing the salad. Family and friends gather to Lo Hei together, signifying prosperity and togetherness. The briefing was punchy and positive with the staff recognizing the contributions of volunteers.
The South Central Community Family Service Center is an example of successful informal community and elder care. The staff and volunteers have created an open venue where residents are encouraged to join community activities and contribute their talents. Can their model of community involvement and ownership be replicated elsewhere? For example, could elder care as a larger industry move toward being more community based and operated? Share your thoughts with us by leaving a comment.
1. The Singapore Totalisator Board, also known as Tote Board, manages the surplus funds generated by Singapore Turf Club and Singapore Pools. They channel funds in support of various causes in Singapore such as arts and culture, social services, community development, education, health, and sports.
This post is the first in a series of articles focused on design thinking and aging. In future posts, we will explore the use of personas in designing solutions for seniors. We will also address problems identified by seniors themselves.
Last week, the ACCESS Health Singapore team attended a DesignSingapore forum titled Rethinking Health and Wellness for the Elderly. Among the fresh perspectives and opinions shared at the forum, one point really stood out to us: Often, designers who design products for seniors view seniors as isolated individuals. In reality, the elderly live and interact with others in their families and communities, such as family members and health professionals. They engage others in their external environment multiple times throughout the day: when getting coffee, seeing their neighborhood doctor, seeing specialists at hospitals, visiting community centers, going to the supermarket, and even through online sites and discussion boards. Behind these interactions, or touchpoints, lie many higher level entities that share an active interest in the wellbeing of the elderly, such as ministries or charities.
This learning point came from applying design thinking and ethnography to aging. One principle of design thinking is that all design activity is social in nature. Ethnography aims to explore social phenomena from the point of view of the subject, in this case seniors. At the forum, videos were shown of interviews with various seniors and their caregivers. These seniors and caregivers were asked what challenges they faced in daily living. Beyond these answers, researchers also followed the seniors on their daily activities, like cooking and exercising, in true ethnographic fashion.
In one clip, a frail senior was shown cooking for himself. His legs are weak so he sits on his wheelchair at the stove. But this position is often low and awkward. Upgrading to an adjustable height chair could make cooking easier for him.
One woman interviewed in the video had left her job to care for her father full time. Even while providing fulltime care, she said, there are moments when she cannot be there, physically, to catch her father if he falls. Such personal examples peppered the forum, turning abstract issues into real and moving stories.
When we think of the people, places, and organizations seniors interact with, many opportunities come to light. One senior featured in the video had lost his leg to amputation due to diabetes. After being fitted with a prosthetic, he still found it tiring to navigate his neighborhood. He told the interviewers that he was truly glad to receive a motorized personal vehicle from a welfare organization. Some limitations remain. Narrow corridors and places without ramps are inaccessible to him. However, he is now able to take public trains and go shopping, everyday tasks that would have been nearly impossible before. The motorized vehicle has improved his quality of life. In this case, an organization found a solution that has allowed this senior to engage more with the people and places around him.
Engaging ethnography and design thinking for the elderly may seem unconventional. But some researchers acknowledge the benefit of taking into account social and environmental aspects of aging. A recent BMJ article reviewed existing ideas and concepts of Successful aging refers here to physical, mental, and social wellbeing in older age. The authors found that traditional conceptions of successful aging focused largely on individual bodily health. For example, the Activities of Daily Living scale tests a senior’s ability to complete a basket of self care tasks. These tasks include feeding, toileting, and grooming.
The authors found in their review that psychosocial and external factors are important to successful aging too. Yet, the authors found that these factors are underrepresented in traditional models of successful aging. For example, the Activities of Daily Living scale does not measure social activities such as holding a conversation or enjoying a sport outdoors. The authors wrote, “[Successful aging] is clearly not simply a physiological construct, so it seems intuitive that psychosocial components should be included in otherwise biomedical models of [successful aging].” The authors concluded that conventional models for aging can benefit from including social and external components of seniors’ lives.
Design thinking and ethnography can be applied at all levels of the ecosystem surrounding seniors. Consider seniors, the people they interact with, the people and places they engage with, and the organizations that help support them. Imagine a senior living out a typical day in this environment. What gaps and opportunities do you see? Are there any potential collaborations between organizations? We feel these added perspectives will help craft more targeted, efficient products and solutions to help seniors.
Today’s blog post is written by Kristina Saudargaite who is the founder of inBelly. This organization is already helping children at schools to have better food by identifying and classifying additives. Now, inBelly wants to branch out to another sensitive target group, the elderly. Read Kristina’s story here:
My name is Kristina Saudergaite and I love food. I love eating, cooking, going to the grocery store etc. I also love knowing what I eat. For this purpose, my friends and I once looked at the ingredient list. We saw many chemical names that we could not understand or tell how they affect our health. Thus, we checked.
