The Handbook On Successful Ageiing

The
Handbook on
Successful
Ageing
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G9.10424 TSAO AR 08.indd b 24/09/2008 11:07 AM
The
Handbook on
Successful
Ageing
Tsao Foundation
Annual Report 2008
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First Edition
Copyright 2009
TSAO FOUNDATION
298 Tiong Bahru Road
#15-01/06 Central Plaza
Singapore 168730
Tel: 6593 9500

Fax: 6276 7128
Email: tsao1@tsaofoundation.org
www.tsaofoundation.org
Concept and Design by Epigram

Illustrations by Stephanie Wong and Michelle Wan
Printing by Saik Wah Press
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Wrinkles should merely indicate
where smiles have been.
Mark Twain
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CONTENTS
1 Introduction
5 Health & Healthcare

7 How to Take Charge of Your Healthcare
9 How to Choose Your Primary Care Doctor
13 How to Avoid Serious Illness
20 How to Manage Your Medications
23 How to Deal With Sleep Problems
28 How to Deal With Chronic Pain
29 How to Get Started on Exercise
31 How to Exercise Safely
35 How to Effectively Use Traditional Chinese Medicine
40 How to Cope With Menopause
47 Frail Care
49 How to Care For the Frail Older Person
58 How to Prevent Falls
61 How to Engage Seniors to Plan For Future Care
63 How to Recognise Depression in Seniors
64 How to Recognise Dementia
66 How to Prepare For Caregiving Role
71 How to Get Help on Community Support Services
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79 Social Well-Being
81 How to Live Positively
82 How to Manage Stress
83 How to Cope With Loss
87 How to Manage Your Emotions
89 How to Stay Engaged With Life
91 Financial Security
93 How to be Financially Independent in Your Old Age
99 How to Budget For the Future
101 How to Save For Emergencies
102 How to Build a Financial Safety Net
104 How to Invest Your Money
106 How to Plan Your Estate
108 How to Live Longer and Healthier
111 How to Plan For Your Work-Life After Retirement
117 Corporate Information

118 How We Carried Out Our Mission in 2008
122 How We Started
124 How We Operate
125 How Our Board of Directors is Composed
126 How We Managed Financially
128 How to Contact Us
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The Handbook on Successful Ageing
INTRODUCTION
The year 2008 saw the Tsao Foundation continue its work in the area
of improving the ability of our ageing population to master self-care as
well as providing them with the ability to access the most appropriate
and affordable health services. This will enable them to maintain optimal
wellness and health regardless of their level of frailty.
It was also an exciting year of active preparation for Tsao Foundation

and for the people we serve. The move in October to our new premises
at Central Plaza in Tiong Bahru was not merely physical. It was the
culmination of 17 years of planning and hard work to deliver on our
master plan to create a new, comprehensive, and integrated service
model. The aims are to promote and support a self-care driven model of
active ageing over the life course starting from 40+, and provide a range
of essential community services for ageing in place. We are now better
able to fully carry out our service mantra of being person-centric in a more
seamless manner. From a preventive, health promotion, chronic disease
management, long-term care and end-of-life perspective, we would be in
a better position to provide what a person needs the right services, at
the right time, and in a holistic way.
Our goal is to prepare people to age well, regardless of life stage, health
status or physical ability. Ageing well also means being supported during
their journey to self-mastery, making the most of their physical, mental
and emotional health, and making choices about how they want to live. To
this end, we tightened our alignment with the World Health Organizations
Three Pillars of Active Ageing, and brought the following significant
initiatives to fruition in 2008.
Pillar I: Income Security

We launched the Citi-Tsao Foundation Financial Education Programme for
Mature Women in April to reach out to women from the lower income
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Tsao Foundation Annual Report 2008
bracket, and who are between 40 and 60 years old. It equips women
with basic money management skills, empowers them to navigate
financial systems and negotiate their financial needs, and helps them
to take better charge of their own financial security as they grow older.
The programme, with over 20 weekly sessions covers two major areas:
personal finance and social empowerment. It also encourages the wider
community to be more aware of, and responsive to, issues affecting the
financial and social security of economically disadvantaged women.
Pillar II: Health/Healthcare

In November, we invited eminent geriatrician and primary care specialist
Dr Harrison Bloom to deliver a keynote lecture at the Tsao Foundation
Professional Forum on Challenges of an Ageing Population the
Primary Care Perspective. Dr Bloom is the Director of Clinical Education
Consultation Service at the International Longevity Centre in the US. He has
also trained 500 doctors and healthcare professionals in Singapore on various
aspects of primary care for elders, such as age appropriate health promotion,
health screening, chronic pain assessment and management. He also
participated in roundtable discussions with government agencies on topics
such as support for general practitioners as primary care providers, geriatric
research and long-term care.
Pillar III: Participation

In November, we also officially launched the Voices of Older People
Programme to engage seniors and promote their active participation in
the wider community in particular, their contribution to the process
of formulating and implementing national policies that affect their well
being. As part of the launch, we submitted a report to the government
representing the seniors collective voice that was based on findings
from discussions with elderly Singaporeans on what the countrys
housing policy has to take into consideration when catering to their
needs and desire to age in place. To date, we have carried out focus
group discussions with more than 750 older people, and we are in
the process of identifying at least 45 older people to develop their
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leadership capability so that they can effectively engage their peers in

the community.
The year also saw a milestone for our Hua Mei Training Academy in its
appointment as a Continuing Education and Training (CET) Centre for the
Workforce Development Agencys Workforce Skills Qualification (WDA
WSQ) Programme, and the successful launch of its first Certificate in
Community and Social Services training programme in June. We are
proud to note that 70% of our certified graduands have already embarked
on their careers in the aged-care sector.
Beyond these efforts, the Foundation will continue to provide an integrated

and comprehensive service to improve older Singaporeans well-being
and ability for self care through effective education programmes which
can result in positive, sustainable behaviour change in health and health-
seeking attitudes, financial preparation and social engagement.
We will be busier in 2009 and 2010, as we streamline our care and

counselling services, strengthen our role as capacity builder, and
collaborate with others for research and trend analysis to plan for the
needs of future cohorts of seniors. We are also looking forward to
building on our Living Room concept, which incorporates an adult day
health centre for high-risk seniors with significant chronic diseases and
frailty. It is a place they can consider as their home away from home and
participate in programmes for their personal development while receiving
necessary medical care and social support.
Finally, this years Annual Report is crafted in the form of a Handbook on

Successful Ageing, replete with practical tips on how to age successfully
and meaningfully. It represents yet another instalment in achieving our
vision of fostering a society that supports active ageing, values the
contribution of older people and provides for successful, secure old age.
Dr Mary Ann Tsao

President, Tsao Foundation
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1
Health & Healthcare
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Hua Mei Seniors Clinic

An Age Friendly Clinic
The clinic is a pilot site for the World Health Organizations
Age Friendly Primary Health Care Project to implement key
recommendations in three main areas:
Improving the attitudes, education and training of healthcare

providers so that they can assess and treat conditions that
afflict older persons and empower them to stay healthy.
Adapting primary healthcare management systems to the

needs of older persons.
Making physical access easier for older persons who may have
mobility, vision or hearing impairments.
Our Approach
Promote and support ageing in place by addressing both the
health and social care needs of patients and their families.
Shift from an episodic care model to a proactive, care

management model to optimise health outcomes.
Strengthen the preventive aspect of primary care through

age appropriate health promotion, prevention and early
detection of diseases well as patient education through the
life course.
Practise a patient-centred approach to care with emphasis on

patients ability to master their own self-care.
Exercise tight control and management of chronic diseases

to avoid complications and disability.
Prepare patients and their families for advance care

planning and end-of-life issues.
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HOW TO TAKE
CHARGE OF YOUR
HEALTHCARE
Good health is something we all aspire to, but a robust,

healthy and disability-free life especially in old age
requires active management on your part, starting from
young and throughout your life, to make it happen.
The leading causes of disease, disability and death (such as

high blood pressure, diabetes, heart and lung diseases, stroke
and common cancers) are preventable or manageable through
a lifestyle that includes a healthy diet, regular exercise, not
smoking and managing your stress. You would have to have
the knowledge and desire to make lasting changes to optimise
your lifestyle by knowing your health risks (a combination of
your age, sex, family history, own health history and lifestyle
behaviour) as well as what to do about it.
You also need a good health partner to guide you in all

domains in health, ranging from:
Health promotion through knowing and doing what is

necessary to achieve the best possible health and state
of well being.
Disease prevention and early detection of disease

through appropriate immunisations and appropriate
health screening that fits your personal risk profile.
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Appointments
clearly marked
out on calendars
Regular health screening helps to maintain your

health and identify problems early.
Chronic disease management when chronic diseases

(such as diabetes) do occur, what are the medical and
lifestyle actions that are necessary to keep good control
of these chronic diseases and avoid disabling and often
irreversible consequences, such as strokes.
Long-term care once complex diseases and complications

arise (e.g., diabetes leading to heart disease, stroke and
kidney failure with disability, inability to care for oneself,
and need for day to day care), how do you prevent further
complications, find the necessary support services in the
community, and help your families cope.
End of life care how to plan for and have a good death.
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HOW TO CHOOSE
YOUR PRIMARY
CARE DOCTOR
Finding a good doctor a partner, guide and healer that you

trust and can rely on to walk your lifes health journey with
is essential. Medical care is getting increasingly complicated
and sub-specialised. Multiple appointment visits to see
different specialists and healthcare professionals address
only specific issues, can be costly, time-consuming and cause
confusion with medications. This is particularly true for the
older person, who is likely to have multiple health problems.
Most people do not understand the important role of the

primary care doctor, a specialist trained to work in the
frontline and who is able to see the patient as a whole and
in the context of his family, community and environment.
A good primary care doctor is able to provide the following:
First stop for all the patients health needs.
Patient-centred care with the patients best interest in

mind and who has a strong emphasis on nurturing the
doctor-patient relationship.
Continuity of care versus only episodic care.
Comprehensive care from health promotion,

screening, acute care, chronic disease management
and long-term care issues.
Holistic approach in managing the social and

psychological aspects of care.
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Who Did We Help

In 2008, Hua Mei Seniors Clinic helped at least 2,318
seniors. We found that most of our patients had more than
one chronic illness. The common ones were hypertension,
diabetes, hyperlipidaemia, ischaemic heart disease, stroke and
degenerative joint diseases. More women than men sought
our services, the majority of whom were between 50 and 74
years old. Most were independent in self-care, while two or
three out of 10 patients required assistance (these patients
tended to have caregivers).
We also saw an increasing number of patients with common

geriatric conditions such as falls, urinary incontinence,
depression, dementia and polypharmacy.
The majority of our patients come to us by word of mouth.

About 10% are referred by specialist clinics in hospitals.
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Co-ordination of specialist care and communication

with other healthcare providers to ensure smooth
transition of care.
Counselling and care for both the patient and the caregiver.
If you are over 65, it is helpful to have a doctor with interest

and experience working with older people. You may wish to
choose a primary care doctor who has additional training in
geriatrics (i.e., Diploma in Geriatric Medicine or Masters in
Family Medicine).
Talking to Your Doctor

You have the right to ask questions to help you better
understand the diagnosis and treatment options. Make an
appointment and come prepared with a list of questions and
concerns that you may have. Healthcare professionals have
a duty to answer those questions to the best of their ability.
Dont let language get in the way and ask for translation
when necessary. You should have the answers to these
basic questions:
What is the condition or diagnosis (i.e., what is the cause

of my symptom?)
What are the medications being prescribed and how do

they help?
What are the possible side-effects?
What else can I do to help in the recovery

(e.g., special diet, specific exercises, etc.?)
What are the warning signs that I should look

out for and report to the doctor?
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Things to Take With You

Medical records.
All available tests and investigation results.
Medications both prescription as well as over

the counter products; bring the bottles.
Notebook to record the doctors recommendations

and care plan if necessary.
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HOW TO AVOID
SERIOUS ILLNESS
A large number of people 65 years and older have at least

one chronic health condition. Major chronic diseases include
diabetes, high blood pressure, high cholesterol levels, heart
disease and stroke. These conditions often have no early
signs or symptoms, yet can result in complications, hospital
admissions and affect a persons function.
Apart from adopting a healthy lifestyle (dont smoke, be

physically active and eat a healthy diet), health screening
can detect early disease and might even save your life. Early
treatment prevents the risk of serious complications if the
condition is managed properly.
What is Health Screening?

