Could you provide us with a brief introduction of yourself and what motivated you to take up the Gerontology Ph.D. programme?

As Director of Operations in SingHealth Community Hospitals, I enjoy the opportunities that I get from working on inter-disciplinary initiatives for seniors, such as those involving the process of social prescribing. After obtaining my MSc in Public Policy and Administration at the London School of Economics and Political Science (LSE), Gerontology is my natural calling. It allows me to combine practice with policy and research.

I am extremely fortunate to be able to apply gerontological knowledge in my research work, especially on caregivers for seniors, the focus on of which is also supported by my role at SingHealth Community Hospitals.

Further, I intend to apply the knowledge and skills I have acquired from the research I do as a Gerontology student in my role as a healthcare practitioner, which allows me to contribute meaningfully to society. Particularly, my work with caregiving research is underlined by my personal experiences. Being the primary caregiver to my parents and parents-in-law, I can fully appreciate the needs of the caregiving process and thus naturally gravitated to this topic in my Ph.D. research.

What is your research project about?

My research focuses on the effects of inpatient social prescribing for primary caregivers. For example, if a patient suffers from loneliness (a determinant of poor health), caregivers may encourage them to participate in social prescribing activities that will alleviate their loneliness. However, as caregivers reintroduce the patient into the community after discharge, the effects of inpatient social prescribing may inadvertently affect the caregiver as it is possible that patients who are socially activated may rely less on their caregivers, and caregivers may also partake in the activities for their own well-being. Hence, I seek to understand how social prescribing activities influence these relationships, and I am thankful to Associate Professor Lee Kheng Hock, my Ph.D. co-supervisor from SingHealth Community Hospitals, for providing me with the opportunity to work on this particular project.

What is social prescribing and how does it work?

Social prescribing is about linking individuals to the community to improve their social determinants of health through lifestyle and behavioural changes. For example, in an intermediate care setting such as a community hospital, social prescribing entails getting the seniors involved in community activities while being hospitalised, such as gardening—hence the term ‘inpatient social prescribing’. This may help patients with previously poor social determinants of health, such as loneliness, whose connections with the community are then facilitated while still holding inpatient status. Subsequently, after the senior patients are discharged from the hospital, they may connect with the community to continue these activities. These lifestyle and behavioural changes will then motivate the seniors to be more engaged physically and socially. However, inpatient social prescribing may also have known or unknown effects on the caregivers. My research aims to understand the relationship between the effects of social prescribing, senior patients and caregivers.

What led you to focus your research on the primary caregivers of the elderly?

As I am the primary caregiver to my parents and parents-in-law, I understand intimately the procedures of caregiving, and naturally gravitated to this topic for my research. I am also well aware of the specific needs and support that caregivers require. For instance, I am interested in looking into caregiver training to equip caregivers to be able to manage stress and even the trajectory of changing caregiving needs. Further, I am also interested in actively empowering and engaging our seniors in technology and activities which may reduce the caregiver burden.

What are some possible implications of the project, and how has the COVID-19 pandemic affected the social prescribing activities in Singapore?

The findings from this project reinforce the increasing importance of research in caregiving. Singapore’s rapidly ageing community, coupled with a declining old-age support ratio, poses more significant challenges to care needs and makes caregiving research ever more crucial and timely, especially research focused on primary caregivers for seniors, so that caregiving concerns and any support required may be examined holistically in terms of policy-making, practice, and research perspectives.

The current COVID-19 pandemic has created new avenues for the project, especially for social prescribing activities. In addition to the various brick-and-mortar community organisations we are familiar and working closely with, COVID-19 presents new digitalisation opportunities for social prescribing that allow us to integrate with virtual communities. Social prescribing through digital platforms can bridge the social-digital gap between care recipients and caregivers, strengthening the bond between them. This could pave the development of a hybrid online-offline model, where seniors and their caregivers have the option to remain digitally engaged through activities and networks leveraging on this technological platform. Hence, we may further explore the new norms posed by a society fast going fully digital, and how this could benefit the caregiving community in the post-pandemic future.

Finally, I think social prescribing in Singapore has gained prominence since SingHealth Community Hospitals first implemented it. It is heartening to see that social prescribing can be popularised in the caregiving space. I imagine and hope for its impact to continue to grow significantly, given the high number of caregivers in Singapore and worldwide.

Acknowledgments

The interviewee would like to express his gratitude for the Alice Lim Memorial Fund Scholarship for allowing him to pursue a Ph.D. Programme in Gerontology at the Singapore University of Social Sciences (SUSS), and Professor Kalyani Mehta, his Ph.D. supervisor, for this cherished research opportunity.

The Centre for Applied Research conducted the interview with Tai Kiat in September 2020. 

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