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No bed at the nursing home, so couple forced to stay apart

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They have been married for 54 years but were forced to live apart for 11/2 years in different nursing homes due to a lack of beds.

When the once inseparable couple was finally reunited under one roof late last year, the wife's dementia condition had deteriorated to such an extent that she could not recognise her own husband.

"She told him: 'This is not my husband' and rejected him," said their daughter, Madam Zaleha Abu, 45. "My dad, who was initially very excited to finally meet her, became quiet. It was heartbreaking and my father wept frequently after that," she added.

Cases such as this raise the issue of whether the shortage of nursing home beds here means that elderly couples who need such services have to spend their golden years apart. In some cases, the separation may be even more acutely felt if one of them has dementia.

The authorities said no priority is given to a person who wishes to enter the same nursing home that the spouse is in, unless the senior citizen's physical or mental well-being is dependent on both of them being under one roof.

Applications for a bed are processed on a first-come-first-served basis and only those with urgent care needs may get to jump the queue.

A similar story that caught global attention unfolded in Canada in August this year. An elderly man and woman, who have been married for 62 years, were placed in separate nursing homes for the better part of a year due to a backlog in the healthcare system.

Every other day, a family member would drive for 40 minutes to bring one of them to the other so they could spend time together. Every time the husband and wife said goodbye, there were tears.

Their granddaughter pleaded with the community to help speed up the move as her grandfather had dementia. The family feared his memory of his wife would fade faster the longer they were apart. The couple were reunited in September.

Madam Zaleha's mother, Madam Nashua Adam, 74, was first placed in an Orange Valley nursing home in Marsiling in late 2013 when her dementia worsened.

The family had initially wanted to put her in a cheaper, charity-run nursing home with dementia care services in the north that provided halal food. There were no vacancies and she was placed on an interim scheme at Orange Valley, a private nursing home, until there was a bed elsewhere that would better meet her needs.

Meanwhile, Madam Zaleha cared for her father, Mr Abu Salleh, 80, at home. Mr Abu, who also has dementia, went for dementia daycare services at Sunshine Welfare Action Mission (Swami) home along Sembawang Walk.

Visiting her mother and caring for her father at home took a toll on Madam Zaleha's health and she developed depression, she said.

So, she applied for a nursing home place for her father and the Agency for Integrated Care (AIC), which oversees nursing home placements, expedited the case because she also had an eye condition that required an operation.

Mr Abu got a place at Swami nursing home in mid-2014. Madam Zaleha then requested for her mother to be transferred to Swami.

The elderly couple always preferred to do things together, so Madam Zaleha thought it would do them good to live together at Swami. But there was no vacancy for female residents at Swami and she said she was told that the expected waiting time was three months to a year.

When one year was up, Madam Zaleha contacted Swami and AIC regarding the move, but she was informed that there was still no vacancy.

In the meantime, she shuttled to and fro between both nursing homes and brought her mother to visit her father once a month. But as time passed, Madam Zaleha grew increasingly anxious.

In August last year, she went to a Meet-the-People session and approached Nee Soon grassroots leaders for help. Her mother managed to get into Swami a few months later in November that year when a bed became available.

Nurses in Swami make it a point to arrange for the married couple to be together every lunch and tea time, as well as during certain exercise sessions or activities.

But after the elderly couple were reunited in Swami, the nurses do not refer to Mr Abu as Madam Nashua's husband. This is because she now recognises him only as a good friend and gets agitated whenever he touches her, for instance.

The husband and wife also live in separate rooms as nursing home policy in Singapore stipulates separate accommodation for residents of different gender.

The wife sleeps in a 15-bedded room while the husband is in a double-bedded room down the corridor.

Said Madam Zaleha of her parents' case: "I understand that their dementia condition may have deteriorated similarly even if they were not separated. But if the application for a spouse to join another in the same nursing home were given priority, and if the waiting list had not been so long, perhaps my parents could have spent more lucid moments together."

She added that while the authorities do face constraints, "they need to bend the rules on a case- by-case basis, even if they can't break all rules".

For now, Mr Abu is content with just keeping his wife within sight.

"I prefer to have her in the same room so that if anything happens to me, she will know," he said. However, he added: "But as long as I can see my wife, it is all right."

Seniors may have to wait months for bed in subsidised home

Senior citizens hoping to get a subsidised nursing home place can expect to wait a few months.

Applications for a bed are processed on a first-come-first- served basis and priority is given only to those with urgent care needs, said the Ministry of Health (MOH) and the Agency for Integrated Care (AIC), which oversees nursing home placement.

This means that a spouse who wishes to join his or her other half who is already in a particular nursing home will be assessed as any other individual application.

However, if the senior citizen's physical or mental wellbeing is dependent on the married couple being under one roof, AIC will try to expedite the process. But this depends on the availability of beds.

There are about 12,000 nursing home beds, and the plan is to have 17,000 in four years' time.

MOH and AIC declined to release specific details on the waiting time for a bed now and would only say that patients may wait for "a few months".

With Singapore's ageing population, waiting times may have gone up. The Straits Times reported in 2010 that the average waiting time for a state-subsidised nursing home bed, for instance, rose from roughly 50 days in 2008 to 60 days in 2010.

In assessing the urgency of a nursing home application and placement, an AIC spokesman said it considers a range of factors, such as the care needs of the person, the safety of the person at home, the availability of other care alternatives and the caregiver's ability to care. "This is then compared against the availability of nursing home beds."

Experts said the backlog in bed capacity is partly due to the residents' length of stay, which ranges from months to years. Some need to be at nursing homes because of heavy nursing needs, but many others are there because there is no one to care for them at home.

Once an elderly spouse gets a place in the home, nursing home licensing requirements also stipulate that residents of different genders need to have separate accommodation because of privacy and modesty issues.

But AIC and MOH said they allow operators the flexibility to manage the living arrangements of married couples. "Whether couples can be housed in the same nursing home room depends on whether the nursing home is able to offer such an option," they said.

"Nursing home operators have facilitated requests from couples to be housed in the same room where possible, or to house a couple in rooms that are in closer proximity with each other. There have also been instances where couples do not want to share the same room."

Given the expected demand for dementia care as well as nursing home services that come with an ageing population, MOH said "it is important for (the ministry) to continue to focus on expanding the capacity of aged care services".

jantai@sph.com.sg

Read also: 10,000 more healthcare workers needed in next 3 years

Growing old: Should you be worried?

'I'd rather die than go to a home'


This article was first published on Nov 06, 2016.
Get a copy of The Straits Times or go to straitstimes.com for more stories.

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<p>They have been married for 54 years but were forced to live apart for 11/2 years in different nursing homes due to a lack of beds.</p>
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Sunday, November 6, 2016 - 14:15
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Growing old: Should you be worried?

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Home. Nursing home. Hospital and community hospital. Ageing in place. Mrs Theresa Hogan, 88, has experienced them all over the past 15 years.

The widow was living with her son when she suffered a stroke that took away her ability to walk or eat.

So, she was put in a nursing home. The pros: She liked the place as it was clean and its nurses took good care of her. She also enjoyed attending its exercise and flower arrangement classes.

The cons: She was lonely, even though she slept in a room with nine other people. Mrs Hogan recalls: "It was dull. The people there couldn't really communicate, and my family hardly visited. I would lie on my bed, just looking at the sky outside the window."

After five years, she went to live with a grandson who managed to obtain a two-room rental flat in Whampoa. She had housekeeping services from homecare company Comfort Keepers, and the non-pro- fit Tsao Foundation helped link her up to services in the community and monitor her well-being.

Which was just as well. Over the past two years, the frail grandmother has had five falls at home, and had to be warded at Tan Tock Seng Hospital and Ren Ci Community Hospital.

Then, four months ago, her grandson died of lung cancer. Mrs Hogan decided to continue living at home alone - what the Health Ministry (MOH) terms ageing in place. Neighbours cook or buy lunch for her every day.

Mrs Hogan's situation of multiple aspects of care in her senior years is not unique.

By 2030, one in every three people here is projected to need some form of eldercare service.

Against the current backdrop of different settings in which to grow old, Insight looks at what is being done to care for the seniors of the future, and whether those moves are fast enough to meet demand.

BEST PLACE TO GROW OLD IN?

Singapore is one of the fastest ageing societies in the world: by 2030, one in four people, or more than 900,000 people, will be aged 65 and above, double the number now.

Ageing is the single most important demographic shift that will affect the future of Singapore, Senior Minister of State for Health Amy Khor said earlier this year when launching a $3 billion Action Plan for Successful Ageing.

The plan's 70 initiatives to help the elderly lead healthy and active lives include a review of the financing system for long-term care, raising the re-employment age and building more centres where seniors can get physiotherapy or take part in activities.

Health Minister and chairman of the Ministerial Committee on Ageing Gan Kim Yong said when initial details of the national plan were released last year: "We need to plan ahead to ensure that Singaporeans need not worry about getting old, but instead embrace new opportunities that come with longevity. We want Singapore to be the best place for Singaporeans to grow old in, and a model for successful ageing."

Yet a recent survey of 1,000 Singaporeans, commissioned by NTUC Income and the Lien Foundation, found that eight in 10 Singaporeans are worried about growing old.

Topping their worries is whether they will be able to look after themselves. Financial concerns such as running out of savings comes next.

This is even as the traditional Asian approach of caring for aged parents at home is still the "retirement plan" for most. However, the best-laid plans can fail when the elderly need round-the-clock specialised care for illness. Some people also do not have family members to rely on or cannot afford a maid.

Last month, Mr Gan said Singapore will need to make "deep and fundamental changes" to the way care is delivered to seniors, as the country ages and more of its citizens suffer chronic ailments.

The Government's focus has been shifting from hospitals to the community - such as polyclinics, nursing homes and daycare facilities - to let the elderly be cared for at home and in familiar neighbourhoods.