Health screening involves a doctor taking a detailed
medical history and examination, together with blood
tests or other procedures and x-rays which will determine
if you have a particular disease or condition. Not all tests
are necessary or helpful (e.g., testing for the whole series
of cancer markers), and your doctor will be able to advise
you on the types of tests needed.
Recommended Screening and Frequency

Go for health screening at private clinics, polyclinics or
hospitals if you fall into the following groups:
Have a family history of chronic disease or cancer.
Adults aged 40 years and above.
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HEALTH DAMAGING BEHAVIOURS
Smoking Lack of exercise
Drinking excessive
Eating processed food
alcohol
Eating fatty food Eating sugar-laden food
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Recommended Health Screening Table

RECOMMENDED RECOMMENDED
DISEASE OR AGE FOR FREQUENCY FOR SCREENING
CONDITION SCREENING SCREENING TEST
Obesity 18 years and Once every year. Body Mass Index (BMI).
above.
High blood 40 years and At least once a year or Blood Pressure (BP)
pressure above. whenever you see your doctor. measurement.
High blood 40 years and Once every 3 years if the first Fasting blood lipids test.
cholesterol above. screening is normal.
Diabetes 40 years and Once every 3 years if the first Fasting blood glucose
above. screening is normal. test.
Colorectal 50 years and Fecal occult blood test every Fecal Occult Blood Test
cancer above if no other year. (FOBT).
risk factors.
Sigmoidoscopy every 5 years. Sigmoidoscopy.
Those who have
a family history Colonoscopy when either test Colonoscopy.
of colorectal positive.
cancer must start
screening at an Alternatively, colonoscopy
earlier age and every 10 years starting at 50.
greater frequency.
FOR WOMEN ONLY
Cervical Women ages Once every 3 years. Pap smear.

cancer 25 65 who are
sexually active.
Breast cancer 40 49 years. Once every year. Mammogram.
50 years and Once every 2 years.
above.
Osteoporosis Women over Osteoporosis Self-Assessment Bone Mineral Density
50 years or Tool (OSTA) for Asians (based (BMD) is measured for
post-menopausal. on age and weight) is able to women at high risk.
categorise women into high,
moderate and low risk.
OSTA see:
www.osteoporosissoc.org.sg
www.hpb.gov.sg
FOR MEN ONLY
Prostate Men above 50 Once a year. Digital Rectal Examination

cancer years or earlier (DRE) and Prostate Specific
in those with a Antigen (PSA) blood test.
family history of
prostate cancer.
Reference: HPB Online.
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How We Helped Mdm Zainab

Mdm Zainab M is an 87-year-old widow who lives with her
72-year-old son in a one-room rental flat. She is frail and stays
home when her son leaves for work. She was referred to Hua
Mei Seniors Clinic by a staff of the Seniors Activity Centre
near her home. The staff member said Mdm Zainab was prone
to falls, but had not sought medical treatment because she
could not afford a private general practitioner and she would
get tired waiting at a polyclinic.
Our Care Plan for Mdm Zainab

At HMSC, Mdm Zainab was diagnosed with hypertension
and also noted to have osteoporosis. She was treated using
the following care plan:
Controlling her condition with effective and regular

medication.
Giving her a scheduled appointment at the clinic so she did

not have to wait long to consult with her doctor.
Giving her highly subsidised treatment.
Arranging for daily exercise therapy at the Seniors

Activity Centre.
Three months on, Mdm Zainabs hypertension was well

controlled and she was able to go marketing and cook simple
meals at home. The daily exercise therapy also improved her
balance and strength, and she no longer falls.
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National Screening Programme Available Locally

Integrated Screening Programme (ISP) subsidised
programme for Singaporeans aged 40 years and
above to screen for diabetes, hypertension, high
blood cholesterol, obesity and cervical cancer.
CervicalScreen Singapore (CSS) subsidised pap smear

screening for cervical cancer is available at polyclinics for
women 25 65 years.
BreastScreen Singapore mammography for the

detection of breast cancer is offered at a subsidised
rate at some polyclinics.
Other Preventive Measures for Those Aged

65 Years and Above
Promote Wellness and Independence
Speak to your doctor about screening for common
conditions that affect the older person which can
interfere with his ability to remain independent.
These include vision or hearing problems, unstable gait

with risk of falls, urinary incontinence, problems with
memory, depression and malnutrition.
Immunisations
Those over 65 years should receive the following:
Annual influenza vaccination.
At least one pneumococcal vaccination; if you are

over 75 years or have severe chronic disease and
were vaccinated more than five years ago, you
should be re-vaccinated.
Booster dose of tetanus and diphtheria.
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Healthy Diet
Encourage a balanced diet high in fruits and vegetables
and low in fat.
Older adults should have daily calcium intake of 1,500mg

a day with 400 800 IU of vitamin D.
Look out for teeth problems and/or poor fitting dentures

which may contribute to poor food intake.
Exercise
Sedentary elders should be urged to increased their
level of physical activity to promote better sense of
well-being, increase energy level, improve mobility
and decrease risk of heart disease and osteoporosis.
Walk briskly 30 minutes a day for 4 5 days a week.
Stop Smoking
Benefits of discontinuing smoking extend even to
individuals over age 65 years.
Cessation at any age decreases the risk of chronic lung

disease, many cancers and heart disease.
The risk of heart disease from smoking falls as soon as

one stops smoking, no matter how long or how much
the person smoked before.
In five years, the ex-smoker is not much more likely

than the non-smoker to have heart disease due to
cigarette smoke.
Maintain Social Interaction and Network

Studies suggest that social support systems, ability to
cope with stress, lifelong learning, meaningful activity
and laughter may contribute as much if not more to
longevity than healthy behaviours.
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HEALTHY DIET
Fats, Oils, Sugar and Salt

Use in small amounts
ss
Le
ct
le
Se
Meats and Alternatives

(2 3 servings per day)
e
or
M
Fruit/Vegetables
ct
le
(2 servings each per day)

Se
Rice and
Alternatives
(5 7 servings
per day)
Ensure that their food intake is rich in vitamins, proteins and

carbohydrates. A healthy and nutritional diet goes a long way in keeping
the body and mind fit. Drink 6 8 glasses of water a day.
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HOW TO MANAGE
YOUR MEDICATIONS
Tips on Safe Use of Medication

Take medication only as prescribed by your doctor.
Ask for information on why, when and how to take your

medication. Write down the information if you feel safer.
Inform your doctor of any past problem with your

medication, such as rashes or dizziness.
When you visit the doctor, bring along all the medication
you are taking, that include over the counter medication
such as vitamins or Chinese medication.
If you are unwell after taking your medication, consult the

same doctor immediately; do not doctor-hop so that he or
she can have a clearer understanding of your reaction and
be able to better fine tune your medication for you.
If you encounter difficulty with your medication, such as

questions about the type of medicine that you should
be taking, the dosage, or timing, ask your doctor for
clarification and any further advice.
Make a list of all your medication. Keep it with you

all the time.
Store medication in a cool dry place away from the sunlight.
Check expiry date of medication; if there is any change

in colour or taste, do not take them.
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Ways to Help You Remember Your Daily Medication

Put medication near the dining table to help in
remembering.
Take medication at a fixed time or in association with

regular activity (such as teeth brushing).
Use pill boxes with seven columns of compartments

that can hold the daily doses of medication necessary
for each day of the week.
Create a dosing schedule chart using paper with ruler

lines. List all medications, the times they need to be
taken, and a space by each dose, so that you can check
off when each is taken. Have a remark column for
consumption of use when necessary medication (such
as for pain or sleeping pill) and any untoward side effect.
Bring chart to show doctor for any increase reliance on
use when necessary medication.
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MANAGING YOUR MEDICIATIONS
200 M L
Daily doses
200 M L of medication
in each
C LIN I C A compartment
Use a pill organiser.
Check the
expiry date
Check expiry date of medication; if there is any change

in colour or taste, do not take them.
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HOW TO DEAL WITH

SLEEP PROBLEMS
Up to 50% of the elderly complain of insomnia, but although

such complaints are prevalent and are often accompanied by
higher rates of mental and physical health problems, sleep
problems are usually not identified or managed appropriately.
Disturbed Sleep in Older People Has

the Following Impact:
Difficulty sustaining attention.
Slowed response time.
Difficulty with memory.
Decreased performance.
Depression and anxiety.
(All of the above may be misinterpreted as dementia.)
Excessive, intrusive daytime sleepiness.
Increased risk of accidents and falls.
Impaired mood.
Impaired vigilance.
Impaired problem solving.
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Although sleep patterns change with ageing, sleep

problems can occur as a result of the following:
Psychological stress.
Medical illness that causes pain, breathing problems,

urination difficulties (especially for older men), and
other physical conditions.
Psychiatric problems such as anxiety, depression or dementia.
Medications that cause insomnia as a side-effect.
What Can You Do to Improve Sleep:

See your primary care doctor for a proper assessment
and advice. Things that should be checked for include:
Medications that can disturb sleep.
Medical conditions (such as heart and respiratory

diseases) that disturb sleep.
Sleep disorders.
Common Conditions that Disturb Sleep in Older People

Restless Legs Syndrome (RLS) is a sleep disorder charac-
terised by unpleasant leg sensations that disrupt sleep. The
most common symptom is a compelling urge to move the
lower extremities. Creepy crawly, itching, burning, and pain
are reported as well. It can occasionally affect the arms.
Obstructive Sleep Apnea is a condition in which people

stop breathing while asleep due to blockage of the airway
and is very common in older people. Affected people have
day time sleepiness, snoring at night, or are observed to be
breathing but air not flowing air when sleeping.
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Improve Sleep Hygiene

Prolonged use of sleeping pills can result in falls,
dependence and withdrawal effects, so barring any
underlying medical conditions (as noted on the previous
page), you should aim for other, non-medical ways of
improving sleep before using sleep medication.
Try to Improve Sleep by the Following Measures:

Establish regular sleeping hours.
Use the bedroom only for sleep and not for other
activities such as watching TV.
Avoid caffeine and cigarettes at least four hours

before bed.
Avoid alcohol at least two hours before bed and do

not use it as sleeping aid.
Avoid stressful work before going to bed.
Avoid exercise at least two hours before.
Avoid fluids two hours before bed.
Avoid being too hungry or too full.
Avoid daytime naps; if necessary, nap no more than

30 minutes and before 3.00pm.
The bedroom environment should be comfortable and

quiet with appropriate lighting.
Activities that promote relaxation such as listening to

soft music and reading a book can help and be included
in routine before sleep.
Try taking a hot bath 90 minutes before bed.
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Do try to get some exercise and sunlight in the day.
Do not be anxious about falling asleep.
If you cant fall asleep, it is better to wake up, read a

book and wait till the next sleepy cycle before going
to sleep again.
Reference:
1
National Institutes of Health, State of the Science Conference
on Management of Chronic Insomnia in Adults.
Sleep 28(9): 1049 1057, 2005.
2
Information courtesy of Harrison Bloom, MD, International
Longevity Center, USA.
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HOW TO IMPROVE SLEEP
Curtains
drawn
Appropriate
lighting
when
needed
Choose a
suitable
pillow Warm milk
or herbal
tea before
bed
Regular
sleeping
hours
Do not be
anxious about
falling asleep
Improving your sleep will give you more energy, and will help you
deal with pain both psychologically and physically.
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HOW TO DEAL WITH

CHRONIC PAIN
The older person is at higher risk of chronic pain from many

degenerative conditions, such as those involving the joints
and lower back.
Pain can have an impact on a persons physical function

(activities of daily living) as well as psychosocial function
(social interaction, meaningful communication) and
therefore should be taken seriously.
Ask your doctor about possible side-effects of

medications given for pain.
Ask about other treatment options apart from the use of

drugs. Physical therapy and appropriate use of assistive
devices such as a walking stick can alleviate knee pain
from osteoarthritis.
For some painful conditions such as arthritis or the

knee or some types of back pain acupuncture can also
be helpful in addition to western medical management
and treatments (See How to Effectively Use Traditional
Chinese Medicine on page 35).
Look out for depression if you have chronic pain.
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HOW TO GET STARTED

