I love literature, I love music, I love ideas, I love people, I love life, I keep learning.

Constance Singam I am Constance Singam who at 71 is still learning. But then I was a late developer which meant I have extended experiences and learning to much later in life than most people.

For instance, I got married, like most women by the time I turned 24, settled to a traditional married life, became a widow at the age of 42 , obtained my first degree
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29 Aug 2016

 

Thank you all for your expressions of sympathy. I wrote that piece about Elizabeth, on the advice of my sister, Fil, who saw how affected I was by the news of Elizabeth’s death. Writing will help, she said. And, yes, it did. It did more than release me of my pain. Writing about my experience showed me what an impact she has had on my life and how I live it. (those of you who have not read the full article in my blog do go to connie.sg and read. She was an amazing woman and you too will be inspired).

 

When I first went to Melbourne, I was doing one of the bravest things I had ever done in my life:  go to university, live in foreign city, and live an independent life after the death of my husband. I had up to that point in my life led a very protected life. I was 44 then. I was diffident and disempowered. And in Melbourne I met a group of women, all older than me, seizing the opportunity to earn a degree and having fun. Elizabeth and I got along and became firm friends. She was generous and had a positive attitude to life. We had common interests: music and the arts.

 

Old age never bothered her. For her it was natural to continue living the way she had always lived with vitality, laughter and energetic activity. When she found herself crippled with arthritis, she fought it with vigour, with diet and exercise.

The last time I saw her, she was 92, and she came to see me in the city using public transport.  I watched her striding away from me, a little bent now, but still confidant.

 

The way she lived her life up to the end is an example of how to live as I age and a particular challenge for me in this time of my life. I live in a society where old people are invisible and are seen as feeble.  Just as I have imbibed Elizabeth’s energetic attitude to life I fear that I will fall victim to our cultural attitude towards old age. The daily challenge is to fight that attitude and my own inclinations to slow down.

28 Aug 2016

” What though the radiance which was once so bright

Be now for ever taken from my sight,

Though nothing can bring back the hour

Of splendour in the grass, of glory in the flower;

We will grieve not, rather find

Strength in what remains behind;

In the primal sympathy

Which having been must ever be;

In the soothing thoughts that spring

Out of human suffering;

In the faith that looks through death,

In years that bring the philosophic mind.”

 

Ode on Intimations of Immortality from Recollections of Early Childhood

William Wordsworth, 1770 - 1850

 

28 Aug 2016

My friend Elizabeth died on Tuesday 16thAugust 2016 at the age of 93. I will miss her very, very much. She was my inspiration, my cheer-leader-in-chief. And I weep. I weep not just for the loss of a dear friend but I weep for me too, for losing friends; for dreams forever gone, hopes not fulfilled, loves lost, risks not taken. That is the sadness of old age. My heart is heavy but the tears won’t come.

But I think of Elizabeth’s  death, our friendship and how that friendship had enriched my life. Elizabeth John was my friend for almost 40 years. She was so full of vitality; so full of grace. Her face ageless and always lit up with warm, embracing smile.  She was my role model to live a full, energetic and elegant life till the end. During those 40 years she visited me twice in Singapore and I visited her three times. She wrote every now and then, keeping me informed of  her life and activities and we  spoke on the phone.

She showed me Melbourne, the concerts, my first opera, my first contemporary dance performance (”are they nude?”we asked each other. They were), visits to the theatre and to the art galleries and she and I flew to Sydney to catch the first performance in Australia of Andrew Lloyd Webber’s musical “Cats”.We sat together at our music and visual art lectures and then took ourselves off to the café for cups of cappuccino.  I remember escaping to a nearby village to have  our regular fix of cappuccino when we both spend a week at a health spa just outside of Melbourne. She persuaded me to pick up the violin again after a lapse of 20 years. She was a wonderful violinist and teacher. She was the only woman that I know who knew and did fly an aeroplane.

When we met at Monash university I was 44 and she 57 years old. We were both widowed and had been married to traditional men. I was experiencing female friendships for the first time. I didn’t know her age then and not till she turned 90, three years ago, did I realize our age difference. She called me a ‘spring chicken’ during the course of a conversation when she revealed to me of two relationships she has had, the first when she turned 69 and the second when she was well into her 70s.