There has been much discussion of ageing issues over the past 20 years, and from the early 2000s, MOH has been investing heavily in expanding home-based care services. But are there adequate community resources to ensure the elderly can keep living at home?

Despite the years of discussion, long- term private and public residential care options for the elderly are limited.

For many frail elderly people who live with family without the necessary time or nursing expertise, or for those living alone who are unable hire a full-time helper, nursing homes remain their main option.

LONG-TERM CARE: ENOUGH BEDS?

In barely three years, there will be 610,000 people in the above-65 age group, but a projected capacity of only 6,200 centre-based daycare and 10,000 home-based care services.

As of last year, Singapore had 26.1 nursing home beds per 1,000 people aged 65 and above - the lowest proportion in 15 years (see chart) - and well below the OECD average of 45.2 beds.

To put that in perspective, though, researcher Radha Basu notes in her 130-page report on the state of nursing homes here: "With fewer beds than many advanced countries and relatively stronger family networks, it is no surprise that Singapore has very few older folks in nursing homes."

But she cautions: "As families shrink in size, Singapore will need more long-term care options."

In countries like the US, Australia and Finland, about 5 per cent of the elderly population live in some form of residential aged care facility such as nursing homes or assisted living. Going by this, about 50,000 seniors in Singapore will need such facilities by 2030. But there are only about 12,000 beds in nursing homes.

This means that even if 95 per cent of the elderly live and die at home, Singapore may need nearly 50,000 alternative senior living options by 2030, says Ms Basu.

When The Sunday Times asked MOH how it comes up with its planning targets for services and facilities for the elderly and why they were not ramped up more and earlier, a spokesman said the demand for aged care services is projected based on a combination of factors.

She explained: "Beyond the population of seniors, we also factor in the incidence of disability, the level of disability and utilisation rate.

"As the needs and circumstances of seniors and their caregivers are different, we have to plan for a diverse range of options to meet the needs.

"Needs are also not static. In tandem with changing social trends, utilisation of different options will change and so we will conduct regular reviews of our projections and adjust our development plans."

For those who do not need intensive nursing care but are too frail to age in place at home, there is the option of assisted living, which is common in countries such as Australia, Britain and the US. They provide a more home-like environment, such as private rooms, for more independent seniors who need help with personal care.

There are few such standalone facilities here, though the Government says the assisted living concept can take the form of people continuing to live in their own HDB flats but having access to aged care services in their neighbourhoods.

NO ONE-SIZE SOLUTION

It is clear that the more than 900,000 seniors by 2030 will have different needs, financial capabilities and expectations which no single player or model can possibly cater to. A wider range of options will be called for.

The authorities acknowledge the challenges that lie ahead.

"We agree that we should seek to enhance the diversity of aged care options and we welcome more ideas to help our seniors age well in place," says the MOH spokesman. "We hope we can see new and exciting models emerging to meet our seniors' needs, that are uniquely Singapore."

As for Mrs Hogan, when The Sunday Times tried to visit her, she was back at a community hospital after busting her hip in yet another fall at home. She clutched a soft toy rabbit everywhere she was wheeled to.

"My great-granddaughter gave it to me last month for my birthday and I also have a bear, tortoise and doll on my bed at home (in the Whampoa flat). I can't sleep here without the rabbit," she says.

For Mrs Hogan, then, the "home" to grow old in and die in has come to mean anywhere that she feels loved.

jantai@sph.com.sg

tohyc@sph.com.sg

Read also: No bed at the nursing home, so couple forced to stay apart

10,000 more healthcare workers needed in next 3 years

'I'd rather die than go to a home'


This article was first published on Nov 06, 2016.
Get a copy of The Straits Times or go to straitstimes.com for more stories.

Image: 
Blurb: 
<p>Home. Nursing home. Hospital and community hospital. Ageing in place. Mrs Theresa Hogan, 88, has experienced them all over the past 15 years.</p>
Publication Date: 
Sunday, November 6, 2016 - 14:22
Keywords: 
Send to mobile app: 
Source: 
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'I'd rather die than go to a home'

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A stroke in May last year did not kill Mr Goh Keng Char, but the depression that followed almost did.

Before the stroke, Mr Goh, then 77, lived alone in a one-bedroom Housing Board rental flat in Toa Payoh. His flat-mate of over 10 years had died a year earlier.

When he was discharged from Tan Tock Seng Hospital after a seven-week stay, Mr Goh, a bachelor, felt lonely and helpless, having to use a wheelchair to move around.

"I cannot walk... I felt I had nothing to live for," says the former water tank maintenance worker.

"I took the lift to the 12th floor of the block in my wheelchair and wanted to jump down.

"A Malay neighbour saw me in a daze and stopped me. He saved my life."

Today, Mr Goh still cannot walk and he continues to live alone at the rental flat, but he no longer thinks about taking his life. "I have many new friends in the neighbourhood, especially the hawkers," he says. "They do not charge me."

He relies on voluntary welfare organisation (VWO) Touch Home Care for food, medical care and housekeeping. Twice a day, seven days a week, volunteers from Touch deliver lunch and dinner to his flat. "The food is still warm when they arrive," says Mr Goh.

A nurse visits weekly to check on his health, and staff from the VWO clean his flat. The services are free because Mr Goh is on long-term public assistance, getting $500 a month from the Government.

Last December, Touch helped Mr Goh apply for government funding to buy a motorised scooter, and sent two occupational therapists to teach him how to use it this year.

Touch Home Care director Kavin Seow says it provides these services to seniors like Mr Goh as part of a larger government drive to help the elderly grow old where they live, instead of in nursing homes. "We recognise that the elderly want to be independent and many prefer to age at home."

Volunteers from the VWO deliver daily meals to about 400 seniors living alone. Each month, its nurses make housecalls to about 340 seniors. It also runs a daily ambulance service ferrying the elderly to hospitals for check-ups.

Touch operates in Ang Mo Kio, Jurong and Toa Payoh. It plans to expand to Bukit Batok and Yishun next year, but it is feeling the heat from the manpower crunch in the sector.

"Manpower challenges continue to be a concern for us, as it is important to recruit people with the right skills and heart for the work," says Mr Seow.

Mr Goh appreciates the help. "I have no relatives, so she is like family to me," he says, pointing to occupational therapist Doreen Ang, who accompanied Insight to visit him last week. Mr Goh had five siblings but they have died and their children do not visit him.

Ms Ang, who taught Mr Goh how to use the motorised scooter, downplays her role, saying: "Mobility is important for seniors socially, so I helped him get around the neighbourhood safely."

The 24-year-old graduated with a degree in occupational therapy last year and could have easily found work in hospitals, but she opted to work at Touch. She says: "I can make a direct impact on the seniors in a community setting."

Mr Goh is thankful for the motorised scooter, saying he is no longer confined to the flat.

When Insight asked if he would consider moving to a nursing home should his health deteriorate, he retorts: "No. I'd rather die than go to a nursing home... I have lived in Toa Payoh for more than 40 years and in this flat for more than 20. I want to die here."

Ageing in place: More support for seniors living at home

The key thrust of Singapore's ageing policy is based on the view that most people want to be cared for at home or in the community. That's because they feel more comfortable in familiar settings and around people they know.

And that is why the Ministry of Health (MOH) has ramped up aged care services significantly of late. Over the past five years, centre-based daycare places rose by 67 per cent, and seniors receiving care services in their homes increased by 82 per cent, says the MOH.

The ministry intends to keep up this momentum. The number of daycare places, where older people go for rehabilitative and social activities, will jump from 3,500 last year to 6,200 in 2020. Likewise, the capacity to care for seniors in their homes is expected to rise by 45 per cent from the 6,900 available last year to 10,000 by 2020.

Daycare centres and home- based care services - such as meal delivery, medical escorts, personal and nursing care, rehabilitation and "elder-sitting" for those with dementia - allow seniors with mild or moderate disability to still be able to age well at home.

For those with more complex needs, the MOH has started piloting integrated care packages this year that bundle both home- based and centre-based care to serve needs of seniors holistically.

However, the capacity to provide daycare and home-based care services remains minuscule compared with the vast, growing ranks of people turning grey.

The number of elderly living alone increased from 6,000 in 1990 to 29,000 in 2011 and is estimated to reach 92,000 by 2030. Disability rates among the elderly are expected to rise, even as the number of family caregivers shrinks.

To cope with heavy caregiving work, Singaporeans have been accustomed to outsourcing care to foreign domestic workers.

The MOH piloted a programme last year to train domestic helpers - both in the classroom and on the job - so that they can look after seniors better. But that pool of labour is dwindling, with source countries limiting supply and maids less keen to work here.

To have enough manpower, the rest of the community will need to fill the gap, experts say - pointing to volunteers. Tsao Foundation, a non-profit group that specialises in ageing issues, has more than 120 trained volunteers who help regularly in counselling and organising activities.

"Volunteers make a critical contribution to the care of our elderly clients," says Ms Doris Low, director of community relations at Tsao Foundation. "(Volunteering) is also one way in which we can support one another in an ageing society instead of seeing older people as 'others'."

Right at home in a nursing home

Photo: The Straits Times

For the past 16 years, home for Madam Chew Eng Huay has been a chronic sick ward, and then a nursing home.

A stroke in 2000 left her unable to walk, talk or feed herself, so she went from her sister's flat to the Ren Ci long-term care facility in Hougang. Eight years later, she was wheeled into Ren Ci nursing home in Jalan Tan Tock Seng where she continued to be bed- bound and fed through a tube.

The nursing home is made up of seven single-storey buildings. Madam Chew, 70, lives with 29 others in one of the cavernous rooms.

Her first thought when she was brought in was to go back home. She was fearful of not being able to go wherever she wanted. Today,she seems to be a different person.