ON EXERCISE
Make a list of the reasons why you would like to

incorporate exercise into your life. Be sure to include
health problems that might be improved by exercise.
Make a list of any reasons that keep you from participating

in exercise and think of ways to overcome them.
If you feel that there is any reason why you should

not participate in an exercise programme, check
with your doctor before beginning a programme.
See if a friend would like to join you in your quest to

become more active. Things are a lot easier and a lot
more fun when a friend or your family is involved too!
Call your local community centre, senior activity centre,

or Peoples Association to find out if they offer any
programmes or classes that may interest you. Many
Exercise is a lot easier and a lot more fun when

a friend or your family is involved too!
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senior centres offer an array of exercise classes (taiji, yoga,

aerobics), dancing lessons, swimming lessons, etc.
Locate parks in your area and walking trails like the East
Coast Park Connector. They are good places for brisk
walking or biking.
Keep an activity journal. In it, list all of the activities

you have done each day and how long you did them.
A journal will help you track your progress, help you
set goals and identify the activities that you like best.
Remember it is never too late to start exercising regularly.
Benefits of Exercise
Regular exercise improves aerobic fitness, muscle
strength and flexibility which can help to maintain full
functioning and independence in older people.
Regular exercise protects against the development of

coronary heart disease, stroke, hypertension, obesity,
non-insulin-dependent diabetes mellitus, osteoporosis,
colon cancer, and depression.
Regular exercise keeps your bones strong and protects

against osteoporosis and fractures.
Regular exercise produces changes in certain chemical

levels in the body that can help to reduce stress,
symptoms of moderate depression, and improve
mood and general well-being.
Regular exercise boosts the blood flow to the brain and

helps to protect brain function and prevent cognitive decline.
Regular exercise appears to enhance the function of the

immune system, thus helping to reduce the number of
colds, flu, and other viruses.
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HOW TO EXERCISE
SAFELY
Exercise does not need to be strenuous to achieve health

benefits. Men and women of all ages benefit from a
moderate amount of daily exercise (e.g., 30 minutes of brisk
walking or 15 minutes of jogging). People who have been
sedentary and wish to begin an exercise programme should
start with short sessions (5 10 minutes) and build up to
the desired level of activity.
Go for a medical checkup before beginning an exercise

programme.
Do not exercise if you do not feel well on the day.
During the exercise if you experience discomfort such as

chest pains, stop the exercise immediately and see a doctor.
Always warm up before the exercise and cool down

after the exercise.
Do not exercise if you do not feel well on the day.
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Wear appropriate exercise clothes and comfortable sports shoes

and socks. Use sun protection when outdoors.
Progress slowly in the exercise programme.
Wear appropriate exercise clothes and comfortable sports

shoes and socks. Use sun protection when outdoors.
Drink plenty of water before, during and after the

exercise to prevent dehydration.
Choose primarily activities which engage as large a

muscle mass as possible, e.g., brisk walking, jogging,
cycling, swimming, etc.
Plan time between sessions for your body to rest

and recover.
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The following are some websites you can visit to know

more about nutrition and exercise.
Nutrition
Health Promotion Board
www.hpb.gov.sg/foodforhealth
Nutrition.com.sg
www.nutrition.com.sg
Nutrition.gov
www.nutrition.org
American Dietetic Association

www.eatright.org
MyPramid.gov
www.mypyramid.gov
Exercise
Exercise for Seniors: MedlinePlus
www.nihseniorhealth.gov
American Council on Exercise

www.acefitness.org
American College of Sports Medicine

www.acsm.org
National Heart Lung and Blood Institute

www.nhlbi.nih.gov
Singapore Sports Council

www.ssc.gov.sg
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Hua Mei Acupuncture

and TCM Centre
The Hua Mei Acupuncture and TCM Centre (HMAC) provides
Traditional Chinese Medicine (TCM) services to treat a variety
of diseases and conditions. The treatment approach emphasizes
a partnership between TCM practitioners and western doctors
for treatment of chronic conditions which are often difficult
to manage through allopathic medicine. The services seek
to support successful ageing by providing patients with a
choice of the best of both possible worlds of TCM and western
approaches to treatment.
Services
The Clinic adheres to both international and local health
standards for best practice and treats conditions that
have been approved by WHO for acupuncture therapy.
The acupuncturists and herbalists have all been trained at
prestigious Chinese universities approved by the Singapore
Ministry of Health and staffing includes licensed nurses and
trained acupuncture assistants to provide:
Needling (acupuncture).
Moxibustion (burning of medicinal herb with acupuncture).
Cupping.
Ear acupuncture.
Electrotherapy.
Tui-na (Chinese therapeutic massage).
Prescription and dispensing of Chinese herbs with

treatments.
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HOW TO EFFECTIVELY
USE TRADITIONAL
CHINESE MEDICINE
Traditional Chinese Medicine (TCM) has been practised

for thousands of years.
Western research on TCM is still in relative infancy,

but there is increasing evidence on TCMs efficacy,
especially in treating chronic painful conditions.
TCM uses herbs, acupuncture, moxibustion, tui-na

(a form of massage) and therapeutic foods to treat
illnesses as well as to rebalance and improve peoples
overall health and vitality especially for older people.
For older people with degenerative and chronic pain

conditions for whom surgery or chronic medications
may not be the optimal options TCM offers a
complementary (not replacement) treatment modality
to western medicine.
As with any health treatment, it is best to seek advice

from a Chinese physician before consuming any Chinese
medicine. Doing so will also ensure effective diagnosis
and prescription.
Remember to check if the medication should be taken

before or after meals; it is usually advisable to wait one
hour between medication and meal times, or between
taking western and Chinese medicine.
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YOUR FIRST TCM SESSION
Our Chinese physician

has training in both TCM
and western medicine.
He will assess the
patients conditions
Acupuncture
Stay
relaxed
TCM uses herbs, acupuncture, moxibustion, tui-na (a form of massage)

and therapeutic foods to treat illnesses.
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The World Health Organization has established that

acupuncture is effective in treating the following conditions:
Osteoarthritis.
Frozen shoulder.
Cervical spondylosis.
Tennis elbow.
Multiple joint pain.
Acute joint sprains.
Chronic low back pain (due to slipped disc in younger

age group, and spinal stenosis in older people).
Stroke.
Irritable bowel syndrome.
Gastritis and hyperacidity of the stomach.
Constipation.
Sinusitis/Rhinitis.
Insomnia.
Facial palsy.
Migraine headaches.
Painful, irregular or lack of menstruations.
Typically, an effective course of acupuncture treatment

would require ten sessions, each lasting 30 45 minutes,
and often complemented by other TCM modalities, such
as tui-na, herbs or moxibustion, to enhance the benefits
of acupuncture.
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Who Did We Help

We have treated more than 6,677 patients since 1996. Women
form more than 50% of our patient base; while patients aged
between 50 and 69 years form nearly 45%.
We help patients suffering from conditions such as:
Chronic pain: such as lower back pain and migraine, and

stress and anxiety.
Cancer: cancer patients who take TCM herbs in conjunction

with their allopathic treatments appear to have a higher
survival rate; clinical research has shown that some TCM
herbs boost the bodys immunity and increase its receptivity
toward radiotherapy and/or chemotherapy treatments.
Stroke: patients given western medication and acupuncture

treatment within the first three months of a stroke have
been able to significantly regain their physical strength
and dexterity, compared to those prescribed only western
medicine and physiotherapy.
Diabetes: a combination of TCM and western medication has

helped patients to stabilise their blood-sugar level.
Kidney disease: patients in the early stages of Nephritic

Syndrome (kidney disease) have been given TCM herbal
medication to prevent complications and delay renal failure;
those in renal failure have benefited from herbal medication
to improve their level of comfort.
Womens health issues: women with menopausal symptoms,

painful periods, problems with fertility can benefit from
herbal medicine and accupuncture.
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NOURISHING SOUPS
FOR ELDERLY
Rib Soup with White Fungus and Water Chestnut

Dry white fungus 20 gm, 15 fresh water chestnuts,
spare ribs 500 gm.
Method
Soak white fungus until soft, remove stems and set aside. Peel
water chestnuts and cut in half. Blanch ribs in boiling water. Boil
half a pot of water, put in all the ingredients and simmer on low
heat for 2 hours. Season with salt.
Effect
Nourishes the lungs and helps to clear phlegm.
Pigs Tail and Black Bean Soup

Black bean 60 gm, peanuts 60 gm, 10 red dates (seeded),
one pigs tail.
Method
Soak black beans and peanuts separately for one hour. Cut pigs
tail into chunks, blanch in boiling water, dish out and wash. Boil
half pot of water, add in all ingredients and bring to a boil, then turn
to low heat and simmer for 3 hours. (Slow cookers such as a crock
pot can be used for convenience). Add salt to taste.
Effect
Nourishes the blood and kidneys.
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HOW TO COPE WITH

MENOPAUSE
Menopause is a normal physiological process that occurs in

women over 40 and is marked by the absence of menstruation
for at least 12 months, when the activities of the ovaries
cease, female hormone levels drop, eggs are no longer
released and fertility ends.
Menopause is not a medical condition, but for some women,

menopause can be accompanied by uncomfortable symptoms.
However, these symptoms will naturally improve 2 5 years
after its onset and can be treated if they are severe and interfere
with your quality of life.
Menopause hormonal changes, however, do increase the

risk of osteoporosis (brittle bone) and fracture as well as
heart disease. Peri- and post- menopausal women should
seek regular health screening, learn about their health
risks and actively manage their health and healthcare
(See How to Take Charge of Your Healthcare on page 7).
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Symptoms of Menopause
Hot flushes This is a feeling of intense heat that
spreads from the face, neck and chest that usually
lasts for a few minutes, and can be accompanied by
sweating and palpitation; hot flushes can start two
years before menopause and last for a few years after.
Night sweats This is the same as hot flushes but can

interfere with sleep.
Sleep disturbance Frequently the result of night

sweats, this can also be related to anxiety and stress,
but the lack of sleep can lead to day time fatigue,
irritability, as well as poorer short-term memory and
concentration.
Vaginal symptoms The decrease in female hormone

levels lead to thinning of the vaginal lining, which lead
to vaginal dryness, itching, and discomfort as well as
discomfort during intercourse.
Mood changes Hormonal changes can also lead to

depression, anxiety, irritability, and nervousness in some
women around the time of menopause, and can be
exacerbated by sleep disturbances and mid-life stresses
such as coping with issues of the sandwich generation,
with care-giving responsibilities for elderly parents and
teenage children.
Urinary symptoms Increased frequency of urination, urinary

tract infections and incontinence (the inability to control ones
bladder with involuntary passing of urine when laughing,
coughing or lifting heavy weights) may occur.
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How We Helped Mr Chua

Mr Chua Geok Poh had suffered from a back problem for the
past 11 years, a condition that prevented him from bending
over to pick things up. He was offered surgery but was wary
and decided to give TCM a try after seeing Dr Gu Falong, the
medical director of Hua Mei Acupuncture & TCM Centre, on
television.
Our Treatment Plan for Mr Chua

At HMAC, Mr Chuas received the following treatment plan:
Giving him thrice-weekly sessions of Acu-Moxibustion

combining the use of needles with the burning of the moxa
herb (mugwort) so that heat from the herb travels through
the beginning, and gradually reducing the frequency to
twice weekly.
Now, Mr Chua not only picks things up without searing back

pain, he is also able to enjoy a game of golf with his friends.
He only needs to receive maintenance treatment once a week
at the Centre.
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Joint pain Early morning pain and stiffness of the hands,

knees, hips, shoulders and lower back occasionally occur
around the time of menopause.
Physical symptoms and changes Hormonal changes

also lead to changes in skin texture (dryer or oilier
and appearance of fine lines from loss of elasticity),
thinning of scalp hair, increase in facial hair, weight
gain, redistribution of fat from hips and thighs to the
abdomen. Occasionally, there is the sensation of
insects crawling on or under the skin; the medical term
is formication and has a similar physiological basis as
that for the sensation of pins and needles.
Treatment
For some women, lifestyle changes such as regular
exercise, a healthy diet, limiting alcohol and caffeine intake,
developing better sleep habits, managing stress and quitting
smoking would be sufficient to manage menopausal
symptoms and the increased risks for heart disease and
osteoporosis. If necessary, however, other medications
are available.
HRT (hormone replacement therapy) used to be the

mainstay for treatment of menopause symptoms and
associated health risks, but recent research has shown that
HRT increases the risk for cancer of the lining of the uterus
(endometrial cancer), slight increase in risk for breast cancer
(with four years or more of treatment), blood clots, heart
disease, and stroke (especially for older women on higher
doses of HRT). Some form of HRT may still be indicated
for some women, but only after risks and benefits are
discussed with a physician experienced with HRT.
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Acupuncture has also been shown in recent research to be

effective in managing symptoms, especially hot flushes,
anxiety and insomnia, and although there is not yet sufficient
research done to show evidence, herbs are routinely used
in China for the management of menopausal symptoms.
Traditionally, TCM recommends certain herbal soups for
post-menopausal women, but when necessary, personalised
acupuncture and herbal treatments prescribed by a TCM
physician may be helpful.
Diet rich in certain foods, such as soy and flaxseed, has

shown to have an effect on the symptoms of menopause.
Research showed that Japanese women experience much
fewer symptoms than their Western sisters, and to some
extent, this is related to their soybean rich diet (such as
tofu), which contains high levels of phyto-estrogens
chemical compounds similar to female hormones. Although
food alone will not be able to address severe menopausal
symptoms, it is helpful to include phyto-estrogen rich foods,
such as soy products, in a post-menopausal diet.
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TONIC SOUPS FOR
POST-MENOPAUSAL WOMEN
Pa-Chen Chicken Soup

Half a black chicken, a packet of Pa-Chen (from herbal shop)
10 red dates, wolfberry 5 gm.
Method
Rinse the black chicken with hot water; place in a crock pot
(or similar slow cookers) with the packet of herbs, red dates,
and wolfberry. Add in water (about two rice bowls) and cook
for 2 3 hours. When ready to serve, add salt to taste.
Effect
Enhances vitality.
Stewed Kampong Chicken Herbal Soup

One whole black chicken, Dang-Sheng 6 gm, 8 red dates,
wolfberry 10 gm, Bei-Qi 4 gm, dried longan 8 pieces,
Huai-Shan 2 pieces.
Method
Blanch the chicken in boiling water; wash and clean. Place all the
herbs and chicken in a large pot and bring to a boil; stew for 2 hours.
Add salt to taste.
Effect
Enhances energy.
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G9.10424 TSAO AR 08.indd 46 24/09/2008 11:08 AM
2
Frail Care
G9.10424 TSAO AR 08.indd 47 24/09/2008 11:08 AM

