A Systematic Review and Case Studies of Health and Social Services Provided for Community-Dwelling Older Adults
摘要
In Singapore, rapid population aging is generating increased research and policy attention toward promoting aging in place. Individuals who grow older in familiar communities are more likely to be socially engaged, leading to better health and social outcomes. To assist aging in place, Singapore has recently begun developing eldercare centers that provide integrated health and social services to meet the needs of older adults. This chapter aims to review how community-based health and social care programs have been implemented internationally and summarize their effectiveness. We also present key lessons learned from the evaluation of two types of community-based programs in Singapore and explore how findings from the literature may help bridge some of the implementation gaps and barriers. Health and social care programs in our review can be categorized into physical activity, nutrition, chronic disease management, psychosocial, and cognition. Most of the programs showed some success in improving older person’s health and psychosocial well-being in the short term. Implementation gaps identified in the evaluation studies included socioeconomic inequalities in reach, a lack of clarity in the linkage between program activities and expected outcomes, a mismatch between staff competency and roles assigned, and staffing constraints. Understanding the unmet needs of older persons and the assets or resources available in the community should be the first step in developing community-based health and social programs. In addition, researchers and program practitioners should collaborate to formulate programs that are accepted by older adults, effective in achieving intended outcomes, and can be sustained by community-based centers.