Healthy Ageing Programme
2024/12/06
Welcome to Our Healthy Ageing Programme: Empowering Lives, One Seionr at a Time
The Healthy Ageing Programme focuses on helping our seniors optimise opportunities to maximise their physical, mental and spiritual health across the continuum of inpatient, outpatient and community settings. This Programme is helmed by Geriatricians – a group of specialists dedicated to managing the needs and well-being of older adults.
What is Healthy Ageing and Why Does it Matter?
Ageing is a natural and inherent part of life’s journey. According to the World Health Organisation (WHO)1, “Healthy Ageing” is not merely the absence of disease but a state of physical, mental, and social well-being that enables older adults to lead fulfilling lives by maintaining their functional ability. This includes the ability to meet basic needs, be mobile, make decisions, build and maintain relationships, and contribute to society.
At Alexandra Hospital (AH), we also believe that ageing healthily should be welcomed, celebrated, and supported through dedicated care and commitment. Our fundamental principle is to empower individuals to age with grace, dignity, and vitality.
What Sets Our Programme Apart?
We are committed to enhancing the wellbeing and vitality of older adults through comprehensive, multidisciplinary patient-centred care. We understand that every individual's ageing journey is unique, and as such, our programme is tailored to meet each person's specific needs.
Our Key Program Features
- Expert Multidisciplinary Geriatric Care: We are a dedicated multidisciplinary care team comprising geriatricians, nurses, pharmacists, physiotherapists, occupational therapists, speech therapists, dieticians, podiatrists and social workers. We also work in close collaboration with other specialties such as Neurology, Urology and Dentistry.
- Personalised Care Plan: We provide a comprehensive multidisciplinary geriatric assessment and evaluation of patient’s’ medical conditions and design a care plan that is tailored to their needs, goals and preferences.
- Proactive Health Management: Beyond addressing existing conditions of patients, we prioritise preventive care as a cornerstone for healthy ageing. Regular health check-ups, screenings, and vaccinations are integral components of our programme. In accordance with local and international guidelines, we engage in active screening of geriatric syndromes such as frailty, sarcopaenia and malnutrition, to identify older adults at-risk of developing these syndromes. Through this, we can engage in preventive measures or early interventions to prevent, reverse or delay the progression of these syndromes.
- Empowerment through Education: We believe in empowering our patients and their loved ones to be active participants in their ageing journey. Our programme offers educational resources and tools that help patients understand their condition better. These resources can range from patient information leaflets to caregiver education sessions, that are held both in-person and virtual.
- Community Collaboration: We recognise that staying engaged and connected to one’s community is not only vital for emotional and mental well-being of older adults, but is also an integral component of healthy ageing. We actively collaborate with community partners who share our commitment to supporting healthy ageing and ageing- in- place. This allows us to expand resources, provide holistic care with tailored solutions and create a network of support for our patients.
We run our inpatient Geriatric Medicine service for patients across the wards at Alexandra Hospital. In addition to this, we have a dedicated Geriatric Medicine ward, Ward 2 Rasa Sayang, for older patients who are 65 years old and older, and have one or more geriatric syndromes such as fall, functional decline and behavioural disturbance.
Our Rasa Sayang ward also features a separate EMERALD Unit (Enhanced Monitoring and Early Recovery of Older AduLts in Delirium) within the ward – a specialised geriatric unit with specially trained medical, nursing and therapy staff, who provide person-centric care of older patients with delirium (confused behaviour) or dementia patients with behavioural issues.
The EMERALD Unit follows the principles of the Hospital Elder Life Program (HELP)2, an internationally acclaimed and evidence-based model of care that has shown to be highly effective in reducing and promoting early recovery from delirium in hospitalised at-risk older patients, through a series of multicomponent interventions tailored to each patient’s needs.
Features of our EMERALD Unit include:
• Restraint-free policy
• Regular re-orientation of patients per shift
• Structured engagement activities throughout the day
• Therapy sessions with physiotherapists and occupational therapists
• Inter-generational therapy in partnership with Little Skool House at AH
• Reminiscence therapy
• Music therapy
• Pet therapy
• Group therapy
With a rapidly ageing population, more elderly Singaporeans are being seen at hospitals across the inpatient and outpatient settings. Thus, delivering comprehensive geriatric assessment to this vulnerable population in the hospital is more important than ever.