Hua Mei Mobile Clinic

Our Goal
To be the first homecare service in Singapore, and to share our
model and lessons learned with other organisations in order to
support and advocate for seniors who want to live at home and
remain in their communities for as long as possible.
Our Approach
We devise a dedicated care plan for each homebound patient by
adopting a systematic care management approach. First, teams
comprising a doctor, nurse and social worker conduct in-home
geriatric assessments to identify each patients needs in the
areas of health, social life, daily activities and psychological
well-being. They then draw up a plan that is presented to the
patient and the family for discussion in the language or dialect
the patient prefers. The social worker in the team also helps
the patient to identify community resources that will help in
enabling the patient to continue living at home. Our homecare
teams also arrange for hospital admissions and nursing
home placements, and prepare patients and their families for
hospital discharge.
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HOW TO CARE FOR

THE FRAIL OLDER
PERSON
With advancing age, some older people will develop frailty

and disability a combined effect of the ageing process and
health experiences as well as chronic diseases.
When caring for a frail older person, one should respect the
universal desire of all people:
To have good health.
To be optimally independent, live in their own home and

community, and age-in-place.
To have self-determination and make decisions for

themselves.
To be cared for and supported by family and people who

they love and who care about them.
While long-term care arrangements, such as nursing home,

may be necessary for those who totally lack care support
at home or who needs 24-hour nursing care, even disabled
older people with complex medical and social problems (such
as following a significant stroke), as well as bed bound elders,
can actually be cared for at home. This can be achieved
with a combination of family and community support, an
organised and coordinated system of professional community
services for care where family is unable to provide (due
to work and other resource constraints), and a consistent
and capable medical provider. (See How to Get Help on
Community Support Services on page 71).
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Achieving Optimal Health

For frail elders with multiple health problems and their
caregivers, the medical issues can be overwhelming as
they can have many specialist appointments and many
medications. Here are some ways of organising and
managing the medical issues.
Find a good primary care doctor who is trained and has

experience caring for seniors, who can coordinate with
the many specialists, to be the elders primary health
provider and the familys primary partner for information
and guidance (see How to Take Charge of Your
Healthcare on page 7).
Learn how to best manage the seniors conditions. Most

chronic diseases require lifestyle and diet changes in
addition to medication to really control the disease (e.g.,
diabetes). Caregivers can ask the elders doctor, check
the internet, and contact the Health Promotion Board
for information pamphlets as well as health education
services in the community.
Be organised about their medications (see How to

Manage Your Medications on page 20).
Pay attention to any changes in energy and cognition level.

Older people can have significant infection and illnesses
(e.g., heart disease) and manifest very little symptoms
other than excessive fatigue, decreased mental alertness
or confusion. Call the doctor immediately if the older
person suddenly loses his or her ability to self-care, stop
walking or become very sleepy.
Make sure that the elder is immunised for flu annually

and pneumococcal vaccine once every five years after
65 years of age.
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Compile and regularly update a health folder that includes

a list of the medical conditions and related medications,
laboratory reports, the doctors and their contact information,
appointment schedule as well as any additional care plans and
instructions such as special diet, etc. This not only helps the
elder and the primary caregiver, but also if the caregiver has
to be away, then someone else will be able to take over care
responsibilities more easily, especially if the elder has a
medical appointment or has to be admitted to the hospital.
Pay attention to hydration, diet and nutrition. Check the

elders teeth and make sure they can chew; adapt the
softness of their food accordingly. Make sure they drink
enough; older people do not perceive thirst as well and
dehydrate easily; aim for 6 8 glasses of water each day.
Monitor the bowel habit. Constipation is a very common

problem due to inactivity, insufficient fluid intake and
decreased fibre in the diet. Constipation can lead to
poor appetite, lethargy and sometimes confusion, as
well as to other health complications. Ask the doctor if
constipation persists even with adequate fluids, fibre
and physical activity. Acupuncture can be effective to
complement lifestyle and western medical measure.
Improve sleep. Many older people have difficulty with sleep,

which can lead to day time fatigue, decreased memory,
energy, and concentration and increased irritability (See
How to Deal With Sleep Problems on page 23).
Check and moisturise skin. Older peoples skin is thin

and breaks down easily, particularly in areas where there
is pressure, such as the buttocks and back. Do visually
check (2 3 times a week) for skin break down to
prevent pressure sores.
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Who Did We Help

In 2008, HMMC helped more than 130 homebound seniors.
We found that 70% of our patients suffer from between five
and nine chronic illnesses, such as stroke, hypertension,
diabetes, dementia, depression and Parkinsons disease. The
majority of patients are women (73%) and 90% of all patients
are Chinese, with an average age of 84 years. We also found that
70% of our patients are eligible for government subsidy, based
on the Ministry of Healths Means Test for Long-Term Care
Facility. Approximately 70% of patients qualify for admission
to a nursing home; they are either in wheelchairs or bed-bound,
requiring a high degree of physical help and nursing care. Of
all the patients we serve, 20% receive palliative care, where the
goal is no longer to prolong life but to relieve suffering and
promote comfort.
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Very importantly, do not overly focus on medical problems

and leave no space for the elder to have a life! Health
problems can be managed so the elder can pursue
interests and enjoy their remaining years, such as spending
time with their family, grandchildren and their friends,
working on their spiritual pursuits, plant a new garden, etc.
Functional Independence and Mobility

One of the highest priorities in the care of the older person
is to help them to be optimally independent within the
Health problems can be managed so the elder can pursue

interests and enjoy their remaining years, such as spending time
with their family and grandchildren.
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context of their frailty or impairments to optimise their

ability to walk and take care of themselves.
Encourage and support seniors to do the things they

normally do for themselves as long as it is safe. Dont
be overly protective and do for them what they can
do for themselves. Older people some times become
helpless because caregivers inadvertently encouraged
them to be so.
Use it or lose it. Help them to be as strong as can

be by encouraging them to walk and exercise regularly.
Excessive sitting and bed rest can lead to the loss of
muscle mass and strength. Most frail elders have higher
functional potential than they are doing because of
disuse. Consider a rehab evaluation and programme to
bring their strength and mobility to their optimal level
(many senior day centres offer day rehab; see How to
Get Help on Community Support Services on page 71).
The more they can walk and do things for themselves,
the less dependent they will be on others and the
happier they will be (and their caregivers too!).
Minimise handicap from disability and frailty by adapting the

environment to compensate, such as using walking aids,
adaptive devices, adding handrails to bathrooms, hallways
and stairs; putting frequently used items in accessible
places, etc. Again, rehab therapists can help to assess
the elder, make recommendations for rehab, walking and
functional aids as well as appropriate home adaptations.
Check their hearing and vision. This is frequently

neglected but its critical importance is self evident.
Help seniors who wish to live in their own homes to do

so. Their homes carry cherished memories, sense of
belonging and self-mastery, and being uprooted from
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Check their hearing and vision. This is frequently neglected but

its critical importance is self evident.
ones home, familiar neighbourhood and social network

within ones community is highly disruptive for anyone
but particularly for an older person. While it is often more
convenient for family caregivers to move the elderly
into their own home occasionally sharing responsibility
between siblings for care by rotating the elder from
home to home, this is often distressing for many
seniors. While moving sometimes cannot be helped,
there are community services that can supplement what
the family cannot do when the senior lives on his or her
own and its worth exploring options to support the
elders wish to live in his or her own home.
Self Determination
When older people become frail and need care, the
common perception is that they become child-like
stubborn, uncooperative, and insistent on having their own
way. The truth is that no one likes being told what to do,
especially older people who have been making decisions
for themselves and their families their entire lives.
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How We Helped Mdm Yeo

Mdm Yeo, 74, lives with her eldest son in a one-room rental
flat. She used to be independent until a fall in April 2007. Her
son then became her main caregiver. Mdm Yeo was not able to
walk because of severe back pain and could not even lie down
due to the intense pain. As a result, she also suffered from a
chronically infected venous leg ulcer. She was referred to our
Mobile Clinic by her doctor and care manager from Hua Mei
Seniors Clinic and Hua Mei Care Management.
Our Care Plan for Mdm Yeo

At HMMC, a team of doctor, nurse and social worker devised
the following care plan for Madam Yeo:
Admitting her into an acute hospital and subsequently into

a community hospital.
Applying for financial assistance through the Community

Development Council.
Linking her to a home-help service centre to arrange for

home-delivery of meals and escort services for her eye
check-ups at Alexandra Hospital.
Monitoring her medical conditions through bi-monthly

nurse visits and bi-annual doctor visits.
Mdm Yeos ulcer has now healed, and she is well and fairly
independent at home and medically stable in the community.
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Even when a father or mother needs help or care, the

relationship is the same they are still the father and the
mother. Out of good intention, family members often
assume they know what their father or mother wants and
what is good for them without discussing with them, but
that often is not true.
Taking away a persons right to making decisions for him

or herself compromises ones dignity and ability to control
ones own life. It is critically important to support seniors
to make their own decisions by providing appropriate
information and discuss options. The elder may defer the
decision to a family caregiver, but they have the opportunity
to exercise their choice to do so. Always seek their opinions
on what they like and how they would like to be cared for.
Expressing Love and Support

With the pressure of modern day life, one often forgets to
express ones love and affection for our elderly loved ones.
Do update photos of grandchildren; frame family photos and
place by bedside; if one cannot make time to visit, do pick
up the phone to call and let them know that you are thinking
of them; reminisce about happy times that were spent
with the senior. Do talk to them even when they are bed-
bound, appear to be quiet, with their eyes closed and seem
uninterested in whats happening around them.
You may also wish to tap on the many resources available

in the community to support frail seniors. There are
community aged-care specialists (care managers) who can
help assess, plan and navigate the health-social support
network for your older relatives.
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HOW TO PREVENT
FALLS
An injury from a fall can limit an older persons ability to lead

an active, independent life. Each year, thousands of older
men and women are disabled by falls in the home. One
third of those age 65 or older suffer one or more falls a year;
half of those who fall will fall again! The older you are, the
higher the likelihood of falling.
Making simple changes in the home or personal practices

can prevent many falls.
Tips for Preventing Falls

Exercise at least 20 minutes daily. Start with slow exercises
once a day and increase the pace and intensity gradually to
three or four days a week. Exercises such as walking, taichi
and yoga can increase your energy level, lift your mood,
and enhance your fitness, flexibility and balance.
Store regularly used appliances within easy reach. Do

not climb or bend too low to get things.
Wear comfortable, firm fitting, flat shoes with low broad

heel and soles that grip. Do not rush to and from one
point to another, take your time.
Know what medication you are taking and their side-

effects. Get your doctor to review and advise which of
your medications can affect your alertness or balance.
Fall-proof your home. Install good lighting, reduce glare

and install grab bars and non-slip tiles or mats in toilets
and where slippery surfaces can be found. Remove things
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that will cause you to trip such as loose rugs, loose

electrical wiring, etc.
See your doctor if you have a medical condition.
Tips on What to Do If You are Alone When You Fall

Dont panic.
Stay calm.
Decide whether you can get up by yourself.
If you cannot, shout for help if you can or grab an object

within easy reach and bang it to make loud noises to
attract attention for help.
It is always best to have a phone by your side, it is

your lifeline.
See your GP afterwards for all falls, even if you have not
hurt yourself, because all falls are potentially serious and
need advice or treatment.
Tips on What to Do If I Find Someone Who Has Fallen

Stay calm.
Check that the person is breathing and conscious (if not,

call for help and ring for an ambulance immediately).
Reassure the person (if conscious).
If you think they have broken any bones

dont move them.
Get help and call for an ambulance if necessary.
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MODIFY YOUR BATHROOM
Before
Emergency
pull cords
Grab bars
Non-slip tiles
Dry floors
After
Modify your bathroom to reduce fall hazards, install grab bars, improve lighting,
and remove items that can cause you to trip.
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HOW TO ENGAGE
SENIORS TO PLAN
FOR FUTURE CARE
Healthcare Proxies and Advance Care Planning
Discussions on advance care planning and end-of-life care

preferences optimally should occur when a person is well,
informed and has time and opportunity to discuss with
ones physician and family.
Let the elders initiate the discussion. Dont talk about it

before they are ready to.
When our seniors initiate the discussion about the future,

dont miss the opportunity to listen to what they have to say.
If the decisions about end-of-life issues sound too irrational

and negative to you, there could be depression and a
doctor should be consulted.
One may try to prompt thoughts about future care

plans by talking about the past, about their friends, about
lifes meaning, their spirituality and their ideas about the
afterlife. An incidental visit to the hospital or a poignant
movie may help to start the conversation.
When discussing about the future care, cover these areas

patiently. Do not rush through like a marketing survey.
Who is the person to make decisions the designated

health proxy when the senior cannot make or
communicate his own decisions? There can be more
than one such decision makers.
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Are there any particular choices of where the senior

would not like to be cared for? Nursing homes,
hospices or hospitals?
Are there any life-support measures that the senior

would refuse under all circumstances? Cardiopulmonary
Resuscitation (thumping on the chest if ones
heart stops), Intensive Care Unit, Cancer Surgery,
Chemotherapy, Radiation Therapy, Feeding Tubes,
Hospitalizations or even antibiotics?
Are there any religious or spiritual beliefs that the senior

holds dear and would like to be reflected in his care or in
the rituals after his death? Would the senior like to practise
the teachings or engage in regular fellowship?
Would the senior like to make a will at the lawyers

office? If not, how would he like to distribute his
possessions after his passing?
Are there any particular issues that weigh heavy on his

mind that he hopes to resolve? It could be the care of a
child or a disabled loved one.
If family members find it difficult to discuss future

care plans (advance care planning) with the elders,
professionals such as their doctors, lawyers, social
workers and nurses may be able to support these
discussions.
Advance care planning and end-of-life care decisions are

sensitive and important communications. A trusting and
caring relationship is a crucial prerequisite.
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HOW TO RECOGNISE
DEPRESSION IN
SENIORS
Warning Signs
A previously stoic individual become full of worries and
physical complaints.
Sleep disturbances excessive sleep, poor sleep or

excessive wakefulness.
Changing appetite usually the loss of appetite,

sometimes with weight loss.
Deteriorating memory, especially when the senior keeps

complaining about it.
Losing of interest in things the senior previously enjoys,

such as losing interest in going out with friends, favourite
foods or hobbies.
Having frequent episodes of low mood or anger tantrums.
Saying things that convey a sense of worthlessness and

self-loathing.
Saying things that infer that death is better than life.
Expressing feeling of unfound guilt.
Complaining about the lack of energy when there are no

physical reasons to account for it.
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HOW TO RECOGNISE
DEMENTIA
Short-term Memory Loss