It was barely lunchtime when The Sunday Times visited her two weeks ago and "Ah Huay", as she is affectionately called, was already cooking a pot of red bean soup for dessert. She whips up a sweet treat for the residents every Thursday.

"I cook anything, red bean, green bean, chrysanthemum or barley soup," said Madam Chew, brandishing a ladle as she stretched to stir the soup from her wheelchair. She carefully scooped up pandan leaves from the pot with her left hand, as the right side of her body is paralysed.

With intensive rehabilitation and good care, she is now able to talk, eat on her own and wheel herself around by using her left leg to propel the wheelchair forward.

"I like it here, I like everything about this place," she said.

Madam Chew may be one of the many residents of the nursing home, but she enjoys helping the nurses run the place.

During breakfast, she helps to feed one of the residents. Then she transfers herself onto a motorised scooter to go around delivering bedsheets, eggs and bread to residents in other wards. After lunch, she sometimes plays mahjong with her close friends using her one good hand.

"I need to have things to do. It makes me happy," said Madam Chew, who could not sit still even during this interview. Intermittently, she would check on her red bean soup or ensure that someone was feeding a certain resident.

She said she is accustomed to hard work as she used to sell coffee and bread at Lau Pa Sat. Later, she also helped her father sell ice kacang at his hawker stall in Havelock Road.

Madam Chew is single and has an older sister and an estranged younger brother. Their father left them a three-room flat in Bukit Ho Swee, which they sold.

"I don't like to stay alone at home as I am scared. What if I die and no one finds me even after one or two weeks?" she said in Mandarin.

"Even if there are care workers who can come to my home to help, I don't think they are able to do so every day," she added.

She said she does not mind sacrificing personal space and privacy. One neighbouring resident, she pointed out, scolds her each time she passes by and another rambles on about winning the lottery.

She has injected her personality into the impersonal space by pasting Hello Kitty and other cartoon stickers on the cupboard next to her bed. And she wears red and black floral blouses and trousers instead of the green pyjamas that everyone else wears. A nurse from Myanmar, who treats her "like mum", bought the outfits for her.

Madam Chew, with her cheerful disposition and active lifestyle, may be an exception in her ward. The other residents seem listless and stay in their beds or chairs.

"I used to work so hard in the past and didn't have time to help others. So this is my form of volunteer work now," said Madam Chew.

Nursing homes: Mega, multi-storey facilitiesbeing built in rush to increase number of beds

For the past few months, motorists driving along Ang Mo Kio Avenue 1 near Bishan-Ang Mo Kio Park would have seen the new Ren Ci Nursing Home taking shape. When the 11-storey building is completed around next June, it will house up to 470 residents.

Meanwhile, in Chinatown, beds and blood-pressure measuring machines have replaced desk and dusters at a former primary school. The Pearl's Hill Care Home, which officially opened in September, is Singapore's first government-run nursing home.

From constructing new buildings to refurbishing old ones, Singapore is expanding the number of nursing home beds in a hurry.

Singapore has around 12,000 nursing home beds, up from 9,200 in 2010. Another 5,000 will be added by 2020, an increase of 85 per cent over 10 years.

By financial year 2015, the Government was spending $360 million on nursing homes, most of it for patient subsidies, manpower costs and construction. This is more than three times what it spent in financial year 2011.

The pressure to ramp up capacity rapidly has led to two heavyweights - the Government and the National Trades Union Congress - jumping into the segment to run their own nursing homes.

By next year, Kwong Wai Shiu Hospital will have Singapore's largest nursing home in a new 12-storey hub that will see a doubling in its number of beds to 622. An 11-storey, 342-bed home in Chai Chee run by NTUC Health Co-operative and a 290-bed home in Hougang run by Thye Hua Kwan Moral Society are expected to be ready this year.

Such massive projects have led observers to ask whether Singapore is churning out cookie-cutter nursing homes with soulless dormitory-style wards.

Pearl's Hill Care Home, for example, has four large halls for 32 residents each. The Ministry of Health, which runs the home, declined Insight's request for a visit.

Dr Phillip Yap, a geriatrician who has published research papers on nursing homes here, says: "Dormitory living and regimented routines are the norm. Residents have little control over their daily routines and there is minimal privacy."

Meanwhile, the MOH has tried to improve the quality of care in nursing homes by introducing the new Enhanced Nursing Home Standards (ENHS) as part of licensing requirements. Nursing homes were given one year - ended April this year - to comply. Ms Loh Shu Ching, chief executive of Ren Ci Hospital, notes: "The ENHS will definitely provide safer care for the nursing homes but it is going to make things more difficult for those of us trying to turn the nursing home into a home and not a hospital."

There's Hope for dementia patients

Photo: The Straits Times

It is only 11.20am but a lunch queue has already formed at an in-house cafe along Upper Changi Road North. In the line are old folk, leaning on walking sticks, waiting patiently for their turn.

They tell the servers the portions they are feeling up to that day. They then carry their plates to nearby tables and join whoever they want to dine with. When they are done, they empty the food waste in a bin and leave the plates and utensils in separate tubs.

These elderly folk, most of whom are in their 80s and 90s, have dementia. But the people who run the assisted living facility where they live believe that getting them to do little things and make decisions for themselves will empower them.

"This is not the kind of place where they just sit there and wait to be served. Giving them a say in simple things matters, because it keeps them engaged in life," says Ms Josephine Khai, senior staff nurse of Peacehaven nursing home.

The home is run by a charity, the Salvation Army, but these relatively independent seniors are housed next door in a separate five-storey building. Called Hope, the area where they live is modelled after an HDB block. There are about 60 senior citizens with mild to moderate dementia who live in single or four-bed rooms.

In the morning, they wake up whenever they want. They are expected to change out of their pyjamas. In contrast, at some nursing homes, it is common for residents to wear the same outfit all day.

"These are environmental cues and will put them in the frame of mind to get their day going," says Ms Khai.

When Insight visited two weeks ago, some were in the cafe, piecing together jigsaw puzzles. Others watched television or read the newspapers. Another group went into a room to belt out the classics tunes of Taiwanese pop singer Teresa Teng.

They do not need to follow a regimented timetable, but there is a list of specific activities available each day. If they prefer to rest in their rooms, they may do so.

Before going into their rooms to deliver fresh laundry or remind them to shower, nurses make it a point to knock on their doors first to ask for permission to enter, so as not to intrude on their personal space and privacy.

Though some of the seniors are prone to wander, they are not kept within their "HDB block". Every Wednesday, they go to a factory across the road for a morning snack at the canteen. Every Friday, they walk to the Japanese school next door to say hello to the children.

Hope was started in 2006 after the charity saw a need to provide care that helps relatively independent seniors with dementia. Since then, about 100 have lived there. They pay the same rates as the nursing home residents next door, between $2,800 and $4,500 before subsidies of up to 75 per cent.

Peacehaven is not alone in having the concept of assisted living facilities.

Over at Lentor Residence, two in three of its 208 beds are in single or twin-occupancy rooms with attached toilets. The floors of the common areas are carpeted and there is free Wi-Fi.

The home's chief executive Jonathan Koh says it was set up as a retirement village in 1997. "But there was no demand, so we ran it like a nursing home, taking in subsidised residents."

A room does not come cheap - $240 a day, or more than $7,000 a month. The price includes meals, laundry and housekeeping services.

Ms Khai says that living in a home-like environment has helped residents enhance their quality of life. Assessments show an average of a 30 per cent increase in the sense of well-being after living there.

Assisted living facilities: Govt integrating services for seniors within neighbourhoods

The elderly in Singapore have hardly any other housing options besides nursing homes if they grow frail and need someone to take care of them.

In countries such as the United States, Australia and Finland, about 5 per cent of the elderly population live in some form of residential aged care facility. Going by this estimate, about 50,000 seniors in Singapore will need such facilities by 2030. But there are only about 12,000 nursing home beds now.

Assisted living facilities provide a more home-like environment, such as private rooms, for more independent seniors who need help with personal care.

Standalone assisted living options are virtually non-existent in Singapore. The small pockets that exist are mostly nursing homes that have set aside separate spaces for assisted living.

While Singapore has 14 senior group homes, they do not count as assisted living facilities as residents do not get help with daily activities. Senior group homes are clusters of rental flats meant to let elderly folk with little or no family support live together with one another in an environment which they are familiar with.

The Ministry of Health (MOH) says assisted living is a service worth studying. "Many citizens own their own homes within public housing estates. Therefore, assisted living takes the form of injecting a range of services within such estates in Singapore," says its spokesman.

The Government seeks to integrate services within neighbourhoods in two ways. First, it has been retrofitting existing mature estates to create conducive environments for seniors. In Marine Terrace, Jalan Batu, Nee Soon Central and Beach Road, for instance, there is a range of services and facilities - including an active ageing centre, community kitchen, senior activity centre and day rehabilitation centre - within the same area.

Second, it is including senior services in new public housing developments. New Housing Board projects will have "Active Ageing Hubs", or larger spaces where various eldercare services such as daycare centres and rehabilitation are located.

The MOH is also encouraging private operators and voluntary welfare organisations to provide assisted living services, such as housekeeping and grocery-shopping, for seniors who require assistance. A senior activity centre at a new studio apartment development in Marsiling has been offering residents nearby health and dental check-ups, and taking grocery orders.

Nursing homes like Peacehaven have also taken the initiative to experiment and come up with assisted living spaces for more mobile and able seniors, who still get the usual nursing home subsidies of up to 75 per cent.

jantai@sph.com.sg

tohyc@sph.com.sg

Read also: No bed at the nursing home, so couple forced to stay apart

Growing old: Should you be worried?

10,000 more healthcare workers needed in next 3 years


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10,000 more healthcare workers needed in next 3 years

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Some 10,000 healthcare workers are needed in the next three years to look after the swelling ranks of ageing Singapore residents.