Interface Geriatrics aims to bridge this gap via the following liaison services:
• Geri-EDTU (Extended Diagnostic Treatment Unit) “EMBED” (Elder Care and Multidisciplinary CollaBoration in the Emergency Department): provides opportunistic multidisciplinary assessments and interventions for seniors in the Emergency Department ensuring early identification of geriatric syndromes and seamless transitions to community with adequate support.
• Geri-Dental “ENHANCE” (Elderly deNtal and Health AssessmeNt, Care and Evaluation): facilitates seamless, trans-disciplinary and integrated patient-centred care pathway between Healthy Ageing and NUCOHS Dental Clinic @AH to provide holistic care across the inpatient, outpatient and community settings.
Our specialist outpatient clinics are dedicated to providing healthcare services tailored to the unique needs of each older adult being reviewed here. Our clinics range from general geriatric clinics to specific subspecialty clinics listed below.
Hallmark features of all our outpatient clinics include:
- Comprehensive geriatric assessment
- Review by Geriatrician
- Multidisciplinary team review, depending on individual needs, comprising advanced practice nurses, pharmacists, physiotherapist, occupational therapist, speech therapist, dietician, podiatrist, social workers and case managers
- Telemedicine (video consultation) for medically suitable patients in the community or in nursing homes
- Identification and management of
- Medical conditions
- Geriatric syndromes – cognitive impairment/dementia, functional decline, falls, fragility fractures, polypharmacy, frailty, sarcopaenia, malnutrition etc
- Movement disorders eg Parkinsonism
- Preventive health screening
- Osteoporosis: A common condition in older adults, where there is more bone loss than formation hence making you more prone to fracture. Fragility fractures may be preventable by early identification and treatment.
- Frailty & Sarcopenia: Sarcopenia is an age-related condition where there is progressive loss in muscle mass and strength and affects your function. Frailty is a state of increased vulnerability to other diseases and stressors. Both Sarcopenia and Frailty may be preventable or reversed by early identification and targeted interventions.
- Vaccinations: Timely vaccination against vaccine-preventable diseases like influenza and pneumococcal diseases is recommended. Older adults, in particular, are more vulnerable to serious complications from these conditions. Find out more: https://www.healthhub.sg/programmes/163/vaccinate
- Advance Care Planning Service (ACP)
- A process for patients to plan for their future health and personal care
- Involves a discussion with patients and their loved ones to plan and document patients' wishes and healthcare goals
- Should patients be unable to speak for themselves one day, the advance care plan will serve to guide patients' loved ones and healthcare team in caring for patients.
- For further information, please visit: https://www.ah.com.sg/our-services/supportive-and-palliative-care-programme/advance-care-planning
General Geriatric Clinic
- Comprehensive assessment by geriatrician to address complex care needs in an older adult, who may have multiple medical and functional issues that influence their well-being
- Depending on assessment, geriatrician may request for further investigations to be done
- Appropriate reviews by multidisciplinary team depending individual needs
- Subsequent visits will depend on complexity of issues identified
Memory Clinic
- Comprehensive assessment to evaluate and diagnose cognitive issues
- Management of complications of dementia across its different stages through a holistic approach
- Multidisciplinary team review, depending on individual need
- Caregiver education
- Regular Dementia Education series
- Close collaboration with the Agency of Integrated Care (AIC) and community partners to better serve our elderly with dementia. Collaborations include:
- Post-Diagnostic Support Community Outreach Team (CREST-PDS): post-diagnosis support to newly diagnosed patients with dementia and their caregivers
- Community Resource, Engagement and Support Team (CREST): a community outreach team that serves as a community safety network for people with and/at risk of depression, dementia and other mental health conditions. It also supports their caregivers with resources they need to continue to care for their loved ones at home and in the community.