Elizabeth loved walking and travel, and the more adventurous the better. She was an enthusiastic bush walker and was a member of several bushwalking clubs including the Melbourne Bushwalkers.  She was prepared to work hard to enjoy these activities and here are a few snippets -

- To combat arthritis in her late 50s she rose at 5 each morning to run round Elsternwick Park .

- at 63, she went trekking in Nepal and on return happily let it be known that ‘big strong men’ had fallen down from altitude sickness, while she went marching on.

- at age 65, she ceased music teaching “to do other things” and first on the list was a rubber raft trip down the Colorado River.  Asked why, she said “if I don’t go now I might get too old!”.… the rapids were difficult, and the boats capsized and people had to swim, and she loved it. She was browned by the sun, and in a reservation was delighted when two small boys asked “are you a red indian?”

- at age 69 she travelled the silk road with many adventures, and found a new companion to share her life, John. John was older and unfortunately died just a few years later.

- determined always to keep fit, Elizabeth loved dance aerobics and kept at this until her late 80s – and even in the Gym she would always dress with style

Later, in her seventies she once again found a companion to share her adventures in Mac Caton.  Mac was an experienced walk leader from Melbourne Bushwalking and very happy to take care of the everyday needs of living, and was attentive and devoted. They both loved dancing, and Elizabeth and he went on many trips – as Elizabeth said one day ”we came home, and the house was a mess, so we just went off somewhere else!”  These happy years came to an end quite suddenly when Mac passed away in year 2000.  He was 65 and she 77, and Elizabeth felt his loss greatly.

Determined, she kept walking even in her late 80s when mitral stenosis slowed blood circulation, and at the age 91 underwent a mitral valve replacement and recovered to an extent.  She came out of hospital to find that her car had been taken away from her. When I met her last year she was still very angry about being deprived of her car.

I watched her, for the last time, a year ago, after we had met to see an exhibition at the Gallery and had tea together at a café by the river, walking – she strides rather than walk –  towards Flinder’s Station to catch the train to her home. I marvelled as I watched her, this 92 year old friend, still energetic, still smiling, still elegant, striding away from me , I realise now, for the last time.

 

26 Aug 2016

My breakfast this morning:

 

Piglet and Pooh eat your heart out.

 

Having got out of bed this morning I made myself , I actually made myself a breakfast of Puttu which was  eaten with ghee and sugar no less. I have lived an incredulous 80 years and a bit of ghee and sugar is not going to kill me..if it does it is time to go! Meanwhile I shall stay in bed as long as I like and eat a late breakfast. This morning breakfast was at 11.00 am.

25 Aug 2016

The highlight of my week is the Monday evening art class that I attend. I don’t know why I waited so many years to do something that I had enjoyed in my younger days. Of course I do know why. I was always too busy.

It is  a delightful pastime during a more leisurely phase of my life. Here’s the result of 6 sessions and I am one happy girl!

 

 

 

 

 

24 Aug 2016

credits: Alan Siew of Epigram books

 

 

 

 

 

 

 

 

 

 

 

The day in the life of an 80 year old!

The first challenge is to wake up and think ‘do I have something to do? Once I have decided that I do and can spend my time productively the next challenge is to actually  get out of bed.

What is the next thing to worry about? Oh yes. What am I going to have for breakfast?

I am reminded of a conversation between Pooh and Piglet in A.A. Milne’s “Winnie-the-Pooh:

“When you wake up in the morning, Pooh,” said Piglet at last, “what’s the first thing you say to yourself?”

“What’s for breakfast?” said Pooh. “What do you say, Piglet?”

“I say, I wonder what’s going to happen exciting to-day?” said Piglet.

Pooh nodded thoughtfully. “It’s the same thing,” he said.”

A.A. Milne, Winnie-the-Pooh

 

I haven’t quite arrived there yet.


I can’t believe that it has been a year since my last posting. But it has been an interesting year. Firstly I am part of a group which has set up the Singapore Advocacy Awards and we gave out the first awards in August last year. The next one is due at the the end of July. The awards are meant to recognise and celebrate advocacy awards and civil society activism.
Secondly the person responsible for suppressing activism, the founding father of Singapore is now dead. He has left a very successful and affluent country but a people in real need of asserting themselves, a people who can enjoy freedoms that other democracies enjoy and whose ideas and needs will be listened to and taken into consideration by policy makers.