Difficulty in remembering events that happened recently
and yet still retain memories from long ago. For example,
they may totally forget that you have visited them
yesterday, or that they have eaten their dinner.
Asking the same questions over and over again.
Frequently misplacing things and accusing others of

stealing from them.
Buying the same groceries again and again, appears to

stock pile unnecessarily.
Deterioration of Judgment
Deteriorating standard in performing daily chores, such
as standard of cooking and dish washing.
Having difficulty with handling multiple monthly bills and

neglecting them as a result.
Language Difficulties
Exhibited in later stages, the elders vocabulary seems to
become more limited and affecting their self-expression.
At final stages, they can become withdrawn and quiet,
and sometimes they exhibit challenging behaviours
as a result of not being able to articulate or express
discomfort, such as hunger or pain.
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Orientation to Time and Place

Sufferers may get lost in the neighbourhood.
They may insists on going home even when they are

already home. This occurs especially when they have
just returned from a stay in the hospital.
They may mistake night for day and be very active at

night. For example, they may switch on all the lights,
wander at home, and begin to do laundry or to cook.
Problems With Object Recognition

Elderly patients may mistake denture cleanser as
drinking water, or a fork for a spoon.
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HOW TO PREPARE
FOR CAREGIVING
ROLE
The journey of a caregiver can sometimes begin unexpectedly

and tumultuously, particularly in sudden onset of illness of
the older person with little time to prepare for the caregiving
role. The older person may also have changes in mobility,
mood, cognition, personality and ability to perform daily self-
care activities. At the same time, there are multiple duties that
require attention and can be overwhelming for a new caregiver.
Competing Demands
The first few months after discharge from hospital are the
most difficult. Both the older person and the caregiver may
experience emotional distress and reduced well-being.
During this period, multiple competing demands can throw
the caregiver into a state of crisis and chaos. For instance,
the caregiver needs to make adjustments to his or her
lifestyle to accommodate the following:
Provide physical care to the older person.
Arrange transport to bring older person for important

appointments.
Look into home modification.
Take time off from work or quit the job to care for the
older person.
Monitor the older persons daily routines, such as

medication management, exercise, and diet.
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Support the older person who, at times, have frequent

admissions to hospital for infections or medical
complications.
Caregiver Issues
Providing care to a frail older person can be a long-term
commitment. The caregiver needs support because at
times, she will feel physically and emotionally drained. She
is worried and concerned for the older persons recovery
and medical care. Very often, she gets so caught up with
the care responsibilities, she neglects her own needs, her
own self-care, personal interests and leisure pursuits. She
also receives little positive reinforcement for her care.
Preparation for Caregiving Role

Deciding on the Caregiver
The commitment to care for an older person has to come
from the confidence that one has the ability and the means
Providing care to a frail older person can be

a long-term commitment.
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Hua Mei Care Management

Our Goal
To assist seniors with high medical risk and low social support
to find the right service, at the right cost, to manage their
medical conditions. We empower seniors and caregivers with
knowledge and the means to make informed choices in the
planning and determination of their care.
Our Approach
We are a one-stop centre for the coordination and management
of social and medical services, taking each patient through the
following process to ensure that needs are best met:
Fully assess their medical and social needs versus available

support and resources.
Identify their strengths and desired outcomes, and set

common goals.
Carry out care planning in collaboration with patients and

their family members.
Match available formal and informal services to cater to

their needs.
Monitor the acceptability and effectiveness of their care plans.
Evaluate the process and outcome of care.
We are co-funded by the National Council of Social Service and

Ministry of Community Development, Youth and Sports, and aim
to maintain the integrity of the elderly and family relationships
by facilitating choices. We have successfully matched hundreds
of community and hospital services to patients needs, supporting
seniors to remain independent and to age in place.
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to provide for and sustain the older person at home. The

caregiving role involves multiple responsibilities such as:
providing physical care; making arrangements and contact
if external professional services are engaged; making
decisions and acting in the interest of the older person;
and providing financial support. These responsibilities
need not all be undertaken by one person alone. It can
be shared among family members. Decisions need to be
made as to who will be involved and how will they want
to support the older person to remain at home. A family
conference to discuss these pertinent issues can be helpful
as expectations can be clarified. If the best option is to get
a maid, it is good to carefully select a maid that has some
experience looking after the elderly and that language will
not be a barrier.
Caregiver Training and Information

Prior to discharge from hospital, it is important to participate
in caregiver training conducted by a nurse or therapist in
the hospital. This will equip the caregiver with practical
skills to look after the older person.
The family may also consider it useful to engage the

doctor, case manager or medical social worker to discuss
the discharge care plan.
Talk to the doctor to gather information of the disease,

progression, side effects, etc.
The medical social worker can provide information on

available community resources, such as rehabilitation
programme, transport services, respite care, community
hospitals, dementia day care, home help services and
caregiver support services.
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Financial Support
The medical expenses and cost of looking after an older
person can result in financial strain to the family. One way to
manage the expenses is to do up a list of required items and
compute the average expenditure per month. Balance this
with the available disposable income. If there is a shortfall, be
realistic to appraise the budget and see if there are any areas
where spending can be reduced.
Caregiver Well-being
The caregiving role can place a caregiver at risk of stress,
poor health and social isolation. When taking up this role, it
is necessary to maintain and improve the caregivers well-being.
Have sufficient sleep, diet and exercise.
Keep a positive mindset.
Have realistic expectations.
Learn to relax.
Get support from others.
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HOW TO GET HELP ON

COMMUNITY SUPPORT
SERVICES
When an older relative needs care that the family cannot

easily provide, community-based services are available to
provide help. For older people with complex needs and family
who does not know where to get help, care management
service can help the family organise and get the necessary
services for the elders care at home. The following is a list
of available services and how they can help.
Home Nursing Service

Provides community nurses to assist the sick person
who is homebound by providing nursing care and training
home caregivers on how to care for their family members
at home.
My mother cannot come out of her house and she requires

wound dressing, changing of feeding tube, checking of
blood pressure
Home Medical Service

Provides ongoing medical treatment, nursing care, health
education and training for homebound/bedbound person
through regular home visits by doctor and nurse.
It is very hard to transport my bedbound father out to see

his doctor regularly. He also requires much nursing care
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Who Did We Help

In 2008, we assisted 255 home-bound seniors. All our patients
had least one chronic illness requiring medical follow-up, while
69% needed coordination of at least three social, emotional and
medical needs. The diseases that they suffered from include
hypertension, diabetes, hyperlipidaemia and stroke; as well
as diseases of the nervous system and sense organs (cataract,
glaucoma, eye disorders and adnexa), of the circulatory
system (heart diseases), of the respiratory system (COPD),
and of the genito-urinary system.
Our Client Profile

78% of our clients are single, separated, divorced or widowed.
76% of our clients are 70 years and above. 85% of our

clients income is $360 per month.
67% of our clients need supervision or assistance with their

activity of daily living.
20% of our clients have caregivers care for by their elderly

spouse or children who are mentally challenged.
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Community Hospital
Provides continuation of care for client who requires longer
inpatient rehabilitation, nursing and respite care after
treatment in the acute hospitals, before they are discharged
back home.
My grandma just had a broken hip and she is unable to

walk after her operation.
Day Rehabilitation Centre

Provides day rehabilitation services such as physiotherapy
and occupational therapy to older people who suffer from
strokes, heart disease, bone fractures and other conditions
that impair functional abilities.
My father cannot walk properly and safely after a stroke.
Dementia Day Care

Provides structured day care programme for an older person
who suffers from dementia; programme provides social
care during the day as well as respite, training and support
for the care giver.
My mother cannot find her way home and has short-term

memory problem and I dont feel safe to leave her at home
alone while Im at work
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Home Therapy Services

Provide home-based rehabilitative services (physiotherapy,
occupational therapy or speech therapy) to clients who have
rehabilitation potential but may have difficulty going to the
centre-based services due to mobility limitations.
My father refuses to go out of his flat after his recent

fracture from fall; he is now fearful of leaving his home
Hospice Day and Home Care

Provide palliative care as well as physical and emotional
comfort to patients and their families when a terminal
illness no longer responds to treatments.
My mother is terminally ill; where can I seek help and

advice to care for her?
Caregiver Support Services

Provide advice and support to caregivers through information
and referral, consultations, training, support group and other
support programmes.
I do not know how to provide care for my parents;

I need support.
Counselling Centres
Provide an avenue for older persons and their caregivers to voice
their concerns and problems and find actionable solutions thus
improving their psychological and emotional well-being.
I am frustrated, angry, constantly feeling tired and crying

suddenly for no reason. I need attention too!
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Family Service Centre

Provide professional services, advice and support to families,
manage their responsibilities and challenges.
I am overwhelmed by my family problem and I need to talk

to someone about my family issues.
Neighbourhood Links
Neighbourhood focal points for community activities where
residents, particularly seniors, come together for activities
and community services.
Senior Activity Centres

Drop-in centres for seniors residing in one-room HDB flats
as well as immediate neighbourhood. Provide social and
recreational programmes and activities, befriending, mutual
help schemes, emergency alert response calls, guidance,
advice, information and referral.
Social Day Care Centres

Provide daytime support and care for frail seniors while their
family members are at work. Aim to maximise the physical
functions of the seniors, while offering opportunities for them
to socialise and engage in meaningful activities.
My children go to work. I am bored, lonely and I want to

join in some activities and programmes so that I can get to
know more friends.
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How We Helped Mdm Lee

Mdm Lee lives in a two-room flat with her 55-year-old mentally
challenged son, who suffers from hypertension. She has two
stepchildren in their 70s from her husbands first marriage but
is not in contact with them as their relationship is strained.
After fracturing her hip in a fall, Mdm Lee was placed in a

nursing home as she has poor social support and there were
concerns over her sons ability to care for her. However, upon
her sons insistence and her concern for his welfare she soon
moved home. The nursing home referred her to Hua Mei Care
Management for assistance.
Our Treatment Plan for Madam Lee

A nurse and a social worker from Hua Mei Care Management
provided the following help:
Monitoring her medical condition with frequent home visits.
Packing her medication into pillboxes and creating a

medicine-taking routine for her to adhere to.
Connecting her to a Community Rehabilitation Programme

to maximise her Activities of Daily Living (ADL) and
Instruments ADL, and home modification.
Getting her Public Assistance reinstated.
Teaching her son to care for her and himself.
Today, Mdm Lees medical condition is stable and she lives

contentedly at home with her son. Her son is happy and
faithfully visits a primary care physician for his hypertension.
He also keeps track of and escorts Mdm Lee to her medical
appointments, fulfilling his responsibilities as a caregiver.
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Befriending Services
Relieve loneliness, isolated and bored homebound and
single elderly who live on their own or with other elderly
in one- or two-room HDB rental flats.
I am homebound, lonely and bored, no one visits and

talks to me.
Home Help Service

Provides a host of services such as provision of meals,
laundry service, housekeeping, assistance in personal
hygiene and grooming as well as escort service for
medical appointments.
I am weak and frail, unable to cook my own meals or do my

own household choresbut I want to stay at home.
For further information on the above services, please log on to:
Ministry of Community Development, Youth and Sports

www.mcys.gov.sg
Touch Community Services

www.touch.org.sg
Asian Womens Welfare Association

www.awwa.org.sg
Ministry of Health
www.moh.gov.sg
Agency for Integrated Care

www.aic.sg
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3
Social Well-Being
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Hua Mei Training Academy