More than one-third of the vacancies will be for professional, managerial, executive and technical (PMET) jobs such as doctors, nurses, facility managers and administrative staff, the Ministry of Health (MOH) tells The Sunday Times.

The ministry last month announced it needed 30,000 healthcare workers overall by 2020, and has now updated this to state that of these, 10,000 are required for the eldercare sector alone.

The vacancies will be filled by both local and foreign workers, says a ministry spokesman.

Asked how this will be achieved, MOH says: "We are ramping up efforts to build a stronger local core in the healthcare sector, such as investing in skills training and job redesign so that our healthcare workforce can do more at each level."

It is also "expanding the training and recruitment pipeline to enable young job-seekers, mid-career entrants, former nurses and part-time workers to join the sector".

But experts say a more pressing issue is to tackle why Singaporeans shun jobs in the healthcare sector.

Last week, a check of the government-run National Jobs Bank, where employers are required to post job vacancies before they can hire foreigners, found more than 800 job vacancies in the healthcare and pharmaceutical sectors (which are lumped together).

"There's the unpleasant job at the lowest level, bathing and cleaning frail people," says human resource consultant Martin Gabriel from HRMatters21. "Some people see it as a maid's job."

"To draw Singaporeans into the sector, there is a need to provide proper career progression and to minimise the parts of the job that are seen as unpleasant," he adds.

Indeed, the Government acknowledged in 2012 that foreigners were going to take up the bulk of lower-end jobs such as feeding and bathing of patients that Singaporeans found unappealing.

"We expect that 70 per cent of the new support-care manpower demand, or 6,000 new positions, will need to be met through foreign recruitment," wrote the Prime Minister's Office in a research paper in November 2012 on the projection of foreign manpower demand in the healthcare sector.

Healthcare is part of the services sector where employers can hire two foreigners on work permits for every three full-time local workers. The Government has said that it will ensure flexibility in applying the cap so that healthcare institutions are able to fulfil their staffing needs, but it has never spelt out how the flexibility will be applied.

Meanwhile, efforts to fill the PMET vacancies in the sector with Singaporeans may get a push from an unexpected direction - the slowing economy.

"With growing concerns with the economy and jobs, healthcare is increasing in attractiveness," says Dr Chia Shi-Lu, chairman of the Government Parliamentary Committee (GPC) for Health. "This is a pattern we see with previous economic downturns, as healthcare is traditionally viewed as a 'safe' haven where employment is concerned," adds the orthopaedic surgeon at the Singapore General Hospital.

Mr Patrick Tay, chairman of the GPC for Manpower, says the stability of the healthcare jobs aside, another way of attracting Singaporeans to the sector is to streamline work and automate to raise productivity. "This will reduce the reliance on manpower," says the long-time productivity advocate.

Member of Parliament Tin Pei Ling is optimistic that there will still be Singaporeans drawn to the sector (see story on Elena Lagman).

"Caring for the elderly requires the human touch," says Ms Tin, who is a member of the GPC for Health. "There will continue to be those who find meaning and purpose in caring for the elderly, all of whom are Singapore's pioneers."

The local: Caring for the elderly feels like home

When Ms Elena Lagman retired from her job working in a family business five years ago, she wanted a job that involved working with people.

"I am a cheerful person and I like interacting with people," says the 62-year-old.

She found a job as an activities coordinator at a pre-school and childcare centre, helping teachers mind their young wards. But a year later, she decided to switch to working in a nursing home.

"I enjoy looking after children, but I thought it would be more meaningful looking after older people, like I am looking after my parents," she says.

She responded to an online job advertisement put up by Lentor Residence. Despite her lack of work experience in the field, she was hired as a patient-care assistant.

She was put through training, for example on how to transfer wheelchair users from the bed to the wheelchair, and handle those with dementia.

After working at the nursing home for four years, she now earns about $1,500 a month. "The salary is about the same as in childcare."

She works from 9am to 6pm on Mondays to Fridays and alternate Saturdays, organising and co-ordinating activities.

When Insight visited her at the home last week, she was playing a Donkey card game with some residents.

"The game involves memory. It is a fun game to keep the mind alert," says Ms Lagman.

When asked if it was difficult to switch from looking after children to seniors, she says with a laugh: "It is actually the same. Some of the residents, when they have dementia, they are forgetful like children."

She adds: "My job is to keep them occupied through games and activities, that is also the same.

"And whether they are young or old, I need to listen to them and give them my attention, so it is the same skills."

The most difficult part about caring for seniors is changing their diapers. "It is the smell. Not everyone can get used to it. For me, I don't mind," she says.

But what gives her the greatest satisfaction, she says, is when residents regard her as a family member.

"During Hari Raya this year, one of the residents went to his brother's home, but wanted to come back to the nursing home on the same day because he said here is his home and I am like his family," she says.

"It was very touching. At that moment, I knew I made the right move switching (from childcare to eldercare)."

The foreigners: Starting from scratch in Singapore

Both Ms Martinez and Mr Ordonez came here from the Philippines and started out as nursing aides. She is now a senior supervisor at Econ Medicare Centre and Nursing Home, while he is a senior staff nurse. Photo: The Straits Times

Back in the Philippines, they were highly qualified nursing staff - one has a nursing degree, while the other is a trained physiotherapist.

Yet when they came to Singapore to work in nursing homes, they started on the lowest rung as nursing aides because their qualifications were not recognised here.

After spending between eight and 14 years here, they now hold professional, managerial and executive jobs at Econ Medicare Centre and Nursing Home after their employer gradually promoted them.

Mr Jeffrey Lomboy Ordonez came to work in Singapore in 2008 after graduating from university with a nursing degree.

"Singapore is the only place I have worked," the 29-year-old says.

He was hired as nursing aide on a work permit. The work permit, the lowest category of work pass, is mostly for foreigners doing low- skilled work. Most of the one million work-permit holders here are construction workers and maids.

He got his break in 2010 after he passed a Singapore Nursing Board exam and was officially registered as an enrolled nurse. He was then promoted twice, to staff nurse in 2012 and senior staff nurse in 2014.

He now works 44 hours a week, in morning, afternoon or night shifts, over five or six days a week, administering medication to residents and monitoring their health.

"I do not have to work overtime," he says. "I know nurses in hospitals do."

When asked about the stress of the job, he says residents' family members sometimes expect round- the-clock personal attention.

"It is difficult. There is a staff-to- residents ratio that we follow," he adds. "Thankfully such requests (for personal attention) are rare."

His colleague, Ms Melany Vinoya Martinez, agrees. "Most of them treat us as family members because they know we are trying our best to look after their loved ones," says the 41-year-old.

She came to Singapore as a nursing aide on a work permit in 2002, although she was a trained physiotherapist.

She is now a senior supervisor handling administrative work like admissions and training.

Their employer declined to disclose their pay, citing confidentiality. Both are now on the S Pass, a mid-tier work pass given to foreigners holding junior professional jobs and earning at least $2,200 a month.

On how she feels as a foreigner looking after the old in Singapore, Ms Martinez says: "When their health deteriorates, I feel sad. When they pass away, I cry. I go to their wakes after work. I don't see myself as a foreigner and them as Singaporeans. I see myself as a caregiver. That's what matters."

tohyc@sph.com.sg

Read also: No bed at the nursing home, so couple forced to stay apart

Growing old: Should you be worried?

'I'd rather die than go to a home'


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Better pay draws better pre-school teachers

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Educators in publicly funded pre-schools in Boston are on the same pay scale as those teaching in primary schools if they have the same qualifications, learnt some Singapore pre-school principals visiting the American city.

Mr Jason Sachs, the director of the early childhood education department in Boston Public Schools (BPS), told them: "This same pay scale is one of the reasons, I believe, that we are getting the results we have. These teachers are of the same quality as those in (higher education levels), and that's really important."

He was speaking two weeks ago to 24 Singapore pre-school heads taking part in Principal Matters, a leadership programme led by local philanthropic house Lien Foundation. The six-month programme aims to help principals be more effective leaders and improve the quality of pre-school services.

BPS pre-school educators generally get a starting pay of about US$55,000 (S$76,100) per year with a bachelor's degree. They have to earn a master's degree within five years, and their pay can reach US$75,000 a year then, said Mr Sachs.

In Singapore, all new teachers must have at least an early childhood education diploma, but more degree holders have been joining the sector too.

Pre-school teachers earn an average of $2,200 to $3,000, based on data gathered by the Early Childhood Development Agency last year.

This is usually lower than that of primary school teachers.

SIGNIFICANCE OF PAY

Ms Amy O'Leary, an adjunct professor in early childhood education at Wheelock College in Boston, told The Sunday Times that about a decade ago, higher education programmes for pre-school training were closing down when a pre-school educator's average pay was only US$25,000 a year.

"Why would you go get a four-year degree if you're going to make only that amount of money?" she said.

Besides attracting teachers, good salaries also help to build the small staff-child ratios needed for inclusive pre-schools where children need more attention, said Ms Vicki Milstein, who leads the Brookline Early Education Programme (Beep) pre-schools in Brookline, a town near Boston.

The public Beep pre-schools are known for their inclusive model, and about a third of their children have special needs.

Good pay also helps to reduce staff turnover and sustain the effects of teacher training, said Mr Sachs.

QUALITY TRAINING

Mr Sachs has been leading the BPS early childhood education department for more than a decade, and he leads a team of career coaches - who each earn US$100,000 a year - and curriculum experts.

Teachers get professional development generally in the form of monthly seminars and one-on-one training from job coaches who go into the classrooms every week or every two weeks.

BPS also decided to "mandate" what teachers should teach, so there is consistency across the pre-schools, said Mr Sachs.

QUALITY RESULTS

In 2013, a Harvard study found that the academic gains achieved by children in the BPS early childhood programmes were the "largest found to date in evaluations of large-scale public pre-kindergarten programmes (for four-year-olds)".

