Determinants of long-term care needs of community-dwelling older people in Singapore
Aging and urbanization are critical challenges confronting developed cities. Singapore initiated a national project to develop urban solutions for aging, including integration of health and social services within the built environment. Frail older people often have complex, long-term care (LTC) needs and experience frequent rehospitalizations. Community care needs assessments identify needs and service gaps not previously known to health professionals. Meeting these needs through effective care coordination and interventions can prevent complications and hospitalizations. In community-dwelling older people, self-reported perception of health or problems meeting basic needs has been shown to predict morbidity, mortality, physical functioning, and depressive symptom. Although studies have assessed the LTC needs of community-dwelling older people, there is limited information on the determinants of these needs.
Approximately 80% of Singapore's residents live in public housing. Such housing is built based on a town planning concept, in which entire towns are built from scratch in locations nationwide. Towns are compact and contiguous, with community services nearby. Marine Parade town has 20% of public housing residents aged 65 and older, compared with the 10% national average. It is a naturally occurring “aged” microcosm of what other precincts will become in 15 years’ time. To better inform planning of community services, the determinants of self-reported care needs of older residents in Marine Parade were studied.