Our Goal
To promote successful ageing, provide education and skills
development in elder care, and foster inter-generational
understanding and relationships. Play an active role in
capacity building by imparting skills specific to policy
development, programme planning and implementation,
professional skills training, and the education of the
public, families and caregivers to help older persons to
age successfully and in place.
Our Approach
Over the past 13 years, we have specialised in ageing and aged-
care issues, as well as health and wellness-promotion at the
workplace. Our programmes are comprehensive and tailored
specifically to meet the needs of a variety of audiences, all with
the aim of imparting not only knowledge but practical skills
to impact changes at the perceptual and behavioural level. Our
trainers are qualified and experienced health educators with
backgrounds in nursing and social work or psychology.
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HOW TO LIVE
POSITIVELY
Living positively is living life with a sense of well-being

and satisfaction. Spiritually, emotionally, intellectually
and socially, the sense of wellness is expressed through
a deep appreciation of ourselves, the people and the
environment and an enthusiasm and curiosity for change
and engagement. You will live your life engaging with all
that it has to offer but with peace and harmony with
yourself and your environment.
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HOW TO MANAGE
STRESS
When lifes demands become greater than your ability

to cope, be aware of how your body and mind react to
stress. Get to know your own tipping point.
Work on assessing the psychological causes.
Get help from a counsellor or therapist who can help you

to understand and dissect the situation to gain a better
understanding.
If you realised that stress is caused by a certain percep-

tion of the issue at hand or an unfulfilled expectation you
have of yourself or others, you should work on changing
these yourself or with help in counselling and therapy or
coaching.
At the same time, take care of your physical and

environmental condition.
Exercise, be with friends, connect with nature, set aside

time for rest and relaxation, meditation, yoga, going for a
holiday and even retail therapy!
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HOW TO COPE
WITH LOSS
Grieve upon your loss, but with a deep understanding and

appreciation of the fleeting nature of life. Hence, managing
losses would mean:
Acknowledging and appreciating your grief.
Allowing yourself to experience the grieving process

of shock, disorientation, anger, guilt, fear.
Being ready to re-organise and re-enter life when

you are ready.
Allowing yourself to be with people who care and

support you.
Letting your loved ones or friends know that you need

their support and sometimes practical help.
Watching out for your physical health for signs of stress

or illness.
Taking care of your physical well-being.
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How We Fared
We are a Continuing Education and Training (CET) centre
for the Workforce Development Agencys Workforce Skills
Qualification (WSQ) Programme. We professionalise
the Community and Social Services (CSS) workforce by
incorporating the CSS sectors best practices into our content
and delivery, and providing career-upgrading pathways
based on the competency requirements of various job levels.
In June 2008 we successfully launched the first competency-
based qualification training, which awards participants with a
Certificate in Community and Social Services. The objective is
to provide the skills and knowledge necessary for jobs in the
aged-care sector. To date, 45 participants have obtained the full
qualification, and approximately 33% of our graduates have
successfully embarked on their careers in the aged-care sector.
We are also a training partner for the Social Service Training

Institute (SSTI) and Civil Service College (CSC), providing
courses on ageing and helping professionals in the aged-care
sector upgrade their knowledge and skills.
SSTI courses include:

Introduction to Dementia (English/Mandarin).
Approaches to Dementia.
Frontline Workers (Basic).
Essentials of Gerontology.
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CSC courses include:

Creating Positive Bodies & Minds in Midlife and for
Women Only.
Health Management A Personalised Approach for

Officers in Mid 40s and above.
Emotional Well-Being The Key to Successful

Relationships.
Other than these formal training and certification programmes,

we also conduct community-based programmes such as:
Seniors Talkshop empowering seniors and promoting

their active participation in the community by training
them to speak on such topics as the ageing process and
inter-generational issues, and addressing their peers, the
public and other interested groups. We have trained 80
seniors who have delivered 266 talks, reaching out to more
than 5,000 people.
Guided Autobiography (GAB) through reflecting, telling

and documenting their life story, seniors can re-affirm their
achievements, strengthen their sense of self and rekindle
past interests, even unleashing new potential. Of the 22
seniors who participated in three cycles of the programme,
six underwent training to be facilitators for the programme.
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Public Education promoting positive attitudes about

ageing; increasing the self-esteem and opening avenues
of participation for seniors so that they can live their later
years with happiness and a greater sense of well-being;
and equipping families with family life knowledge and
skills with respect to seniors. In 2008, we conducted 31
talks and two workshops on ageing issues, reaching out to
approximately 1,000 people.
Caregivers Training preparing professional and non-

professional caregivers to handle the whole spectrum of
assistance that seniors require, especially as they age and
become more frail, or develop illnesses such as dementia.
In 2008, we conducted two programmes and trained 29
caregivers.
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HOW TO MANAGE
YOUR EMOTIONS
You experience emotional pain when your wishes and

desires are not achieved or there is a suffering of loss.
Disappointment, sadness, regret, anger, fear, hatred and
anxiety can all be experienced as emotional pain.
Be aware of the emotions you are experiencing. Oftentimes,

you would mask it, deny it or replace it with doing, keeping
busy. You can do this through self reflection or with
someone you feel safe with and has the skills to help you
with the reflective process.
Face your emotions squarely. When emotions are unpleasant,

you often have a tendency to push it aside, to ignore it. In
acknowledging your emotions, you sometimes blame yourself
or blame others for the state you are in. Be aware of this pitfall
and avoid it from unfolding.
Understand what led to the experiencing of those painful

emotions. Was it a view you held onto rigidly or was it
an expectation that you have of yourself or of others that
gave rise to these painful feelings? Was your yearning
not met?
Accept that there are things you cannot change. Accept

the changes you can make and let go of expectations or
views you might have. Most of all, see the possibility of
alternatives and that you have the ability to make the leap
towards that new possibility.
Act upon creating a different scenario for yourself.
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FRIENDLY COMPETITION
Staying socially active keeps you energised and alert.
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HOW TO STAY
ENGAGED WITH
LIFE
Being engaged with life is prime in positive living. You stay

engaged because you feel good about yourself, fully aware
of your own strengths and the resources you possess and
that life will have its fair share of ups and downs.
Be at ease, and go at your own pace. There is no need

to rush, or give yourself stress. Just take your time, and
enjoy the process. Its not necessary to compare with
others, having fun with what you are doing is just as
important!
Call an old friend whom you have not contacted for

some time, cook a new dish youve never tried, listen
to an old CD you like, go for a walk in the park, or attend
some activity in the Community Club. No matter how
small the event is, as long as you do it, you appreciate
the effort you put in and enjoy it.
Learn how to let go. Activities you previously enjoyed

but are no longer suitable due to physical changes or
other issues. Its alright to feel sorry or disappointed, but
try to find out why its so important to you, then let go
and try something new.
Dont give up easily. Act on things you like to do and can

do. Even if you might not be able to achieve the goal you
set, you will still enjoy the process.
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4
Financial Security
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Interagency
Collaboration Division
Our Goal
To support active and successful ageing and the desire of
seniors to age with grace and dignity in their own homes
and communities, our three-prong strategy involves:
Developing strong partnerships with local and regional

agencies involved in aged care through networking,
information exchange, and collaboration on projects that
raise awareness and address the needs of seniors.
Contributing to policy planning on ageing by engaging

policy makers in constructive dialogue and providing
research information and feedback from the ground.
Promoting quality integrated systems of care for seniors

in Singapore.
Our Approach
We work horizontally with aged-care agencies and vertically
with policy makers through active engagement, consultation
and sharing of expertise and knowledge. We believe that
with greater interagency collaboration and increased input
into policy planning, we can facilitate the development of an
integrated system of services for older people, thus enabling
their continued participation and engagement in society.
The Foundation has therefore invested resources in creating
systems, strengthening networks, and opening up channels
for partnerships, consultation and resource sharing.
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HOW TO BE
FINANCIALLY
INDEPENDENT IN
YOUR OLD AGE
Having a good financial plan will help you get there. You
go through various life stages that determine your financial
needs. It is important to anticipate several events or factors
in order to prepare for whatever each stage demands.
The life choices and decisions you make have an enormous

impact on your financial security throughout your life span.
Unplanned life events can alter the course of your plans and
economic status.
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How We Fared
Citi-Tsao Foundation Financial Education Programme:
In April 2008, the Tsao Foundation and Citi Singapore launched
the Citi-Tsao Foundation Financial Education Programme for
Mature Women that reached out to women from the lower income
bracket, between 40 and 60 years old. The programme equips
women with basic money management skills to help them become
more financially stable and secure as they grow older.
Needs Assessment Findings

The programme was launched after a needs assessment
conducted by the National University of Singapore that revealed
women understand the value of saving money; even those
without savings expressed the desire to save if there was a
surplus. In almost all cases where the women had children,
the education of children took priority in family expenditure.
However, most women were averse to obtaining study loans for

their children, preferring to spend their cash in hand for this
purpose. In addition, the mothers did not expect their children
to support them when they retire. This likely added to the
common worries about retrenchment and prolonged illness in
their retirement years. Although ownership of their house or
flat may serve as a possible source of financial security, it was
by no means a guaranteed option.
Five-Month Intensive Training Sessions

To address these issues and overall financial literacy needs,
the five-month Citi-Tsao Foundation Financial Education
Programme for Mature Women covers two major areas:
Personal Finance and Social Empowerment.
Personal Finance focuses on topics such as savings, debt,

investments and insurance.
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Social Empowerment builds the womens capability to understand

their roles and the relationship dynamics within their families; to
negotiate for support among their family members; to be equipped
with the appropriate knowledge in having transactions with
financial institutions; and to be adequately prepared for old age.
Through practical-skills based workshops, the women are

discovering their financial vulnerability, are learning how to
build financial safety nets, how to access common financial
instruments, investments and entrepreneurship, and are being
empowered to better handle their future.
An important facet of the programme involves enhancing

womens role by encouraging employment or entrepreneurship
to increase their income levels especially among those who
are homemakers, full- or part-time workers, and who are
married, single parents or have never married. At least 1,400
women with monthly household incomes between S$1,500 and
S$3,500 are expected to benefit from the programme, funded
by Citi Singapore and Citi Foundation.
Wider Implications And Applications

Apart from directly helping women with practical knowledge and
skills in managing their personal finances, the programme also en-
courages the wider community to be more aware of and responsive
to issues affecting the economic and social independence of mature
women. In the longer term, graduands of the programme may even
become entrepreneurs themselves and be able to help others.
Tsao Foundation also intends to develop an impact assessment

model by 2011 to analyse behavioural changes in participants.
Positive changes include their ability to establish good financial
habits, sustain their financial plans over five years, and achieve
a return on investment of 1:5 based on the actual amount
invested in them over the course of their training.
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Furthermore, the programme modules are expected to be available

for use by other Singapore-based organisations interested in
offering similar programmes in their respective sectors.
Voices of Older People

In November 2008, Tsao Foundation officially launched a pro-
gramme to engage seniors and promote their active participation
in the wider community, in particular their contribution in formu-
lating and implementing national policies or initiatives affecting
their well-being. As part of the Voices of Older People programme
launch, Tsao Foundation also submitted a report to the govern-
ment, based on findings it collected from elderly Singaporeans on
what the countrys housing policy has to take into consideration
when catering to their needs and desire to age in place.
The seeds of the programme were planted as early as

January 2007, when the Council for Third Age (via its
Golden Opportunities (GO!) Fund) funded the programme.
The following year was spent training 70 senior volunteers
to lead focus group discussions with older Singaporeans to
understand their concerns based on three aspects: financial
security, health, and social support.
Focus Group Discussion On Housing Concerns

From May to October 2008, the programme organised 30 focus
group discussions among seniors in different communities and
housing estates as part of its Housing for Seniors: Growing
Old at Home in Singapore study. These focus groups discussed
housing from different aspects: financial, physicality; lifestyle
and values; community participation, lease buyback/reverse-
mortgage schemes; and ageing in place.
Findings from the discussions include:

Changing perspective in living arrangement: Older
Singaporeans want to live alone and independently. They value
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privacy, comfort, safety and the freedom to do what they want

to do in their own homes. In order to do so, they would like to
continue working, even on a part-time basis, to keep busy and
have a means to support their monthly living expenses, such as
food and utilities, without using their savings.
Ageing in place: Growing old at home is a desire for most

seniors who own their house, especially those who have stayed
in their community and neighbourhood for more than 20 years.
They would like to grow old in familiar, secure, safe and com-
fortable surroundings. To them, it is important that amenities
such as MRT/bus-stops, markets, food centres, banks, clinics
and other healthcare facilities are easily accessible, preferably
located near their homes.
Community participation: Most seniors reminisce about

and miss the Singapore of old, where the kampong or
community spirit was very much alive. Today, they see and live
in communities that they feel are not elderly friendly and cater
mostly to the needs of the younger population. The seniors
hope the kampong spirit can be revived through more
platforms and activities created for them to participate in and
contribute to community development.
Further Development And Wider Applications

To date, the programme has carried out focus group discussions
with at least 445 older people in order to develop capability
among other groups and organisations working with and for
seniors. It is also working to identify and develop the leadership
capability of at least 45 older people, who would have the
knowledge and skills to engage their peers in the community.
This group of elderly leaders would also be empowered to
represent the voices of older people at local residents committees,
or the decision-making platforms at the community level.
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SAVING HABITS
Glass jar
Bank book
Put your coins into a glass jar at the end of each day and deposit
this money in the bank every month.
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HOW TO BUDGET FOR

