A search of police news releases by CNA TODAY found that for people who had died in nursing homes and welfare homes in 2024, there were at least 14 reported cases of appeals for their next of kin.
In 2023, the Ministry of Health said that about 83,000 seniors will live alone by 2030.
National programmes such as Age Well SG support seniors “ageing-in-place” – encouraging them to grow old in their homes and communities – but what happens to those who cannot lean on anyone because they do not have family or friends?
With the support of grants, donations and volunteers, nursing homes provide long-term medical care for seniors with chronic illnesses or disabilities who need daily assistance.
Then there are the welfare homes overseen by the Ministry of Social and Family Development (MSF), which cater to destitute individuals who are generally more mobile and independent but lack the means or family support to live on their own.
As of February this year, around 1,500 people reside in these homes, with 60 per cent of these aged 60 and above, MSF told CNA TODAY.
The reasons why these people with no next of kin end up in long-term residential care can vary, as do their levels of grief, loneliness and acceptance of their circumstances.
Yet, for many seniors who first entered these eldercare facilities fearing isolation and abandonment, there is a sense of belonging and companionship still to be found in their twilight years.
Speaking to CNA TODAY, they told of how, despite initial apprehension about easing into life at these facilities, they eventually grew to appreciate the companionship of staff members, volunteers, as well as fellow residents who also understand the fear of growing old alone.
Residential homes, too, go beyond just providing care and strive to create a lively atmosphere with activities that encourage social interaction and outings that keep residents connected to their past.
“It can’t be helped that I’m staying in a nursing home – I can’t walk,” Mr Lee said in Mandarin.
“But I’ve come here and it’s good. There’s someone to take care of me. I can play mahjong, go outside and I have friends here.”
RESIDENTIAL CARE IS THE ONLY OPTION FOR SOME
Mr Zack (not his real name), 70, who is single, has been a resident at MWS Christalite Methodist Home operated by Methodist Welfare Services since 2020. Due to the sensitive circumstances of their admission and stay, the welfare home cannot disclose residents’ identities.
After a few stints of being imprisoned for drug and theft offences, Mr Zack sought shelter in public places because he did not want to burden his family.
Over the years, he lost contact with his surviving relatives and relied on his limited savings.
“Here, food and basic necessities are all prepared for me,” he said in Malay. “Back then, I had to go around to find (food) myself.”
Mr Zack is one of many seniors living in Singapore’s 11 welfare homes, which are run by social service agencies to provide care for destitute persons.
MSF said that an individual may be admitted into a welfare home under the Destitute Persons Act for “social investigation”.
The ministry added: “The social investigation seeks to establish that the individual meets the definition of destitute persons under the Act, that is, an individual who has no visible means of subsistence or place of residence or is unable to give a satisfactory account of himself or herself.”
Because of these criteria, many ageing residents in these homes are those without caregivers or next of kin to support them, making long-term residential care their best or only option.
Associate Professor Helen Ko from the Singapore University of Social Sciences (SUSS) said that with the rise of dual-income-no-kids households and the “beanpole” family structure, where each generation has fewer children, the number of seniors in such circumstances is sure to rise.
Since a number of the elders are from lower-income families, or are frail and have limited social support, they are also more likely to be reliant on institutional care, Assoc Prof Ko added. She oversees the university’s master’s and doctorate programmes on gerontology, which is the study of old age and the chnages it causes the body.
Speaking to CNA TODAY, 77-year-old Ah Tan, who has been staying at MWS Christalite Methodist Home for 17 years, recounted how he was found rough sleeping in the Tekka area in Little India after his brother, with whom he was sharing a flat, had died.
“My brother, my sister, my mother … they have all gone, so I’m alone,” Ah Tan, a double amputee, said in a choked voice.
Methodist Welfare Services said the common circumstances that have led the residents to stay in the welfare home include the lack of finances, long-term prison sentences or admission to the Institute of Mental Health (IMH), which eventually result in a loss of accommodation.
Many of them, such as Ah Tan, receive direct counselling and attend social activities during their stay, to manage the “complex psycho-emotional challenges” they face.
“For this group of individuals who are so rarely seen in public, it’s possible that many Singaporeans either do not know of their existence or have misperceptions about them,” its representative said..
Mr Richard Quah, chief executive officer of St John’s Home for Elderly Persons, said that about 8 per cent to 10 per cent of the residents there have no contact with their families.
“This may arise from various situations, including disagreements, communication breakdowns, life transitions or the differences related to caregiving responsibilities,” he added.
Nursing and welfare homes said that many of these elders lacking family support also come from lower-income backgrounds, previously living alone in one- or two-room rental flats, and they have significant health conditions.
Ms Tho Pei Leng, a senior medical social worker at social enterprise NTUC Health, said that some of these individuals have experienced past family conflicts, including physical abuse, absentee parenting, or issues related to gambling and money lending.
As for who foots the bill for these seniors with no next of kin, Ms Bridget Monica Das, head of psychosocial services at Ren Ci Hospital, said that some seniors may lack family connections but are able to pay their own bills.
For seniors without the financial ability, however, the nursing home taps government subsidies, money from charities and MediFund, a government endowment fund that helps needy Singaporeans who cannot pay their medical bills.