- Cognitive Intervention Program (CIP): cognitive stimulation programme for patients with mild to moderate stage dementia
Falls and Balance Clinic
- Specialised clinic for older adults with or at-risk of falls, that aims to enhance mobility and institute evidence-based falls and fracture prevention strategies
- Multidisciplinary team review by geriatrician, advanced practice nurse, pharmacist, physiotherapist and occupational therapist
- Other allied health team review depending on individual needs
- Assessment and appropriate management of modifiable & non-modifiable falls risk factors and gait & balance disorders
- Specialised falls risk assessment conducted eg Physiological Profile Assessment (PPA)
Parkinson’s Disease Hub
- Specialised clinic that is a collaboration between the Geriatric and Neurology departments at AH
- Assessment and management of patients with Parkinson's Disease and other movement disorders through medications and other supportive therapies
- In addition to multidisciplinary team review, the clinic features an integrated feeding assessment by speech therapist and dietician
Continence Clinic
- Bladder problems are common as one grows older and is often due to multiple causes. Older adults also have more than one major health problem and this makes their care more complex. A holistic approach that takes their individual needs and preferences into account is key to successfully managing the continence related issues.
- Continence Clinic aims to empower older adults to gain continence control and enable them to lead fulfilling lives free of the restrictions and stigma of incontinence.
- In addition to multidisciplinary team review, the clinic features a dedicated pelvic floor physiotherapist
- We hold seamless links with our care partners: Urology & Uro-gynaecology
Geriatric Service Hub (GSH): EMBRACE Healthy Ageing
- A community based one stop Geriatric Service Hub making Geriatric care more accessible to our seniors in the Queenstown neighbourhood.
- Our multi-disciplinary team includes geriatricians, nurses, physiotherapists, occupational therapists, pharmacists, dieticians and medical social workers
- Comprehensive geriatric assessment done in the community setting including:
- Cognition assessment
- Assessment of falls, fragility fracture risk, fear of falls and function
- Nutrition screening
- Caregiver support
- Psychosocial assessment
- Medications review
- Discussions about wishes and preferences for your future care
Community Liaison
We work closely with our hospital’s Community Liaison teams such as the Nurses in Community (NIC), Care Managers, Pharmacist Outreach Program (POP) and Community Health Post to help our seniors in the Queenstown community to continue to Age in Place.
Dr Santhosh Kumar Seetharaman
| Designations: Head and Senior Consultant, Division of Geriatric Medicine, Department of Medicine, Alexandra Hospital
Head, Healthy Ageing Programme, Alexandra Hospital
Specialty: Geriatric Medicine
Special interest: Falls & Fractures, General Geriatrics
Clinical Programme: Healthy Ageing Programme, Alexandra Hospital
|
| Dr Tan Li Feng | Designation: Consultant, Division of Geriatric Medicine, Department of Medicine, Alexandra Hospital Specialty: Geriatric Medicine Special interest: Memory, General Geriatrics Clinical Programme: Healthy Ageing Programme, Alexandra Hospital |
| Dr Preetha Menon Venugopalan | Designation: Consultant, Division of Geriatric Medicine, Department of Medicine, Alexandra Hospital Specialty: Geriatric Medicine Special interest: Parkinson’s Disease, General Geriatrics Clinical Programme: Healthy Ageing Programme, Alexandra Hospital |
| Dr Rana Aroos | Designation: Consultant, Division of Geriatric Medicine, Department of Medicine, Alexandra Hospital Specialty: Geriatric Medicine Special interest: Continence, General Geriatrics Clinical Programme: Healthy Ageing Programme, Alexandra Hospital |
| Dr Goh Kar Cheng | Designation: Consultant, Division of Geriatric Medicine, Department of Medicine, Alexandra Hospital
Specialty: Geriatric Medicine
Special interest: Memory, General Geriatrics
Clinical Programme: Healthy Ageing Programme, Alexandra Hospital |
| Dr Hong Liyue | Designation: Associate Consultant, Division of Geriatric Medicine, Department of Medicine, Alexandra Hospital Specialty: Geriatric Medicine Special interest: Memory disorders, Community health, General Geriatrics Clinical Programme: Healthy Ageing Programme, Alexandra Hospital |
| Dr Arthi Premkumar | Designation: Associate Consultant, Division of Geriatric Medicine, Department of Medicine, Alexandra Hospital Specialty: Geriatric Medicine Special interest: General Geriatrics Clinical Programme: Healthy Ageing Programme, Alexandra Hospital |
Education
Alexandra Hospital is part of the National University Health System (NUHS) – Singapore's healthcare academic powerhouse consisting of three schools: NUS Yong Loo Lin School of Medicine (which includes the Alice Lee Centre for Nursing Studies), NUS Faculty of Dentistry and NUS Saw Swee Hock School of Public Health.