THE FUTURE
Many people are not convinced that they have a need for
a budget. Other people fully realise their need, but simply
have no idea where to start. With this in mind lets walk
through the basic steps of creating a personal budget.
Steps:
Create a list of all your monthly income and
all your monthly expenses.
Determine if your income covers all of your

current expenses.
Adjust expenses based on your financial goals.
Exercise will-power and self-control.
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Tips:
Learn how to get the most out of your money.
Exercise will-power and self-control.
Develop a good record-keeping system.
Evaluate your budget regularly.
A major advantage of living on a budget is that it relieves

a great deal of financial-related stress. Another advantage
is that it allows you to regularly place money into savings
plans. This will provide financial cushion to cover emergency
situations that may arise.
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HOW TO SAVE FOR

EMERGENCIES
Life is unpredictable. When it comes to money, its always a

good idea to have an emergency supply of it. Most financial
advisers recommend setting a fund that will cover six to eight
months of living expenses. An emergency fund is intended to
cover your basic living expenses in case we lose our jobs or
have a major medical expense.
Here are some practical ideas for creating your own

emergency fund:
Start by doing the math. What are your bare bones

living expenses each month? How does this figure
compare to what you actually spend right now?
Once you know that monthly figure, multiply it by

six or eight, whatever you believe is your goal.
Decide how long it will take you to build up your

emergency fund. Take your time and be realistic about it.
Create a special savings account as your emergency

fund. Select an account that will accrue interest or
earning but one that will offer liquidity so that you can
withdraw when an emergency occurs.
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HOW TO BUILD
A FINANCIAL
SAFETY NET
Planning a financial backup for lifes emergencies is a

prerequisite to beginning an investment plan. As a rule
of thumb: obtain adequate life insurance generally
eight to ten times your annual family income.
Life Insurance
The primary purpose of life insurance is to make sure that
anyone who is financially dependent on you will not lose
support if you die. Dependents can include spouse, children,
parents and siblings.
When deciding whether or not you need life insurance,

ask yourself this question: Is there anyone dependent on
me for financial support? If you can answer no, then you
probably dont need life insurance.
Your CPF and You

Retirement
At the age of 55, the CPF savings may be withdrawn after
setting aside the CPF Minimum Sum. The CPF Minimum Sum
may be used to purchase life annuity from a participating life
insurance company, placed in a participating bank, or left in the
Retirement Account with the CPF Board. From 62 years old
onwards (current draw-down age) monthly payments may be
given to help meet basic needs in retirement.
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If CPF Minimum Sum is left with a participating bank or

the CPF Board, you will receive a monthly income until
the amount is exhausted.
If life annuity has been purchased, you will receive a

monthly income for life.
Healthcare
Monthly contributions to the Medisave Account help build
up savings for healthcare needs. Medisave may be used to
cover for self or dependents hospitalization expenses and
for certain out-patient treatments such as chemotherapy
and radiotherapy treatments.
Medisave savings may be used to cover the premiums for

Medishield medical insurance schemes for you and your
dependents. They help to meet the high medical costs of
prolonged or serious illnesses.
For older CPF members, there is Eldershield, an affordable

severe disability insurance scheme that provides insurance
coverage to those who require long-term care.
Family Protection
The Dependents Protection Scheme helps families to
tide over the first few years in the event of an insured
members permanent incapacity or death.
The Home Protection scheme prevents families from

losing their homes in the same event.
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HOW TO INVEST YOUR

MONEY
When you invest, you do not only have the potential to

earn money on what youve contributed, you also have
the potential to earn money on your earnings.
Stocks, bonds, mutual funds, and cash investments have

different advantages and risks. In order to make this decision,
you need to understand the difference between them.
Stocks and Options

Stock is essentially a percentage of ownership in a company
that is publicly held.
Options require you to purchase and sell shares of an

underlying security for a pre-determined price during a
specific period of time.
Mutual Funds
A mutual fund is a professionally managed investment
vehicle. Mutual funds offer the ability to diversify, as
they hold a large numbers of securities.
Fixed Income
A bond is simply a loan from the investor to the issuer. In
return for the loan, the investor may be paid interest on a
periodic basis and at maturity, the full principal is returned.
Bonds have a stated maturity date and a fixed coupon
or interest payment. This is why bonds are called fixed
income investments.
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There are many types of fixed income investments and

each has unique characteristics depending on the issuer.
Annuities
An annuity is a contract, issued by an insurance company,
which allows you to accumulate money on a tax-deferred
basis for long-term goals such as retirement.
Annuities are among the most popular retirement investments.

Despite their popularity, many people still dont know much
about them. The following will help explain the different types
of annuities. You can contact your financial advisor to see if
annuities fit into your overall portfolio.
Fixed Annuities
Fixed annuities guarantee a fixed interest rate for a period
of time and depending upon your contract, the rate may be
adjusted annually by the insurance company.
Variable Annuities
Variable annuities are generally a collection of sub accounts
issued by an insurance company. Your earnings accumulate
tax-deferred so you dont pay taxes until you make
withdrawals.
Indexed Annuities
Indexed annuities have tax-deferred growth tied to the
performance of the equity markets and minimum interest
guarantees to help individuals achieve their retirement
objectives.
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HOW TO PLAN YOUR

ESTATE
Consider Working with a Financial Advisor

The financial advisor you choose is a key component in
shaping your financial future. You need to entrust this person
with your most personal information, hopes, dreams, and
goals. Thats why the advisor you choose needs to not only
be someone you can rely on, but someone you can talk
openly with about your long-term plans.
Make a Will
If you die intestate (in other words without a will) you run
the risk of leaving behind a trail of stress, cost and even
family feuds. The business of making a will can be quite
straightforward and it wont cost the earth provided you are
aware of the major pitfalls. Here are some pointers to consider:
Choose who draws up your will wisely.
Choose your executors well. Consider appointing a

default or substitute executor.
Appoint guardians.
Appoint trustworthy trustees. Trustees will be responsible

for managing and investing money, or looking after
property until it passes to the beneficiaries, so make sure
they are people with a good grasp of financial matters
and that they are still young enough so they dont die
before you do.
Make specific legacies and make sure you leave a

residual legacy. The residue is what is left over in
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your estate after you have made specific legacies. The

gifts and legacies would pass according to the will, but
the residue would be subject to the laws of intestacy.
Sign your will. If you dont sign it in front of two

independent witnesses, it will not be valid. A witness
cannot be anyone mentioned in the will or married to
anyone mentioned in the will.
Update your will. It is always possible that a number of

factors in your life will change. If this means you need
to amend your will, it is important that you dont waste
time in doing so.
Get it stored safely. Whatever you do dont hide your

will. Your will is no good to anyone if it cannot be found
after your death.
Reference:
70 Answers You Need to Know about Personal Financial Management,
Citi-Tsao Foundation Financial Education Programme for Mature
Women (2009).
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HOW TO LIVE LONGER

AND HEALTHIER
Women and Ageing

Singaporeans are living longer. Since 2006, Singaporean
men can expect to live to 82 years averagely. The average
Singaporean woman can expect to live to 85 years. But
these years may not necessarily be healthy life years.
Women also tend to have more disabilities as they grow
older. Hence, women need to make sure that they take
stock of their own health and start to adopt some lifestyle
changes to ensure that they will have more healthy life
years alongside life expectancy.
Tips For a Healthier Lifestyle

Avoid acquiring serious illness by going for health screen-
ing as and when necessary. Our Hua Mei Seniors Clinic
recommends going for screening, if you are 40 years and
above, and if you have a family history of chronic disease
or cancer. Refer to page 15 for more details and informa-
tion on recommended screening and frequency.
Establish and develop a good relationship with your

primary care doctor. Having a doctor who knows you well
and knows your story including your familys history, will
help to make sure you are going to have a physician who
will be able to advise you better and be someone you can
trust once you need more complicated medical help.
Enjoy eating out with family and friends but eat well. You
can ensure more healthy life years if you start saying
no to food that we know is going to cause that pain or
give us reason to see our doctor again and again. You are
for the most part the decision maker when it comes to
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what food to eat and where to eat. Do not relinquish

this role to your children. Your children will not love us
less just because we choose to eat healthily.
Stay active and engage in meaningful and enjoyable

activities. In Singapore, it is not that difficult to keep
ourselves busy.
Take care of your grandchildren or the young children

of your neighbours.
Go to the community centre nearest you and join their

classes and participate in their activities. You can also
join a womens club or organisation and join their classes
and activities.
Volunteer with organisations within your communities.

Many of them are always trying to find volunteers who
would like to help them.
Join your friends who exercise or make new friends

who like to exercise. Not all our friends and family
members exercise. If you do not have friends now
who exercise, join your local community club or
womens club that have exercise programmes.
Maintain a good relationship with your children. If you

have very little savings and not enough money in your
CPF, your children will have to step in, when necessary.
It is important that you keep and maintain a good
relationship with each one of them as well as their own
families (children-in-law/grandchildren). Most of us do
not wish to be a burden to our children. But in times of
crisis and in emergency cases, you should be able to rely
on them for some help. Having looked after them and
protected them in their younger years, it is but fair that
you seek their assistance, but only if necessary and only
if you choose to do so.
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Maintain your circle of friends and expand

your network of friends.
Maintain your circle of friends and expand your network

of friends. Women in general are more socially inclined
to seek help and assistance among close friends rather
than your own families. It is good to have a circle of
friends whom you know very well and can trust. Keeping
this relationship intact and maintaining regular contact
with friends will help a long way in ensuring that you
are not going to be alone in your widowhood years,
that you will have some socialisation to keep boredom
and loneliness at bay or even just to have someone to
keep you company as you go for that regular exercise,
a learning class or even to see your primary doctor.
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HOW TO PLAN FOR

YOUR WORK-LIFE
AFTER RETIREMENT
Worrying will not help to improve any situation. It creates

even more anxieties, problems and delays you from
advancing to the next stage.
Stay positive! Always think positive, remain focus and

inspired! Create self-awareness, do not allow these
emotions to control you and affect your ability to make
good decisions for your next big step.
Understand and manage the physical, psychological

and mental changes associated with normal ageing. To
cope with the changes, stay healthy, making appropriate
changes and delaying the ageing processes so that you are
fit to move on to a second career, or be your own boss.
Recognise and consider all options available! You do

have options. Do not limit your mind to the work you
were doing in the past. List the possible options available
and conduct research about the options. The options
can include looking for another job in the same industry,
preparing for a new second career, or be your own boss.
This is an extremely important step because it will help
you to stay focused and create plans for moving on.
Update your skills! Take stock of your life skills,

knowledge and experience, identify any need for new
skills, especially in highly technical fields. Monitor the
market conditions, and look for training opportunities
available to upgrade yourself or learn new skills. Do visit
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websites like Workforce Development Agency to tap

on government funding support to upgrade yourself or
acquire new knowledge and skills to make your job
search easier.
Prepare well for job search. Get ready and update your
resume, seeking expert help in preparing your resume,
if necessary.
Invest in grooming yourself for interviews to create

a positive first impression. Anticipate the possible
questions likely to be asked by the interviewers and
be prepared for the interviews. Visit the company
website before the interviews. A little preparation
goes a long way in an interview.
Consider interim job or volunteer opportunities. These

allow you to acquire new skills, knowledge, experience
Monitor the market conditions, and look for training

opportunities available to upgrade or learn new skills.
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and assist you in deciding whether you would like to

pursue this as your next career. These activities may
help to offer some temporary financial assistance. Most
importantly it helps to boost your morale and allows you
to stay in touch with the labour market. Volunteer work
is also a way to upgrade skills.
Continue to build your network. Networking is the most

effective way to stay relevant in the job market. Spread
the word among people around you, including your
family members, relatives, friends, ex-colleagues etc,
that you are job hunting.
Attend career road shows, leave your resume with

employment agencies, visit job portals regularly for
suitable job opportunities. You have to be realistic in
your expectations in line of the new environment,
your physical and mental abilities and the level of your
contribution. You may not get back to the same position
and have to take a step back on the career ladder, but
be realistic and stay happy.
The following are some useful websites to help you on

your way:
Tips on Managing Tough Times

National Council of Social Service
http://www.ncss.org.sg//home/toughtimes.asp
Skills Training Programme with Government

Funding Support
WDA
http://app2.wda.gov.sg/web/Common/homepage.aspx
e2i
http://www.e2i.com.sg/
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BUILD YOUR NETWORK
Networking is the most effective way to stay relevant in the job market.
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Financial, Social & Employment Facilitation

ComCare
1800 222 0000
www.ncss.org.sg/documents/AssistanceSchemes.pdf
WDA
http://app2.wda.gov.sg/web/eventCalendar/EventList.asp
www.socialservicejobs.org.sg
Central Singapore CDC

6370 9901, 6370 3410
www.centralsingapore.org.sg
North East CDC

6424 4000
www.northeast.org.sg
North West CDC

6767 2288, 6463 3626
www.northwest.org.sg
South East CDC

6243 8753
www.southeast.org.sg
South West CDC

6316 1616
www.southwest.org.sg
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5
Corporate Information
G9.10424 TSAO AR 08.indd 117 24/09/2008 11:08 AM

HOW WE CARRIED OUT

OUR MISSION IN 2008
January Tsao Foundation Expert Series:

26 Kathleen Bower
Our American study showed that case management has
successfully reduced the rate of hospital re-admissions
of 102 seniors from 63 times to half, and shortened
the patients average hospital stay from 7 to 5.6 days.
The Tsao Foundation Expert Series on Effective Case
Management drew more than 300 care managers and
healthcare professionals over a period of five days from
seminars to closed doors discussions with ministry on
how to support sick elderly to stay home and age in place.
February United World College Southeast Asia (UWCSEA)