The results shocked us! Commonly used E250 is classified by the International Agency for Research on Cancer as probably carcinogenic to humans or in simple words it is likely to cause cancer. E211 or sodium benzoate is not harmful on its own; however, it reacts with vitamin C and releases benzene – a known toxin. And who does not eat products often containing E211 such as shrimps together with a slice of lemon or maybe drinking Must with a salad
These are only a few examples; but food is increasingly stuffed with chemicals and this puts our health at risk.
The amounts of additives that may cause adverse effects are regulated by the EU. The problem lies in the fact that tests are made on healthy individuals (or animals). However, sensitive subgroups such as the elderly may be much more susceptive to the additives and adverse health effects related to them. Nursing homes do not have enough information to make sure that the food they buy do not contain harmful ingredients.
inBelly has the expertise and a rigorous database on food additives. Moreover, we have a technological solution that enables to quickly check if a product contains anything harmful.
In Sweden we have found many food products containing additives banned in other countries, such as Canada and/or linked to diseases. This knowledge exists in academia and in public documents but since the information is presented in a complicated and scattered manner, it rarely reaches the wider public. inBelly is unique since it uses official and scientific information about food additives and depicts it in a non-scientific “easy-to-understand” kind of way. The app simply shows a sign indicating that the scanned product contains additives banned in other countries. Our service innovation lies in using a mobile solution to translate knowledge from academia into simple visual signs in order to make the information quickly and easily available to everyone. With our mobile app people can scan barcodes and get information whether this particular product contains any ingredients that may be linked to diseases. The initiative won the Stockholm Innovation award in the service category 2012.
We are currently using this knowledge to help pre-schools to choose better food. We are cooperating with the chef at Globala Gymnasium to go through the products they purchase and analyse if any of them contain additives that may be harmful. This helps the institutions to ensure better food.
Since the elderly, similarly to children, is a sensitive group, we plan to offer our services to help nursing homes to go through the food they serve the elderly and check if they contain harmful additives. This would ensure good quality food and best possible health and wellbeing for the elderly.
Follow inBelly on facebook.com/inBelly or on Twitter @inbelly_guide
This week’s Modern Aging blog post comes from an American medical illustrator with a passion to improve health communication for elderly through visual media. Please read about the digital tool she is developing:
“I am excited to share with you an idea I have been developing as a social innovation for the elderly in health care. Today I will tell you about myself, and why I am considering the health needs of the elderly in Sweden. I will introduce the problem needing attention and how I propose to tackle it. Finally, I will let you know how you can connect with me if you would like to be part of this dialogue!
So who am I, and what brought me to Sweden? Well, my name is Anneliese, and I am an American citizen with Swedish heritage from both sides of my family. In 2010 I traveled to the “motherland” to see where my farmor, and my mormors parents came from. While visiting, I bonded with new friends and distant relatives, but visiting with relatives from my grandparent’s generation over fika was particularly special for me. During that trip I decided I wanted to come back to Sweden to study and experience more of Swedish society.
While back in the US making plans to return to Sweden, I was witness to the failing health and death of my mormor, Anna, and morfar, Winston. Winston lost his life, at 93 years of age, as a result of Alzheimer’s. While Anna, who suffered from morbidities common in the elderly, died only a few months after at 91 years. These experiences with my own family helped me to realize many of the challenges facing our aging global population. Now, I look to apply my education, work experience and research to help address these challenges.
My recent research has focused on the communications between patients and their care providers. The clinical setting can present many communication barriers, including a power dynamic between the patient, with limited knowledge, and the care provider, with greater knowledge. For the elderly, dementia, learning style, literacy and language skills can also contribute to communication barriers they face when determining their health needs. Further, many elderly patients have an increased number of health appointments where they might struggle to remember what to ask their care provider, or may not be aware of the proper questions to ask. Additionally, they will need to remember details communicated to them after an appointment. If not recorded, these details can be easily forgotten. My solution is simple, “Ask for Answers.”
Ask for Answers is a media based tool (web/app), which aims to arm the aging population with the questions they should have available when visiting a health provider. The questions target their specific communication needs and are broken down by medical specialties to be more effective. Patients can use the electronic interface to access their questions, type answers, exchange email with the provider, record audio of answers – which can then be transcribed, and even take photos of drawings or notes. The information would then be accessible later when the patient may have trouble recalling details from the appointment, or need to share them with another care provider.
Ask for Answers is centered on improving health communications between care providers and the elderly. It is a simple, user-friendly tool that focuses on enabling and empowering aging patients to better manage their health. With the aid of Ask for Answers, patient knowledge and satisfaction may increase, potentially resulting in improved health outcomes.”