We take pride in being part of a teaching institution and creating a rich learning environment for healthcare professionals across their various stages of training, as part of our commitment to healthcare excellence.
- Pre-clinical Medical Students: Site of training for medical students in their pre-clinical eg Clinical Skills Foundation Programme (CSFP)
- Clinical Electives (Local Medical Students): Structured clinical elective programme with option of research attachments for medical students in their clinical years
- Clinical Electives (Overseas Visiting Students): Clinical electives programme for overseas visiting student. For more information, please visit: https://medicine.nus.edu.sg/current-students/clinical-electives-programme-for-overseas-visiting-student/
Research and Innovation
In line with the National University Health System (NUHS) vision, our core philosophy is anchored to the concept of "Healthcare with Humanity." This is our driving principle for developing evidence-based medicine through research and innovation. This in turn allows us to provide the highest quality of care for each of our patients depending on their unique needs.
- Health Services Development Program (HSDP) Grant 2017 – Community-based and supported Geriatric Service Hub
- NMRC Nov 2021 Grant Call awardee: Dr Tan Li Feng – Validation of a Hospital Frailty Risk Score and Association with Clinical Outcomes in Older Adults in Singapore
1. Association between gout at midlife and cognitive impairment at late life - The Singapore Chinese Health Study.
Tan LF, Li H, Pan A, Teng GG, Koh WP. Arch Gerontol Geriatr. 2023 Aug.
2. Geriatric Services Hub — A Collaborative Frailty Management Model between The Hospital and Community Providers.
Tan LF, Teng J, Chew ZJ, Choong A, Hong L, Aroos R, Menon PV, Sumner J, Goh KC & Seetharaman SK. J Frailty Aging. 2023 Apr.
3. Trends in telehealth utilization across specialties: What are the differences between geriatric medicine and general medicine and surgery?
Tan LF, Goh WGW, Lee CT, Yip AW. Geriatr Gerontol Int. 2023 Mar.
4. The Impact of Frailty, Falls and Cognition on Osteoporosis Management in the Oldest Old.
Tan LF, Ying SM, Teng J, Premkumar A, Tan ATH, Seetharaman S. Calcif Tissue Int. 2022 Aug.
5. Knowledge and perception of fall prevention in hospital: A survey of nursing staff.
Premkumar A, Seetharaman SK, Li Y, Tan LF. Ann Acad Med Singap. 2022 Jul.
6. Association between dentition and frailty and cognitive function in community-dwelling older adults.
Tan LF, Chan YH, Merchant RA. BMC Geriatr. 2022 Jul.
7. Impact of Perceived Safety and Barriers on Physical Activity Levels in Community-Dwelling Older Adults During the COVID-19 Pandemic in Singapore: A Cross-Sectional Mixed Methods Study.
De Roza, JG, Ng DWL, Wang C, Soh CSC, Goh LJ, Mathew B K, Jose T, Tan CY & Goh KC. J Aging Phys Act. 2022 Jul.
8. Effect of frailty on outcomes of endovascular treatment for acute ischaemic stroke in older patients.
Tan BYQ, Ho JSY, Leow AS, Chia MLJ, Sia CH, Koh YY, Seetharaman SK, Yang C, Gopinathan A, Teoh HL, Sharma VK, Seet RCS, Chan BPL, Yeo LLL, Tan LF. Age Ageing. 2022 Apr.
9. Factors influencing fear of falling in community-dwelling older adults in Singapore: a cross-sectional study.
De Roza JG, Ng DWL, Mathew BK, Jose T, Goh, LJ, Wang C, Soh CS, Goh KC. BMC Geriatr. 2022 Mar.
Contact Us
Location: Zone B, B02-01, Clinic K, Healthy Ageing Clinic
Operating Hours: 8.30am to 6.00pm (Mondays to Fridays)
Phone: +65 6472 2000 (Main Line)
Email:
For appointments, [email protected]
For enquiries, [email protected]