16 Tsao Foundation Chinese New Year Lunch 2008
Starting them young! Over the last ten years, UWCSEA
students of K1 and K2 organised the annual CNY lunch
for around 80 elderly under the Hua Mei Clinical Services.
The lunch is sponsored by Ms Shabnam Melawani-Reis,
board member of the Tsao Foundation.
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April Launch of the Citi-Tsao Financial

16 Education Programme for Mature Women
1,400 matured women will benefit from the first financial
literacy programme jointly organised by Citi Singapore and
Tsao Foundation, launched by Mrs Lim Hwee Hua, Senior
Minister of State for Finance and Transport.
April Queen Elizabeth II Cup 2008

20 Double Winning Singapore Turf Club teamed up with
the Tsao Foundation to raise $1 million for Hua Mei
Clinical Services to provide home care for 100 frail elderly
through the QEII Cup Charity Race.
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May IMC Charity Golf 2008

23 Minister Vivian Balakrishnan congratulated IMC Group for
raising $300,000 from its IMC Charity Golf Event for Hua
Mei Clinical Services.
June Launch of WSQ Certificate in

26 Community and Social Services
Tsao Foundation appointed by WDA to be the WSQ
Quality Provider for Senior Services to train and equip
people to work in the elderly services sector and to
upgrade the competencies of workers in the industry.
July Appointment of Centre of Specialisation

10 by National Council of Social Service
Tsao Foundation appointed as the Centre of Specialisation
for Senior Services by National Council of Social Service.
August Tsao Foundation-TNS Survey on Ageing Preparedness

20 Tsao Foundation and TNS conducted the first annual
online research on National Ageing Preparedness Survey.
Two-thirds
T RETIRING OVERSEAS
Considered moving to another
country for retirement?
of Sporeans
think of NO
37%
YES
21 34 yrs: 75%
35 44 yrs: 63%
63% 45 55 yrs: 49%
retiring
abroad: Poll Motivators for moving?
Slower pace of life: 73%
Lower cost of living: 69%
More pleasant environment: 64%
Better facilities for the elderly: 34%
Children/family are overseas: 29%
Reference: The Straits Times, 21 August 2008
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September Tsao Foundation Expert Series:

13 Professor Li Siang Yu
Tsao Foundation Expert Series on TCM: The TCM
Approach to Infertility and Gynaecological Diseases
by Prof Li Siang Yu from Shanghai.
October IPS-Tsao Conference on Successful Ageing

22 in Singapore: Older Men and Women in
a Society of Longevity
More than 200 professionals attended the IPS-Tsao
Foundation Conference on Successful Ageing
in Singapore: Older Men and Women in a Society
of Longevity.
November
Tsao Foundation Expert Series:
112 Dr Harrison Bloom
A total of 500 doctors and healthcare professionals
met with Dr Harrison Bloom, an eminent geriatrician
and Director of Clinical Education Consultation Service
of International Longevity Center in the U.S, over 12
days on preparing and providing primary healthcare for
Singapore greying population.
November
Launch of Voices of Older People Programme
12 The first Voices of Older People that enable older
people to share their feelings and problems that they
face found that the elderly in Singapore desire to live
alone and independently and have more choices in their
housing options.
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HOW WE STARTED
The Story Of Mrs Tsao Ng Yu Shun
Even though founding matriarch Mrs Tsao Ng Yu Shun left school before
turning 13, she did not stop learning. Applying her knowledge of banking
practices and prudent investments, she deftly managed her familys
finances. She also operated a profitable jeweller business, enabling her to
earn an independent income. In all this, Mrs Tsao was a close adviser to
her husband, and he appreciated and trusted her judgement.
When he passed away in 1990, she set up the Tsao Foundation to honour
her father and father-in-law. Memories of her widowed great-grandmother,
grandmother and great-aunt led her to dedicate the Foundations mission
to serving the medical needs of senior citizens. At her request, her
granddaughter Dr Mary Ann Tsao whom she had encouraged to study
medicine took over leadership of the Foundation, which has today
enhanced the way seniors prepare to age successfully.
For her service and dedication, Mrs Tsao was honoured at a United Nations
sponsored global conference on ageing in Montreal in 1999. She may have
passed away eight years ago, but her exemplary life will continue to inspire
all who have been touched by her words, deeds and generous spirit, which
also lives on in the legacy that is the Tsao Foundation.
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I want to ease some of the hardship

and bring some quality of life for
all elderly, especially those in need.
After all, we all deserve some peace
and dignity in our old age.
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HOW WE OPERATE
Vision
We envision a society for all ages that supports active ageing and
values the contributions of older people. We advance services, skills
and knowledge of individuals and communities in eldercare; facilitate
the participation of seniors in society; and promote their views for
policy planning.
Mission
We aim to harness, cultivate and leverage our know-how to be a change
leader in successful ageing in Singapore, Asean and China through the
Hua Mei Centre For Successful Ageing, which champions community-
based model development and replication, training, capacity building
and advocacy. With our person-centric philosophy, our approach will be
innovative, catalytic, collaborative, evidence-based and sustainable.
Values
We strive for innovation, excellence and constructive change. The spirit
of innovation motivates us to find new ways to improve the eldercare
landscape and quality of life for older people in Singapore. In our pursuit
of excellence, we set high professional standards for ourselves, and for
the services we promote to the older people we serve, their caregivers
and our professional colleagues. As a catalyst for constructive change, we
actively promote scholarly research on ageing issues; invite distinguished
academicians to share their expertise with local eldercare professionals;
and support policy planners with ground feedback and constant dialogue.
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HOW OUR BOARD OF

DIRECTORS IS COMPOSED
Franklin Tsao Dr Mary Ann Tsao Dr Robert Chow Er Kwong Wah

Chairman & President Board Member Board Member
Governing Director
Dr Kanwaljit Soin Dr Tan Cheng Bock Phillip Tan Frederick Tsao

Board Member Board Member Board Member Board Member
Shabnam Melwani-Reis Locknie Hsu

Board Member Board Member
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HOW WE MANAGED
FINANCIALLY
2006 2007 2008 % Increase/

S$ S$ S$ (Decrease)
STATEMENT OF INCOME
AND EXPENDITURE
INCOME
Donations in Cash:
Tax Deductible 849,412 1,017,735 804,918 (21%)
Non-Tax Deductible 0 0 243,189 100%
Donations in Kind:
Tax Deductible 0 0 0 0%
Non-Tax Deductible 0 0 0 0%
Tsao Trust Fund 1,500,000 1,500,000 1,500,000 0%
Grants/Sponsorships/
Subsidies 577,994 821,306 1,482,258 80%
Investment Income 0 0 4,074 100%
Investment Gains 0 0 0 0%
Programme Fees 461,184 679,695 729,667 7%
Others 106,321 32,706 55,582 70%
Total Income 3,494,911 4,051,442 4,819,688 19%
EXPENSES
Direct Fund-raising Expenses 0 35,007 196,692 462%
Charitable Activities Expenses
Local 2,462,161 2,911,679 3,697,004 27%
Overseas 0 0 0 0%
Other Operating &
Administration Expenses 780,041 758,217 816,427 8%
Others 0 0 5,340 0%
Total Expenditure 3,242,202 3,704,903 4,715,463 27%
SURPLUS/(DEFICIT) 252,709 346,539 104,225 (70%)
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2006 2007 2008 % Increase/

S$ S$ S$ (Decrease)
BALANCE SHEET
ASSETS
Land and Buildings 0 0 0 0%
Other Tangible Assets 450,625 308,860 871,983 182%
Investments 0 0 239,683 100%
Inventories 5,852 21,503 20,755 (3%)
Accounts Receivable 101,061 131,394 489,494 273%
Cash & Deposits 1,688,251 2,220,866 2,345,500 6%
Others 0 0 0 0%
TOTAL
ASSETS 2,245,789 2,682,623 3,967,415 48%
FUNDS
Accumulated Fund 1,730,852 2,077,391 2,181,616 5%
Scholarship Fund 142,896 140,896 142,099 1%
Health Endowment Fund 144,270 15,718 17,677 12%
Total Funds 2,018,018 2,234,005 2,341,392 5%
LIABILITIES
Long-Term Liabilities 0 0 538,374 100%
Current Liabilities 227,771 448,618 1,087,649 142%
Total Liabilities 227,771 448,618 1,626,023 262%
TOTAL FUNDS AND
LIABILITIES 2,245,789 2,682,623 3,967,415 48%
Other Information
Donations/Grants
and Sponsorship
Given to Other Charities 0 88,746 0 (100%)
Number of Employees 47 45 52 16%
Total Employee Costs 2,385,543 2,658,934 2,758,701 4%
Total Related Party
Transactions 0 93,750 182,500 95%
Fund-raising Efficiency 0 15% 23% 57%
Ratio of Reserves to Annual
Operating Expenditure 53% 57% 48% (15%)
127
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HOW TO CONTACT US
Hua Mei Seniors Clinic

Contact Amelia Tay, Programme Coordinator, at 6273 6632 or
hmsc@tsaofoundation.org.
Hua Mei Mobile Clinic

Contact Mervlyn Soon, Senior Social Work Coordinator, at 6593 9564 or
hmmc@tsaofoundation.org.
Hua Mei Acupuncture and TCM Centre

Contact Karen Hoon, Receptionist, at 6471 5517 or
hmac@tsaofoundation.org.
Hua Mei Care Management

Contact Cynthia Ng, Programme Coordinator, at 6593 9595 or
hmcm@tsaofoundation.org.
Hua Mei Training Academy

Contact Alice Chiam, Administrative Manager, at 6593 9555 or
alice@tsaofoundation.org.
Interagency Collaboration Programmes

Contact Angela Leow, Programme Officer, at 6593 9517 or
ic@tsaofoundation.org.
Or visit the Hua Mei Centre for Successful Ageing

298 Tiong Bahru Road
#15-01/06 Central Plaza
Singapore 168730
Tel: 6593 9500

Fax: 6276 7128
Email: tsao1@tsaofoundation.org
www.tsaofoundation.org
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The Handbook On Successful Ageiing

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The

G9.10424 TSAO AR 08.indd a 24/09/2008 11:07 AM

G9.10424 TSAO AR 08.indd c 24/09/2008 11:07 AM

Tel: 6593 9500

Concept and Design by Epigram

G9.10424 TSAO AR 08.indd d 24/09/2008 11:08 AM

G9.10424 TSAO AR 08.indd e 24/09/2008 11:08 AM

5 Health & Healthcare

G9.10424 TSAO AR 08.indd f 24/09/2008 11:08 AM

117 Corporate Information

G9.10424 TSAO AR 08.indd g 24/09/2008 11:08 AM

It was also an exciting year of active preparation for Tsao Foundation

Pillar I: Income Security

G9.10424 TSAO AR 08.indd 1 24/09/2008 11:08 AM

Pillar II: Health/Healthcare

Pillar III: Participation

G9.10424 TSAO AR 08.indd 2 24/09/2008 11:08 AM

leadership capability so that they can effectively engage their peers in

Beyond these efforts, the Foundation will continue to provide an integrated

We will be busier in 2009 and 2010, as we streamline our care and

Finally, this years Annual Report is crafted in the form of a Handbook on

Dr Mary Ann Tsao

G9.10424 TSAO AR 08.indd 3 24/09/2008 11:08 AM

G9.10424 TSAO AR 08.indd 5 24/09/2008 11:08 AM

Hua Mei Seniors Clinic

Improving the attitudes, education and training of healthcare

Adapting primary healthcare management systems to the

Shift from an episodic care model to a proactive, care

Strengthen the preventive aspect of primary care through

Practise a patient-centred approach to care with emphasis on

Exercise tight control and management of chronic diseases

Prepare patients and their families for advance care

G9.10424 TSAO AR 08.indd 6 24/09/2008 11:08 AM

Good health is something we all aspire to, but a robust,

The leading causes of disease, disability and death (such as

You also need a good health partner to guide you in all

Health promotion through knowing and doing what is

Disease prevention and early detection of disease

G9.10424 TSAO AR 08.indd 7 24/09/2008 11:08 AM

Regular health screening helps to maintain your

Chronic disease management when chronic diseases

Long-term care once complex diseases and complications

G9.10424 TSAO AR 08.indd 8 24/09/2008 11:08 AM

Finding a good doctor a partner, guide and healer that you

Most people do not understand the important role of the

First stop for all the patients health needs.

Patient-centred care with the patients best interest in

Continuity of care versus only episodic care.

Comprehensive care from health promotion,

Holistic approach in managing the social and

G9.10424 TSAO AR 08.indd 9 24/09/2008 11:08 AM

Who Did We Help

We also saw an increasing number of patients with common

The majority of our patients come to us by word of mouth.

G9.10424 TSAO AR 08.indd 10 24/09/2008 11:08 AM

Co-ordination of specialist care and communication

If you are over 65, it is helpful to have a doctor with interest

Talking to Your Doctor

What is the condition or diagnosis (i.e., what is the cause

What are the medications being prescribed and how do

What are the possible side-effects?

What else can I do to help in the recovery

What are the warning signs that I should look