A BPS study in 2014 also found that participation in its programme for four-year-olds closed "achievement gaps" between racial groups - black and Hispanic/Latino children in the programme performed better in literacy tests than white pupils who were not in the programme.

FUNDING SOURCES

BPS pre-schools get funding from the city of Boston, the state of Massachusetts and federal funds. Mr Sachs also has grants from private and philanthropic groups.

It also helps that the Boston mayors - Mr Thomas Menino who served till 2014, and his successor Mr Martin Walsh - see investment in pre-schools as the key to a better workforce, said Mr Sachs.

Despite a budget deficit, Mr Walsh committed US$3.1 million to public pre-schools for the 2016-2017 fiscal year.

Ms Iris Lim, principal of local pre-school Chiltern House, was one of four mentors who went on the Boston trip.

She said: "For the private sector, we don't have as much funding as primary schools, so we can't pay our teachers as well. Our retention rate at Chiltern House is high because of other factors such as medical benefits and the school culture."

Lien Foundation chief executive Lee Poh Wah said: "There is little impetus and it is also not sustainable for private operators here to supplement teachers' pay. The Ministry of Education kindergartens and anchor operators (which get government grants) can lead by example... and strive for pay parity with primary school teachers.

"Pre-school teachers impact young lives. We need to build systems and cultures that prioritise great teaching, particularly for disadvantaged children."

goyshiyi@sph.com.sg


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PM Lee celebrates Lee Clan Gala Dinner with 2,000 Lees

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SINGAPORE - Prime Minister Lee Hsien Loong was at the Lee Clan Gala Dinner on Saturday (Nov 5) night, according to a post on his Facebook page.

He mentioned that there were 2,000 Lees in the room, including "1,000 from overseas" - which he considered "not so many, considering there are 130 million Lees in the world".

Calling it a "triple celebration", he mentioned that it was the "annual reunion of Lee clan associations from around the world" that was hosted in Singapore this time. It also marked the 110th year of the Singapore Lee Clan General Association and celebrated the renovation of its Jalan Besar headquarters.

In the post, PM Lee highlighted the role the Lee Clan Association, like other clan groups, has played in "building Singapore".

Among its activities are social work, and supporting culture and education.

He also fondly recalled a clan scholarship he received from the association in 1970 when he graduated from school.

In his 10-minute speech in Mandarin, PM Lee explained the background of the Lee surname, mentioning that it originated from China's Henan province.

He also expressed his hope that the association would continue to strengthen the sense of belonging of Singaporeans and advance societal harmony, as well as mentioned his delight that the present generation of Lees have demonstrated their gratitude to previous generations.

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Confiscated at Changi: 1.3m items

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PACK it right or risk having your items confiscated at Changi Airport.

Between January and September, travellers had to surrender 113 hoverboards and electric scooters which pose a fire risk, as well as more than 142,000 other prohibited substances like scissors and pepper spray canisters.

Another 1.13 million items of liquids, gels and aerosols like perfumes and make-up that were not packed properly - about 126,000 a month - were also confiscated.

The number is higher than the monthly average of about 113,000 items that were taken away for the whole of last year.

With the year-end holidays round the corner, efforts are being stepped up to ensure travellers at Changi Airport know what they can and cannot bring on flights.

A total of 1.3 million brochures have been printed and will be distributed to households in the next two weeks, the Civil Aviation Authority of Singapore (CAAS) said.

A similar run was done last year but, this time, the brochures have been printed in four languages to reach a wider audience, the authority added.

For the first time, the CAAS is also working with 20 hotels to disseminate the brochures to foreign visitors.

For flight and public safety, there is a need to increase awareness among the travelling public, and seek their co-operation to "pack it right for their flight", said the CAAS.

Director for airworthiness and flight operations, Tan Kah Han, said: "Over the past two years, CAAS has been stepping up our outreach efforts. Continuous education is essential to ensure that all travellers are informed of the dos and don'ts."

Recent incidents, such as the fire risk of lithium batteries in Samsung Galaxy Note 7 phones and hoverboards, are some examples of why travellers need to be aware of what the dangers are in bringing seemingly harmless items on board an aircraft, the authority said.

Apart from lithium batteries that power cellphones, laptops and other gadgets, the focus is also on other potentially dangerous items such as make-up and perfumes.

To carry such liquids, aerosols and gels in hand luggage, the items must be kept in containers not more than 100ml each.

All the items must be placed in a transparent resealable plastic bag with a maximum capacity of 1 litre.

Marketing agent Elaine Ting, 28, said: "The rules can be quite confusing so I usually check with the airline if I'm not sure. It's better to do that than to have your things taken away."

karam@sph.com.sg


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Tigerair flight from Hong Kong to S’pore turns back after ‘bird strike’

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A TIGERAIR flight bound for Singapore from Hong Kong on Saturday night had to turn back after a bird flew into the plane's windscreen, cracking it.

Flight TR2067 was scheduled to depart at 7pm, with 156 passengers on board.

Not long after take-off, the pilot noticed cracks in the windscreen, Shin Min Daily News reported yesterday.

The pilot immediately informed the Hong Kong International Airport control tower, and turned the plane back to the airport, where several fire engines and ambulances were on standby.

Hong Kong's airport authority told Apple Daily (Hong Kong) in a report on Saturday that the airport received a request for help at 7.30pm from TR2067, and the plane subsequently landed safely at 8.37pm.

No one was hurt.

It is understood that the cracks were caused by what is known as a "bird strike", where an airborne animal collides with the aircraft. The authorities are investigating the cause of the cracks.

Responding to Shin Min, a Tigerair spokesman said it arranged for passengers to take flights to Singapore on Nov 5 and 6, and also provided hotel accommodation to those who requested it.

myp@sph.com.sg


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Brain tumour patients enjoy ride in supercars

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SINGAPORE - Not many Primary 3 pupils get the opportunity to ride down Orchard Road in a Lamborghini, but Javier Lim did just that yesterday.

With 29 other beneficiaries, the nine-year-old set off from the Suntec Singapore Convention and Exhibition Centre yesterday for a 30-minute tour of Marina Bay and Orchard Road.

Looking at Javier, beaming away as he took the ride of his life, one would not suspect that he has had five brain tumours in the last three years. He was just a few months shy of his sixth birthday when doctors discovered two tumours in his brain.

His mother Sharon Ng, 35, said: "We wondered, how could such a healthy boy have such things in his head?"

Read also: Boy, 9, has 5 brain tumours in 3 years

Javier has since had multiple operations to remove the tumours, but they grow back every time after they are removed. His next surgery is scheduled for Thursday.

These operations cost more than $100,000, most of which was covered by insurance, said Ms Ng, an assistant teacher.

She said Javier screamed through the night after his initial surgery as a result of pain, which subsided only after he was given morphine.

Javier is one of the beneficiaries of the Brain Tumour Society (Singapore), which helps brain tumour patients and their caregivers here.

 

Through its welfare grant, the society helps needy beneficiaries offset some expenses, including those for rehabilitation and medical aids.

The society, which started in 2014, counts among its members 75 brain tumour patients, of whom 35 are children.

Founder Melissa Lim, 51, said: "While the children have it bad, the parents go through a lot emotionally. It's very heartbreaking to see your children go through such things."

The human resource consultant had herself undergone a 16-hour operation in 2004 to remove a brain tumour, just five years after losing her mother to brain cancer.

Next year, the society hopes to start a registry of brain tumour patients, which Ms Lim said will help to provide an idea of the prevalence of brain tumours here.

Photo: MVF Studios

Yesterday's event was supported by the Lamborghini Club Singapore and marked the third Brain Tumour Awareness Day. It raised more than $100,000 in support of the society's programmes.

The event was attended by Minister of State for Education and Communications and Information Janil Puthucheary, who flagged off the Lamborghinis.

azhaki@sph.com.sg


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Singapore magician cheats death twice

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Magician Jeremy Pei has escaped the clutches of the grim reaper not once but twice and it is no illusion.

The first time was in June 30, 2012. Mr Pei was in his parked car when a truck slammed into it from behind. His car was damaged, but he was intact.

The second time was a few months later, when he discovered he had a brain tumour.

Mr Pei, 32, who started doing magic shows when he was 13, said the experiences changed his way of thinking. He said: "It used to be that magic was the No. 1 thing in my life, with my family maybe in third, but now, family is No. 1."

The car accident occurred when Mr Pei was on his way to a show near the industrial area at Tuas in the morning. He told The New Paper: "I parked by the side of the road to check where I needed to go on Google Maps."

He was sitting in his car one moment and the next thing he knew, he was on his way to National University Hospital (NUH) in an ambulance.

Mr Pei's mother, Madam Wong Siew Soon, 64, told The New Paper in Mandarin: "I was hoping that nothing happened to him. I didn't want to think about what the worst outcome was."

Mr Pei said that he heard later that a truck had hit his car from behind and he had blacked out.

He said: "I didn't feel being hit... and then when I opened my eyes, there were people all around my car and they were asking 'Are you okay? Are you okay?'."

The magician added that he was lucky that his seat belt was strapped on, although he found it curious that he was did not have any broken bones or serious bleeding because all of his props in the car were damaged.

He told TNP: "It was almost as if a fairy came down to save me and kept me in one piece."

But although he did not sustain any external injuries from the crash, the ordeal was not yet over.

Mr Pei was warded at NUH for 14 days as his brain was hurt from the impact of the crash and he experienced difficulties walking and speaking.

He said: "I couldn't move properly. I couldn't walk fast or speak fast; I couldn't even make a Milo."

After some physiotherapy, Mr Pei regained most of his abilities two months after the accident and he travelled and performed magic shows on a regular basis.

In 2013, a few months after the car accident, Mr Pei went to have a check-up on his brain at NUH. It was then the doctors told him that he could have a low-grade glioma, a type of brain tumour, and immediately wanted to arrange a biopsy.