Written by Anneliese Lilienthal
Our most loyal readers on Silverevolution may remember the program Modern Aging that we wrote about in April (see the post HERE). This innovation program for young entrepreneurs with ideas for the elderly kicked off in August this year. A group of 7 entrepreneurs have been selected based on the potential of their improvement idea as well as their motivation to lead the way in transforming the elderly care sector. We are currently in the act of developing their ideas with the help of mentors and coaches and in close discussion with the elderly themselves. During the next couple of weeks the participants will blog about their ideas on the Forum for Social Innovation Sweden and we will post them here on Silverevolution as well.
First in line; introducing himself and his idea is Victor Nordlind. This is his story:
One may ask why a person who is attending one of the world’s top hotel schools would want to pursue a career in developing and improving the elderly care. Most people expected me to walk in my father’s footsteps in the restaurant industry, rather than radically changing field to Elderly care.
But as I was required to carry out a feasibility study about an existing retirement home during my first two years at Ecole Hôtelière de Lausanne (EHL), I was given the opportunity to see the true potential within this industry. It encouraged me to apply for an internship within elderly care, which I am currently pursuing within Strategy and Business Development at Ambea Sverige, whose affiliation is Carema Care. For me, elderly care is an industry where innovation is necessary in order to provide the correct quality of life, which in my opinion is the meaning of hospitality.
When I first came across the Modern Aging program, I did not have a specific idea for elderly in mind. When developing the idea, it was equally important to link the project back to my studies, as to work with something that may truly make a difference within the elderly sector. I decided to contact a friend who has several years of experience within elderly care, and who is currently working in a nursing home here in Sweden. I was convinced that my determination combined with her extensive experience would bring something innovative out of the meeting.
As expected, we had a very interesting discussion, which brought several ideas to the table. Most of them were linked to the use of more technology, which is a frequently debated topic when talking about improvements within elderly care. The trend of using technology to improve efficiency is relatively new in the industry while it has been an essential part of the hotel and restaurant industry for years. More and more apps and other technical devices are being developed to simplify everyday activities for the elderly.
However, one question that came up during the meeting was “how can we use technology to better involve the caregivers within elderly care?” These professionals have valuable knowledge and experience, which they should be able to share easily. With today’s progression of social media and online forums, a place for caregivers and other health care professionals to meet online should be developed. There, they may share ideas, knowledge and ask questions to one another over space and time. This will not only simplify and streamline the daily work, but it will also improve the quality of care in nursing homes in the long run. A forum like this needs to be strictly confidential with only registered users permitted access. The idea is also that this platform shall be the forum that compiles and disseminates knowledge of the latest advances in medical, social and technological solutions for the elderly.
My current internship at Ambea combined with the Modern Aging program has helped me to better understand the current market as well as the future prospects of elderly care in Sweden. To date, Modern Aging has hosted several seminars and workshops carried out by inspiring guest speakers from various fields, such as young entrepreneurs, lecturers from top universities, and professionals from the public health care sector. With this promising start, I am curious and eager to find out where the program is going to take us.
EU-funded unique international project aimed at providing safer and healthier aging is led by researchers at Örebro University (Sweden) in collaboration with twelve partners from six countries Sweden, Italy, Spain, Portugal, UK and Slovenia. The unique feature of the project is that it will provide seniors with smart home system combining both long-term health evaluation and caregiver-user interaction.
The project is called “Giraff” and received its name after remotely controlled mobile robot “Giraff” equipped with a display and loudspeaker. This robot lays in the heart of the smart home system in combination with continuous monitoring through a network of sensors.
Multiple sensors are installed in the apartment and can measure blood pressure, body temperature and register movements. Data from the sensors will enable to identify if someone takes a sudden fall or doesn’t move for unusually long time, analyze sleeping pattern and level of physical activity, which can be of particular importance for physiotherapists. All the data collected from sensors are analyzed by an intelligent system, which is able to quickly alert the caregiver if something goes wrong and to conduct long-term health assessment of the seniors, thus giving caregivers a tool to adapt care plan to guarantee better quality of life.
Robot “Giraff” is designed for conducting virtual visits based on users need or on caregiver’s and family member’s intention to talk to the senior about his/her health measurements. “Giraff” can move autonomously around the apartment, find where senior is located or follow the senior around the apartment during “virtual” physician visit. In future, it will be senior’s decision on whether to use “Giraff” to have a virtual meeting with caregiver or make a journey to the healthcare center instead.
When it comes to privacy of health data, it will be only user who can allow access to health information for concerned family members or other caregivers. This will contribute to creating a user-friendly environment, where seniors will understand that they can receive an opportunity to improve their quality of life while feeling secure about privacy of their data.
The project has come to a testing phase in 15 real homes in Sweden, Italy and Spain. Last news tells about system installation in the homes of elderly women living alone in Malaga (Spain) and in Örebro (Sweden).
It is inspiring to see how modern digital technology can improve quality of life for elderly people! Stay tuned for future blog posts on digital technology for elderly care.
Picture taken from: