chapter  4
17 Pages

Managing later life and health: A study of older Chinese men living alone in Singapore

ByLENG LENG THANG

In line with the emphasis of family as providers of care and shelter for older persons in state rhetoric as well as cultural preference, the phenomenon of older persons living alone is considered more an exception than a norm in Singapore society. Singapore is indeed unique among themore developed nations to sustain a relatively high percentage of intergenerational co-residence. In 2005, 69.4 per cent of older persons (65 years and above) were living with their children, a slight decline from 74.1 per cent in 2000 (Department of Statistics, 2006). Despite being an exception, there are indications that living alone for older

persons is an emerging trend. A survey shows that while only 15.2 per cent of older persons expressed intentions to live alone in 1998, the percentage rose to 24.3 per cent in 2005 (Tan, 2005). In 2005, 7.7 per cent of older persons were living alone, compared to 6.6 per cent in 2000 and 5.5 per cent in 1990 (Department of Statistics, 2006). The proportion is expected to increase further with changing preferences in living arrangements among older persons and the young. Among the older persons, more may opt to live alone to maintain independence, and to avoid intergenerational conflicts with children. The rising rate of unmarried and divorced persons in the population will also impact on the trend. In addition, having more financial resources available among older persons as well as the expanded housing options available to them will make it more viable if they should choose (or be forced) to live alone. For example, expanded housing options arising from new policies and measures such as the building of Housing and Development Board (HDB) studio flats for seniors since 1998 (Tan, 2009), the HDB Lease Buyback Scheme introduced sinceMarch 2009 (Chen, 2009), and a 20 per cent increase to the stock of HDB rental flats to 50,000 in the next few years (Goh, 2008) are making it more affordable and accessible for older persons to live alone. Gerontological literature tends to emphasise the undesirable aspects of living

alone among older persons. Living alone is often conceptualised as ‘social isolation’, where socially isolated persons are defined as vulnerable, tending to be lonely, having small social networks, tending to have poorer health and healthcare access (Hobfoll, 2001; Hortulanus et al., 2006). It is also recognised

as a risk factor for older persons attempting suicide and suffering from depression and other mental health problems (Chan et al., 2006; Chou et al., 2006; Kua and Hong, 2003). A 2008 news report lauding the drop in suicide rates in Singapore noted a higher number of suicide cases among the old, and identified that a majority of calls to the Samaritans of Singapore 24-hour telephone helpline were made by older persons (Jaganathan, 2008). It was reported that: ‘They thought of suicide because they could not bear the loneliness of living alone. They were also troubled by language barriers between them and social workers, as well as their poor health’ (Jaganathan, 2008). The vulnerability of older persons who live alone is further highlighted in

studies which compare lone-dwelling older persons with those who live with others, particularly with their family members. For instance, Larsson and Thorslund’s (2002, cited in Larsson and Silverstein, 2004) study on Swedish elderly persons (aged 81 to 100) found that older persons living alone tended to receive less formal and informal care compared to those residing with others, resulting in social isolation (Findlay, 2003; Klinenberg, 2002, 2005). Chou and Chi’s (2001) study on older persons in Hong Kong found that those who lived alone reported smaller social networks of relatives and receive less instrumental and emotional support than those who live with their family members. Similarly, You and Lee’s (2006) study on Korean elderly found older persons living with relatives to have a higher mean score in terms of physical, mental and emotional health status. However, the experiences of living alone may be mediated by differences

such as health status, personality and gender. It is common knowledge that, with the ‘feminisation of aging’, women constitute the majority of older population; they are known to face more vulnerabilities such as income insecurity and long-term care needs (Chia, 2008; Chia et al., 2008). On the other hand, there are criticisms such as those raised by Luken and Vaughan (2003: 130), who highlighted the hegemonic perception of older women living alone as a social problem. Their study on the social organisation of ‘living alone’ among older women argues against such a construct, for it ‘ignores older women’s everyday competence in living alone in a society organised through class and patriarchal gender relations’. Elsewhere I have argued that in situations where both lone-dwelling older men and women are experiencing the same structural vulnerabilities, older women appear to cope better than older men as they tend to possess more social instrumental skills (Thang, 2009). This parallels empirical and anecdotal evidence which has suggested that, compared to older women, older men tend to have less affectionate relationships with their children. They tend to be more socially isolated and may possess fewer social skills than women. Moreover, activities organised for older persons tend to be female-oriented, which deters male participation. The above background suggests that with the trend towards more older persons living alone, older men as a ‘minority’ segment within this growing group require attention. This study is thus an exploratory attempt to examine how older men living alone manage their later life with a focus on health concerns. What are

they most concerned with about their health? How do they maintain their healthy state? Do they have any plan on how to cope when they need nursing care during the last stages of their life? How do they strategise the social network around them so as to help them cope with their everyday living and health management? The chapter concludes with suggestions on how policies for older persons can be enhanced to promote the well-being of older men living alone, and older persons in general.