But Mr Pei instead decided to continue with his original plans to go to Europe with his wife for their honeymoon.

When they returned in March 2013, Mr Pei visited six other specialists in Singapore. Every one of them said that he had a brain tumour.

During the period, Mr Pei said he felt depressed as he did not want to become a burden to his family and his new wife.

He said: "Actually, we planned to have kids, but I don't know whether it's nice to have a kid and then the kid would have to send the dad away at four or five."

Read also: Brain tumour patients enjoy ride in supercars
 

DIAGNOSED: Mr Jeremy Pei with his brain scans showing the tumour in his brain. 

FATHER

Mr Pei said his father had been a stroke patient for seven years until his death in 2011 and the disease had affected his family. He said he did not want his mother to go through the same scenario with him.

Madam Wong said: "He never wanted to affect the family. Even when he is suffering or in pain, he would always be smiling or he wouldn't coop himself up at home."

Knowing that his life would never be the same after the biopsy, Mr Pei told the doctors to delay it and he spent his days doing things he enjoyed.

Then, his condition got worse at the end of July 2014, when he started having seizures.

Mr Pei said: "I could not talk... and when I came home, every night before I slept, I would have a seizure attack."

His worst experience came in Shanghai, when he had seven seizure attacks in one day. 

And when he had his next check-up in January 2015, Mr Pei was not surprised to hear that the tumour had doubled in size. The doctors insisted he do a biopsy.

The biopsy was done in February 2015, followed by a surgery in October, which removed most of his tumour. However, the doctors could not remove all of the tumour growth as he had delayed the surgery.

Despite that, Mr Pei is remaining positive. He said it could have been much worse as the doctors said he could have lost the use of his right arm and leg and his speech if there were any complications during the surgery.

And in July this year, he received a piece of good news.

He said: "At the check-up, the doctors said 'Congrats, you can see your children get married,' and it made me so happy."
 

Since his operation, Mr Pei has not had a seizure attack. He considers himself semi-retired as he concentrates on and spends time with his family.

"I want people to know how to appreciate life, especially the people around you - the family. Now, I really appreciate my family," he said.

In July 2010, Jeremy won both the Finalist Awards in Close up and Stage Magic Competition at the International Brotherhood of Magicians Annual Convention in San Diego.


ABOUT BRAIN TUMOUR

There are two types of tumours, malignant tumours and benign tumours, said Dr David Low, 43, a consultant at the Department of Neurosurgery for the National Neuroscience Institute. Benign brain tumours are slow-growing tumours and they do not spread and destroy cells.

Malignant brain tumours grow rapidly and they spread into the surrounding brain. When asked about Mr Pei's condition, Dr Low said: "Glioma is a type of brain tumour. It arises from the glial cells of the brain."

Dr Low, who is also the head of Neurosurgery Service at KK women's and Children's Hospital, said that most brain tumours will just keep growing and will cause a coma, then death from pressure on the brain.

He added: "If the tumour is close to the area of the brain that supports vision, the patient will lose vision first and if it's close to the area that supports speech, the patient wouldn't be able to speak properly."

Dr Low said that after an operation, if the tumour does not grow back within five years, the patient is considered cured. The cause of brain tumours are largely unknown although Dr Low said that certain genes predispose patients to having brain tumours.

He said: "Our statistics are not very updated because brain tumours are not one of the top 10 cancers in Singapore. "Brain tumours comprises just 1 to 2 per cent of cancers in Singapore."

leeganjp@sph.com.sg


This article was first published on Nov 7, 2016.
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After Super, which companies make attractive targets?

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SINGAPORE - The mega offer tabled for Super Group last week is just the latest by a growing line of deep-pocketed buyers targeting home-grown companies and household brands on the stock market.

Dutch beverage giant Jacobs Douwe Egberts (JDE) is willing to spend $1.45 billion to acquire Super, a deal that looks like it will succeed.

JDE already had about 60 per cent of Super shares tied up, including the 23.95 per cent held by founder David Teo and his wife June Te, and 11.69 per cent held by YHS Investment.

Most market watchers have given their seal of approval, with DBS analysts Alfie Yeo and Andy Sim calling the $1.30-a-share offer "rich", even though the bid came as a surprise.

Read also: Jacobs Douwe Egberts agrees to buy Singapore's Super Group for $1.45 billion

MORE TO COME

The depressed share prices across the market suggest more buyouts and privatisations are on the horizon, OCBC analyst Jodie Foo told The Straits Times.

"With the current undemanding valuations for the broader market in Singapore, and with the price-to-earnings ratios being one of the lowest in the region and also at a low level versus the historical 10-year trend, we expect the privatisation and acquisition trend to continue," she said.

This is particularly the case in the food and beverage sector, where lacklustre expectations for earnings growth have put a lid on share prices.

Ms Foo added that international buyers lacking a presence in this region would be keen on F&B companies with operations in key emerging Asian markets.

The F&B sector presents a range of potential targets, from bakery and restaurant operator BreadTalk to Japanese restaurant chain Sakae Holdings to Food Empire which is well known for its instant coffee products such as MacCoffee.

"The valuations of these companies are in the 20s and 30s (in price-to-earnings ratios), reasonable enough for strategic acquisitions even if the stock market does not appreciate their value," KGI Securities (Singapore) trading strategist Nicholas Teo said.

PLENTY ON OFFER

Companies with strong regional branding and distribution will be especially attractive to foreign buyers looking to establish a foothold, "similar to the dynamics between JDE and Super", Mr Teo added.

And with Super under the spotlight, Food Empire will likely draw some comparison.

Food Empire has a price-to-earnings ratio of 36.1 and a market capitalisation of about $162.5 million.

It runs nine manufacturing plants in countries as far away as Ukraine, and exports its instant beverage and snack products to over 50 countries, with Russia its main market.

The company's biggest shareholder is Universal Integrated Corporation - or UIC - which owns a 24.79 per cent stake, while founder and chairman Tan Wang Cheow controls 9.84 per cent.

At BreadTalk, founder and chairman George Quek remains the captain of the ship with a 34.01 per cent stake.

Under his management, BreadTalk has grown into the most recognisable bakery chain in Singapore, where it has about 120 outlets, with a further 392 in its key growth market, China.

The market capitalisation of BreadTalk - which also operates restaurants and food atriums - is around $282.7 million, with a 34.7 per cent price-to-earnings ratio.

 A new manufacturing solution developed by Singapore company Pixel Automation. The company developed its “cell” technology in-house, with help from Spring Singapore. Photo: The Straits Times.

MARKET CONCERNS

But while some companies may look like a sweet deal on paper, guessing which one is getting acquired will be no more than "a jab in the dark", Mr Teo noted.

He added: "It all comes down to synergy and expectations. For example, businesses that rely on an outlet model may be less of a draw because their return on equity is probably lower."

Meanwhile, some market observers are concerned about the gradual loss of home-grown companies listed on the local exchange.

Singapore Business Federation chief executive Ho Meng Kit said: "While acquisitions and privatisations are the norm of a functioning market, it also suggests that companies are unable to seek growth and capital through our capital market."

National University of Singapore Business School associate professor Mak Yuen Teen noted the difference between acquisitions and privatisations where major shareholders opt out due to lack of liquidity or listing-rules compliance cost.

"The founders (of Super) did not let sentiments prevent them from doing what is best for the company and shareholders," he noted.

"If the board feels that someone else with the resources and the global scale can take the company further, then it should be prepared to let the company be acquired, provided the price is reasonable."

 

whwong@sph.com.sg


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Trio return $875k won with MBS''bonus error'

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SINGAPORE - Three gamblers have agreed to pay back some $875,000 in winnings to Marina Bay Sands which they allegedly pocketed after discovering a glitch in the casino's loyalty membership scheme.

The move follows a consent judgment recorded last week in the High Court before Judicial Commissioner Pang Khang Chau which averted a scheduled three-week-long civil trial.

Marina Bay Sands had sued businesswoman Ho Man Yuk, a casino player from Hong Kong, together with Indian businessman Shaik Farid and Ms Shaikh Shabana Bi, who has business interests in Singapore, for allegedly colluding to redeem a total of $1,029,200 in Sands Bonus Dollars - which can be exchanged for promotional chips to play in various casino games.

Ms Shabana was a member of Marina Bay Sands' loyalty membership programme, while Mr Farid and Ms Ho were both top-tier members.

Ms Ho, 37, had been eligible to claim Sands Bonus Dollars during two promotion periods in 2014.

As part of the procedure, she inserted her membership card and keyed in her PIN at a kiosk on the premises and found that her successful redemption had not been recorded - apparently because of a programming error.

It meant a patron could repeat the steps and redeem an unlimited sum of bonus dollars. Ms Ho was eligible to reclaim 100 Sands Bonus Dollars during the two promotion periods.

She redeemed the bonus credits twice, in March and April 2014, and then enlisted the assistance of the other two and showed them the steps required to redeem the bonus dollars.

The steps were repeated 10,292 times over a week, reaping some $1.029 million in bonus dollars.

The defendants used the credits to gamble at the electronic roulette machines and walked away with $875,133 in winnings.

Marina Bay Sands, represented by Drew & Napier lawyers Kelvin Tan and Juliet Liew, argued in court papers that the sums were credited as a result of a mistake and the defendants had "unjustly" enriched themselves.

Ms Ho, defended by Mr Sarbrinder Singh from Sanders Law LLC, who is also the lawyer for Mr Farid and Ms Shabana, countered in documents filed in the run-up to the case that the $875,133 payout was legitimate as she had won the money from a roulette machine.

Ms Ho denied knowledge of any alleged system error and claimed that she believed she was on a streak of good luck that kept her winning the bonus rewards.

Under last week's High Court settlement, the three defendants agreed to jointly return the $875,133. No costs were payable.

 

vijayan @sph.com.sg


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20 e-scooters seized after users caught illegally riding on roads

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SINGAPORE - 20 electric scooters have been seized by the Land Transport Authority (LTA) for illegal riding on roads.

Under the law, personal mobility devices (PMDs) are not allowed for use on roads.

LTA said in a statement today (Nov 7) that it "has been stepping up enforcement efforts to deter unsafe and reckless riding behaviour by cyclists and personal mobility device users" since May this year.

More than 860 advisories were issued to cyclists, power-assisted bicycles (PABs) users and PMD users who were caught riding in an unsafe manner on footpaths and cycling paths, said the statement.

More than 1,400 notices were issued for using non-compliant PABs between January and September this year.

Most of these users were observed to be travelling at high speeds with devices that can go as fast as 70km/h, which could potentially endanger themselves as well as other road users.

Other offences include riding against the flow of traffic or riding without a helmet.

Under the Road Traffic Act, anyone found using non-compliant vehicles may be charged in court, and fined up to $2,000 or jailed up to three months for the first offence. For subsequent offences, the offender may be fined up to $5,000 or jailed up to six months upon conviction. The non-compliant vehicle could also be seized.

LTA reminds cyclists and personal mobility device users that they must stay below the speed limits of 15km/h when riding on footpaths, and 25km/h on cycling paths.

spanaech@sph.com.sg

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Parliament: Elected President protects reserves in a way that Parliament cannot, says DPM Teo

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SINGAPORE - Every political system has its strengths and weaknesses, and Singapore conceived the institution of the Elected Presidency as its parliamentary framework may not provide sufficient protection of the nation's reserves, Deputy Prime Minister Teo Chee Hean told the House on Monday (Nov 7).

He noted that some have argued that Parliament provides the best safeguard, but countered that there is little or no incentive for lawmakers to resist appeals from a government should it decide to indulge in populist spending.

"Indeed, the call, from both sides of the House, will often be to do more," he said at the start of the debate in Parliament on proposed constitutional amendments regarding the highest office of the land.

When passed, the Constitution of the Republic of Singapore (Amendment) Bill will, among other things, tighten the eligibility criteria for presidential candidates, ensure members of racial minority groups are elected from time to time, and give more weight to the recommendations of the Council of Presidential Advisers (CPA).

Mr Teo cited the examples of Greece and Australia as "cautionary tales of elections descending into auctions, with political parties competing with each other to promise greater largesse from the nation's coffers".

"The Elected Presidency plays an important custodial role in safeguarding our key assets, in a way a purely parliamentary process cannot," he said.

"It also deters political parties from making wild promises at Parliamentary elections. They know that even if they come to power, they cannot splurge our past reserves on populist measures."

This custodial role was put in action in 2008 during the global financial crisis, Mr Teo pointed out, when the Government sought the approval of then President S R Nathan, to use nearly $5 billion of past reserves to save businesses and jobs, and to guarantee about $150 billion of bank deposits to keep confidence in Singapore.

President Nathan gave his approval after examining the request and consulting the CPA. The sum drawn down was returned to the past reserves by 2011.

The Bill comes after a nearly year-long process that began when Prime Minister Lee Hsien Loong first raised the need for a review of Singapore's political system during the debate on the President's Address in January, and convened a Constitutional Commission to review aspects of the Elected Presidency.

The commission's report was released in September, and the Government set out its position in a White Paper that broadly accepted the commission's recommendations.

Mr Teo reiterated the need to update the eligibility criteria, noting that "the economic environment we live in is very different from when the Elected Presidency was introduced in 1991".

The proposed changes will ensure the criteria is periodically reviewed so that presidential candidates continue to have the necessary expertise to handle complex financial matters as the economic situation changes over time.

During public hearings held by the commission in April and May, several contributors argued that the stringent eligibility criteria for the presidency seemed to be far more exacting than the eligibility criteria prescribed for the prime minister.

However, they later conceded this was a false comparison, Mr Teo noted, as the PM assumes office after through an entirely different process from the president.

The PM is elected as an MP during parliamentary elections, leads the political party that wins the majority of seats in Parliament, and commands the support of a majority of elected MPs.

"These requirements mean that there is a multi-layered filtering process where a person's abilities are tested before he is likely to become Prime Minister," he said.

The president, however, is elected directly and therefore there needs to be a baseline of experience and expertise a candidate should possess, Mr Teo added.

Concluding, he likened the Elected Presidency to the ballast in a ship that prevents it from rolling uncontrollably and capsizing in rough seas.

But too much ballast will affect a ship's speed and agility.

"Our nation, like a ship, needs an optimal amount of ballast - enough to keep us stable, but not so much as to render us sluggish and unresponsive to change," he said.

ziliang@sph.com.sg

Read also: President Tony Tan: Elected president is symbol of national unity, must be able to work with Government


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President Tony Tan: Elected president is symbol of national unity, must be able to work with Government

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SINGAPORE - The elected president plays the key roles of being a symbol of national unity as well as a custodian of Singapore's treasured assets, said President Tony Tan Keng Yam on Monday (Nov 7) in his first public comments on the proposed changes to the office.

In doing so, the president must also able to work with the government of the day so that Singapore can function effectively,said Dr Tan.

The President's comments were read out in Parliament by Speaker Halimah Yacob at the beginning of a three-day debate on amendments to the Constitution following a landmark review of the 25-year-old elected presidency.

"The objectives of the review are clear - to ensure that the institution of the elected presidency stays relevant with time and our local context, and that the Singapore Constitution as a living document is aptly refreshed," he said.

"My five years as president have given me a personal perspective on the role of the elected presidency and how the elected president serves the nation and all Singaporeans. I have therefore agreed with the Prime Minister that I should send this message to Parliament to share my views on the proposals that are being debated," he added.

Drawing from his personal experience since being elected to the office in 2011, Dr Tan said that an important dimension of his role has been working with the different ethnic groups that make up Singapore's multiracial composition.

He noted that it was not a coincidence that Singapore's first four appointed presidents - Mr Yusof Ishak, Dr Benjamin Sheares, Mr Devan Nair and Dr Wee Kim Wee - represented, in turn, the Malay, Eurasian, Indian, and Chinese communities respectively.

"As the president remains a symbol of the nation's unity, it is important that the Office of the Presidency upholds multi-racialism, a core value of Singapore that underpins the social cohesion and harmony we have enjoyed thus far," he said.

While Singapore should aspire in the long run for minorities to be elected as president without the need for any intervention, "we also need to recognise the current realities", said Dr Tan, noting that all but one of the elected presidents since the scheme was introduced have been Chinese.

These realities are why he thought the proposed change to reserve a presidential election for a specific ethnic group if a member of that group has not been the president for five terms was a balanced approach.

He also highlighted the president's role as a custodian of Singapore's national reserves and of the integrity of its public service.

Because the president can disagree with the Government on these matters, he must be qualified to do so. This is why Dr Tan agreed with the move to update the criteria individuals need to meet to be able to run for the office.

"From my own experience, the scope and complexity of the presidential oversight on Singapore's key assets have increased significantly, even in the span of five years of my term," said Dr Tan.

He said that his finance background was useful in helping me understand the technicalities of the Government's proposals, but the decisions often also require good policy acumen and a sound judgment on what is right for Singapore," he added.

Dr Tan added he was of the view that the Government's acceptance of the commission's recommendations is in the right direction.

He also noted that there is a difference between the president acting as a custodian and the president acting in opposition to the Government.

He cautioned that the elected presidency cannot be a second centre of power, but must act in accordance with the roles prescribed in the Constitution, and not hold back the elected government of the day from performing its executive role.

Dr Tan also said: "We must rely upon the wisdom of our electorate to elect a president who is able to work with the Government of the day for the proper and effective governance of Singapore."

He added that as president, his working relationship with the Government had been harmonious.

"The Government keeps me informed of all its major decisions. On a regular basis, the Prime Minister and I meet over lunch and on other occasions, for him to brief me on his preoccupations and intentions, and to exchange views on the strategic direction in which Singapore is heading," said the President.

"Our relationship is built on mutual trust and respect. This, to me, is key to the effective functioning of our system," he added.

Dr Tan also noted that the president had previously been described in the House as a goalkeeper.

"Indeed, if he fails to do the job well, no matter how good our strikers are, more goals will be scored against us and Team Singapore will be set back," he added.

"We need a capable goalkeeper who works with the other players. Only then will Team Singapore continue to do well in the global league, against competitors who may be bigger, stronger and more intimidating."

charyong@sph.com.sg

Read also: Elected President protects reserves in a way that Parliament cannot, says DPM Teo


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Tigerair changes aircraft twice for flight, causing 5-hour delay for 150 passengers at Changi Airport

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SINGAPORE - Passengers on a Tigerair flight bound for Bangkok were forced to switch aircraft twice at Changi Airport, causing a five-hour delay on Monday (Nov 7) morning, reported Chinese newspaper Shin Min Daily News.

The flight, which was carrying 150 passengers, was scheduled for take-off at 7am. But after the aircraft left Terminal 2, the pilots discovered a fault in the braking system.

Passengers were asked to disembark from the plane to board another aircraft at the same terminal.

However, their ordeal was not over as the substitute aircraft had a "slow engine start", according to a Tigerair spokesman.

Passengers then boarded a second substitute aircraft. After five hours of delay, the Tigerair flight took off at noon.

According to the spokesman, 16 passengers did not continue with the flight and will be refunded. Passengers were also provided with refreshments during the delay.

"Safety is of utmost importance to Tigerair and we will spare no effort to ensure the safety of our passengers," said Tigerair in a statement.

The incident comes two days after a bird struck the windscreen of another Tigerair flight, causing cracks to appear. The flight, which had departed Hong Kong International Airport for Singapore, was forced to divert back shortly after take-off.

The plane landed safely back at the airport, with no reported injuries to anyone onboard.

Some of the passengers were scheduled for a later flight that day, while others had to wait for the next flight on Sunday.

ngxtc@sph.com.sg

Read also: Tigerair flight from Hong Kong to S'pore turns back after 'bird strike'


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New guidelines for NUS orientation to include more training and safety measures

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SINGAPORE - The National University of Singapore (NUS) has released new guidelines for its freshman orientation, which will involve more training for student leaders and reinforced safety measures.

The freshman orientation framework will be ready by April next year, and training sessions for staff advisors and student leaders are also expected to begin next year.

This follows a controversy over the inappropriate nature of activities at the university's freshman orientation in late July, including complaints of students being forced to simulate a rape scene. Some also said they were coerced into taking part in other sexually suggestive activities.

It led to the suspension of some student-organised orientation activities, and calls for a comprehensive review of how activities at such camps are carried out. Disciplinary action was also carried out against 30 senior students for their role in the activities.

In a circular sent to students on Monday (Nov 7) afternoon and obtained by The Straits Times, Professor Tan Eng Chye, NUS' deputy president (academic affairs) and provost, stated the recommendations made by a 13-member Orientation Review Committee, which included faculty members, student leaders and alumni.

About 160 students, including orientation committee members and freshmen living on campus were also consulted.

NUS management studied the committee's report in detail, and accepted all of its recommendations, he said.

These include:

* Setting up a freshman orientation framework, which will guide student organisers when they plan activities. This includes objectives that remind students that orientation is meant to "foster a sense of belonging and pride for NUS", and that freshmen should feel "welcomed, assured and supported".

* Developing a customised training programme to ensure that students and staff advisors will be able to lead activities in a "safe and respectful" manner. Important areas that will be covered include crisis management and sensitivity to vulnerable students. These will be conducted in a workshop format, involving face-to-fact interaction.

* Setting up a stringent selection process for student leaders of orientation camps. A selection panel, consisting mainly of student leaders, will put candidates through a detailed assessment that tests their responses to various scenarios to "gain an understanding of their values and moral compasses". Staff advisors will also be appointed based on their ability to serve as a role model for students, and their ability to develop students and set high standards for student leaders.

* Additional checks and safeguards will also be introduced. This includes appointing at least one student to play the role of a safety officer at each orientation camp, with more of such officers at larger camps. The safety officer will be in direct contact with the staff advisor, check on both freshmen and seniors, and report on or put a stop to inappropriate behaviour. Avenues for feedback, including going to the safety officer or staff advisor, will be made known to students at the start of each orientation camp.

* More workshops that "promote diversity, sensitivity and respect among the student community" should also be adapted and incorporated into orientation programmes by more student groups.

yuensin@sph.com.sg


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Power outage in Macpherson HDB block

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RESIDENTS at a Housing Board block in Macpherson had to take the stairs and walk along unlit corridors as the block was partially without power for four consecutive days.

From last Thursday, residents at Block 37, Circuit Road, had to deal with power outages, Lianhe Wanbao reported yesterday. Initially, only the lifts were affected but the problem spread to the lights in the corridors.

A contributor to citizen journalism website Stomp, who identified herself as CK, said she had no electricity in her flat on Saturday for about two hours.

Resident Jiang Yuzhu, 72, told Wanbao that all six lifts stopped working last Thursday.

Since then, the lifts have worked only sporadically, with three lifts restored currently.

Other residents said repairmen were dispatched to fix the lifts when another problem cropped up - the corridor lights went off.

Said resident Zhou Longzhu, 60: "Both yesterday and the day before, our corridor lights would turn on only after 9 plus at night.

"When I came back at 8pm, I had to find my way home in the dark."

He added that it was the first blackout he had encountered at the block.

"I hope the authorities can quickly help us solve this issue, so our lives can go back to normal," he said.

A Marine Parade Town Council spokesman told Wanbao that Block 37 at Circuit Road had experienced a loss of power.

It received feedback from residents last Thursday that the lifts had stopped working.

Said the spokesman: "Our workers went down to investigate on that day and restored the power."

He added that the town council was working with the authorities to investigate the cause of the power outage, and apologised for the inconvenience caused to the residents.

Residents seeking help in a power outage can call the HDB Essential Maintenance Service Unit (EMSU) on 1800-275-5555.

myp@sph.com.sg


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NUS lists guidelines for more wholesome orientation activities

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Come the next National University of Singapore (NUS) freshman orientation, there will be one more person attending: a student safety officer to whistle-blow on inappropriate activities.

Workshops will also be conducted beforehand with student leaders and staff advisers to ensure they lead activities in a "safe and respectful" manner.

These are among the new guidelines released by the university yesterday in an effort to stamp out a decade-old practice of raunchy orientation games.

The latest iteration, in late July this year, was especially controversial: NUS students complained about being coerced into taking part in sexually suggestive activities, including being forced to simulate a rape scene.

It led to the suspension of some student-organised orientation activities and calls for a comprehensive review of how activities at orientation camps are carried out. Disciplinary action was also taken against 30 senior students for their role in the activities.

In a circular sent to students yesterday and obtained by The Straits Times, NUS' deputy president (academic affairs) and provost Tan Eng Chye listed the recommendations by a 13-member orientation review committee, which included faculty members, student leaders and alumni. The university management has studied its report and accepted all recommendations, he said.

About 160 students, including orientation committee members and freshmen living on campus, were also consulted.

Measures include a new framework for orientation. Guiding principles state that orientation should be "enjoyable, educational and memorable". All freshmen should also feel "welcomed, assured and supported".

The selection process for student leaders of orientation camps will be tightened, with a selection panel made up of mostly students putting candidates through tests to demonstrate whether they have the right values and attitudes. At least one student leader will also be appointed as a safety officer at each camp, and he or she will report on or put a stop to inappropriate behaviour.

Student orientation leaders selected will have to undergo face-to- face workshops with experienced trainers following complaints that senior students leading orientation activities either initiated or allowed unapproved activities to carry on.

Previously, orientation guidelines did not have these additional layers of checks or personal training. In the past, student leaders went through written materials with examples of "dos and don'ts". They were also briefed about banned activities such as those involving physical intimacy between members of the opposite sex and ragging.

A practice that requires staff advisers and the Office of Student Affairs to approve plans for orientation will continue, and workshops and talks that "enhance awareness and promote diversity, sensitivity and respect among the student community" should also be adapted and incorporated into orientation programmes by more student groups, said the circular.

Ms Drima Chakraborty, 20, a second-year NUS student, hopes to see more workshops on consent being conducted for freshmen. "The peer pressure that some freshmen might feel (about being coerced into joining activities they are uncomfortable with) still gets dismissed or downplayed. There is a culture of protecting your comrades even if they are in the wrong."

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Read also: 

30 NUS students punished over orientation activities

What NUS students say about orientation camp debacle 

Sexualised games at NUS orientation: Students re-enact rape


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Elected presidency: Malay candidates must meet same standards, says Yaacob

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While it is nice and timely for Singapore to have a Malay president, the Malay candidate must meet the same exacting standards demanded of candidates from other communities, Minister-in-charge of Muslim Affairs Yaacob Ibrahim said.

"We do not want, and we cannot accept, tokenism," Dr Yaacob told the House yesterday, on the first day of debate on proposed changes to the elected presidency. "We want a president to command the respect of all Singaporeans," he added.

Speaking in English and Malay, Dr Yaacob, who is Communications and Information Minister, sought to explain the psyche and concerns of the Malay community and its historical burden of being perceived as lagging behind other communities.

Describing the issue as an "emotive one", Dr Yaacob noted that Singapore has not had a Malay president for 46 years. The last Malay president was Singapore's first president Yusof Ishak, who died in office on Nov 23, 1970.

"An entire generation of Malays have grown up without ever having a Malay president," said Dr Yaacob. "Among the older Malays, having lived under a Malay president, it is understandable that they yearn for one after a very long time."

Younger Malays who grew up under meritocracy may be a little reluctant to see the change to ensure a Malay president from time to time, yet in closed-door discussions many would raise their hands when asked if they want to see a Malay president, he noted, adding: "But very few would say this publicly."

He noted how when the ethnic integration policy for public housing was started in 1989, there was some unease, but today, it has served the national interest, preventing ghettoes and enabling integration.

He himself struggled with it, but recognised the need for such policies "to avoid the pitfalls of other societies that ignored the human tendency to behave in tribal ways".

The changes to the presidency are a similar policy tweak, he noted.

"To have a qualified Malay to do the job speaks to a long-held desire among the community to see one of us serving in the highest office in the land. It is about our place in this nation that we call home," he said.

Malays, more so than other communities, look forward to seeing the success of one of their own, Dr Yaacob said. He cited the example of Natasha Nabila who topped the Primary School Leaving Examination in 2007 and broke the record for the highest scores. "The community was overjoyed," he said.

Dr Yaacob also shared a personal anecdote about his eldest brother Mohd Ismail Ibrahim, the first Malay President's Scholar. The extended family turned up at Paya Lebar Airport in 1968 to see his brother off for his studies, while a fellow scholar was accompanied only by his immediate family. He said: "The airport was swamped by Malays! It was a moment of celebration."

"The truth is that we do not have many Malays in key positions of power and leadership," noted Dr Yaacob. "Having one being a president is not just nice, but timely."

He added: "But this cannot, and must not, be the reason why we should have a Malay president."

Dr Yaacob also said he was concerned the debate was putting minority communities in the spotlight again, a situation the Malay community had frequently been in for the last 50 years. "We lagged behind in education, (had) higher divorce rates, higher crime rates and, more recently, Islam has been associated with the terrorism threat," he said.

The move to ensure a Malay president could be seen as "the Government going out of its way to help a community that has lagged behind". This is why for a candidate to be respected by all Singaporeans, he must meet the same high standards, regardless of race, he added.

Read also: Seven presidents, 50 years


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