Whatever is said about Lee Kuan Yew, the good and the bad, we can’t deny that he was a formidable force in the lives of Singaporeans.
May he rest in

peace.

 

 

4 Apr 2015


Few sights lift my spirit like magnificent trees. This morning walking down the street the magnificent Flame of the Forest is all green, spreading its branches, fan-like , with some flower still lingering even though it is now Autumn. These trees must have been glorious to behold in summer. They are still beautiful.

18 Feb 2014


Pioneer Generation Package – a talk given at the

 

Panel Discussion on Singapore’s Pioneer Generation Package @ LKY School of Public Policy: Thursday 13th Feb. 2014, 12.15 – 1.30.

————————————————————————————————————–

 

Beyond Policies, Politics and Economics

 

 

I would like to highlight four points:

 

  1. The Pioneer Package sees old age as “pathology” and subsidises the needs of the sick old

 

  1. The Package needs to address the issue  of equity – that greater equity in access     and finance be achieved for the aging

 

  1. Ageing is gendered.

 

  1. The approach to ageing should be holistic (the old are always going to be with us)

 

 

I am very grateful for the financial help that has been offered in the Package. At a personal level I welcome the extra subsidies which would allow me to use for treatments at polyclinics, GP and specialist outpatient clinics. These do provide some comfort.  I don’t want to seem ungrateful.

 

But is that enough? It is like having an ambulance waiting at the bottom of the cliff.

 

 

I think the government’s promise of ‘peace of mind’ is hugely ambitious and they have a long way to go. When you hear people’s stories you realise that the need is great. How can they be helped? I don’t know. I only have questions.

 

 

And I have some stories to highlight the plight of the old and sick. I thought , this story I am about to relate  was a happy story till I talked to her- The story of an old lady who sells vegetables and fruits.

 

My first encounter with her was about 8years ago when she used to sit along the path by the side of Shunfu Market selling vegetables and fruits. She sits with these, not a lot, spread in front of her. In the last few years she moved to the five-foot way along the shops in Upper Thomson Road. She greeted us, Mabel my interpreter, happily chatting, smiling telling us about her routine. She is there 7 days a week and has been doing it for 10 years. She is 91 years old – still strong; walks steadily; holds herself up straight.

 

Then as we asked her more questions she became less and less responsive. Her smile disappeared.

 

She is the mother of 11 children and now stays with the youngest son. She wouldn’t tell us why she sits there selling fruits and vegetables. She cooks her own food, usually porridge as no cooking is done in the household. She first refused my offer to buy a drink, lunch. But as we walked away she changed her mind and asked we buy her lunch – bee hoon soup – cost $3.60/.

 

I don’t know what the real story is. Some of her children might be dead. Others may have problems of their own. They may be working long hours. Or may be the old lady wants to remain independent and she doesn’t want to ask for help. She doesn’t want to be stuck in the flat on her own. It could be all of this that takes her to the five-foot way to sell her meagre stock of vegetables and fruits. I admire that old lady for her resourcefulness and for refusing to be old and frail. She has pride.  But nobody that age should have to fend for herself or himself. Where is our society’s sense of pride and our sense of respect for the old?

 

 

A man, also in my neighbourhood, and obviously sick and not quite there, (he could barely walk) could be found walking around  the neighbourhood or sleeping all over the place. We found that he actually lived in one of the flats with family members. But they wouldn’t have him in the house during the day. I don’t see him anymore.

 

I see, as you do I am sure, men in wheelchair sitting around in their wheelchairs, accompanied by domestic helpers. Just sitting around. One of those men, in my estate, used to take his wheelchair-bound wife, stricken down , I assume, by a stroke, trapped in a world of her own, for a walk round the estate. He was very attentive to her needs. She died and within a couple of years of her death (he had stopped chatting, smiling, greeting) I saw him being wheeled around by a domestic help. He died a few months ago. He got the biggest funeral that I had seen in a long time.

 

Because we see old age as pathology we tend to dismiss signs of depression, loneliness, sadness, as a part of growing old.  A research team from NUH’s department of Psychological Medicine found that nearly 21% of those over 80 and 16% of those in their mid to late 70s said that they were sad, lonely or in low spirits. 41 people aged 75 and above killed themselves in 2010.

 

 

We also know, from a study in 2001 that being female elderly. Malay and Indian elderly, elderly with no formal education, lower monthly incomes, those with little social support ‘are most likely to experience a decline’ in health status over time.

 

So another major concern is that of equity. Will this package mean that greater equity in access and finance be achieved for the ageing? Will it ensure health equity, end exclusion and promote social justice? Will it maximise the benefits, capabilities and the general well-being of the worst off ageing members of our society and those with the greatest health needs?

 

An anecdote related to me recently was of a friend’s mother who had heart problems. At first she was in C ward. She was in and out of hospital many times. Another time she was admitted to a different hospital, this time to B class. Here she was offered pace-maker. The family doesn’t know if it had to do with the change in the class or change in hospital. The pace-maker cost $40,000/. She was a pensioner and so it was covered.

 The pace-maker  made a huge difference to her quality of life and ‘peace of mind’.

 

A system of financing that actually gives ‘peace of mind’ goes beyond medical care. It should include disease prevention, access to social activities, assistance with daily living, assistance with medications, monitoring for illness, or more intensive assistance such as that provided in a residential care facility, recognise diversity of needs.

 

This should also include the development/promotion of an environment that is welcoming of older people. Ageing is now framed in a negative sense which will affect Singapore’s long term economic competitiveness.

 

The next point I want to highlight is this:

 

  • Ageing is gendered: Women tend to live longer than men; women tend to suffer from depression; Depression is the number one cause of disability. (study in the USA revealed that women are 70% more likely to suffer from depression. In Singapore 13% of the elderly population are affected by depressive and cognitive impairment; more women tend to be disabled than men – a study showed only 52% of older women were able to carry out their daily activities compared to 80% of older men; women and men experience disease differently; women earn less than men and have less saving. As a result, in these cases women are more dependent – financially and emotionally on families than men – they are thus disempowered and more vulnerable to abuse.

 

 

The elderly are cared for by unmarried children, mostly daughters. The 1995 National Survey of Senior Citizens in Singapore showed that singles constituted 24% of family care-givers caring for those aged 65 and above. This has increased to 26%, according to a Ministry of Health report (2011). Women constitute 74% of those caring for the elderly, according to an NUS Social Work Report of Singapore Family Caregiving (2006).

 

 

  • For the first time we are seeing a generation of 60 year old looking after their 80 years old and 90 years old parents.

 

 

 

 

 

(Rebecca’s story- My friend Rebecca lives and works in Beijing. Her father is  83 and mother 81. When her father showed signs of dementia she came down and placed in a home. From two years ago when she first admitted him the charge has gone up from $1,500 to $2,700 now. This is excluding charges for ambulance when he needs to go to hospital for check-up and medication.  Her mother has to go to check-up every 3months and blood tests and she has to wait at the hospital a whole day for the results.) Rebecca has two sons, one working in the States and the other in the UK. She will be retiring in 2 years and wondered how she was going to pay for her parent’s care. A study (reported in ST in August, last year) revealed that 54% – $2,280/ – per health expenditure was paid out of pocket here in 2010.

 

Another friend, Lily was the main care-giver for her parents, father at 94 and mother 90 for 12 years. They died last year within a month of each other’s death. Lillian is now 62. So from the age of 50 she has devoted completely to caring for her parents.

 

Both Rebecca and Lily worry about their own old age as do I. A 2005 data shows that 13.1% of the old live alone. The elderly living alone will account for 83,000 by 2030.

 

My final story illustrates the problems of many who are very sick and the quality of life of their  care-givers.

 

Tom 82 suffered from a massive stroke in August last year and was hospitalised  for 4 months. The stroke has affected his left side and his spine. Now he is back home. He can only eat soft food and he has to be fed. His only carer is Devi his wife who is 73 years old. Occasionally, when they are available the grandsons help her change his diaper but most times she does it on her own. It is a difficult job as he is in constant pain. She pays a man, from one of the Homes, $20/ daily to clean and bathe him. The hospital bed and wheelchair were donated by the Church and they paid $370/ for a ripple mattress.

 

Anthony is a pensioner and so his hospital bills were covered. Devi is a housewife, left her job to raise a family of four children. Two of those children don’t live in Singapore. A daughter who suffers from mental health problem lives with her. Their only income is Anthony’s pension. When that stops her only financial support will have to come from her one son who lives in Singapore but has a family of his own.

 

Should a mother who raised 4 children and looked after and is the only career for a seriously ill husband be forced to rely for financial support from her children? There is nothing as disempowering as being dependant.

 

 

 

So here I have a list of ‘needs’ for older people of our society, as a society of a rich developed country should provide:

 

For those aged who live with family members – this list has to do with the pathology of old age.

 

  1. Home nursing care . Home service such as  physio theraphy, pain management is important
  2. Respite care
  3. When I asked Lily what could have supported her, she said subsidies for the DW levy and information/knowledge.

Subsidise D.W levy– or if a family member leaves her job to look after a parent, pay her.

Germany introduced a long-term care insurance which offers financial resources- to pay for a care-giver who can be a family member). Interestingly this provision resulted in the emergence of private home-care givers and new residential agencies.

 

  1. Training for domestic workers (the story of DW who have to look after aged)

Even for a family member knowledge/information about the experience of ageing is important to better support the ageing relative. Somebody suggested a checklist…

 

  1. Visits to GPs, ambulance service, out-patient costs covered by medishield – Can there be a system in which a person’s medical history be made easily accessible to the GP. In fact records, test results etc. should be the property of the patient.

 

  1. Subsidise dental care which can be very costly.

 

For those living a life of health and well-being into old age.

 

  1. Intellectual stimulation –  the University of the third Age, for instance which are well attended by retirees in places like Australia and the UK.

 

  1. Reward those who work towards the Maintenance of physical health , yoga , gymn. I understand the US. Private  Insurance picks up the bills for gym membership, weight management etc. In Australia (where you Universal Health Care) and if you take an additional private insurance you can tax exemption for that.
  2. Can we also offer free check-ups and tests for our older folks as a form of preventive measure. In Germany because of the high incidence of breast and colon cancer people from the age of 55 are offered free mammograms and colonoscopy.

 

  1. Make Singapore more elderly friendly. A Singapore friend who has lived away from Singapore for the past three years, returned for a holiday says that Singapore is a very elderly unfriendly place with dangers such as little steps, uneven steps, escalators that don’t work.

 

 

I think also, there is an urgent need for a conversation – firstly about the role/goal of care; end of life preparation, advanced medical directive. Question the need for aggressive treatment – would I really need MRI, CT Scan, extensive investigation, expensive medication?

 

Secondly, a conversation about our values. What is it that we want? Increasing wealth for which we and our families work long hours? These long hours of work means that families have no time for each other, for their old and sick, and no time to cook a healthy meal? Think of what kind of illness that is going to afflict the next generation and what it is going to cost?

 

How can our society ensure dignity and peace of mind in old age? Occasional handouts, top-ups, seeking help from social welfare, government agencies – don’t contribute to our sense of dignity.

 

We really do need to talk seriously about a pension scheme. That old lady doesn’t have to be selling vegetables and fruits by the road side at age 91. Devi who spent a life time looking after her family and the sick won’t have to worry about the indignity of dependency and waiting for hand-outs. “What to do?” she asked me.

 

The problems we are facing with ageing and the way we treat old age is all connected – is connected to our value system, to our sense of who we are as a people.

 

The Pioneer Package and the gratitude expressed by the PM is only the first step.

 

 

Constance Singam

 

References:

 

  1. AWARE (2012) Singapore’s Stressed Singles
  2. Angelique Chan : Singapore’s Changing Structure and the Policy Implications for Financial Security, Employment, Living Arrangements and Health Care: Asian Meta Centre Research Paper Series No. 3.
  3. 3.     Health Care System of Elderly in Germany
  4. Yap Mui Teng, MCYS commissioned  Report On the State of the Elderly:IPS
  5. Wong Kai Wen, Futures of Ageing in Singapore: Journal Of Futures Studies (2013):

 

 

 

 

 

 
 


 

My memoir ” Where I was: a memoir from the margins” can be purchased as an E-Book from the following websites.

Booktique (by Starhub) is not up though (so it looks like they take longer):

Apple: http://itunes.apple.com/us/book/isbn9789810769246

B&N: http://www.barnesandnoble.com/w/where-i-was-constance-singam/1116263971?ean=2940045157551

Sony ebookstore: https://ebookstore.sony.com/ebook/constance-singam/where-i-was-a-memoir-from-the-margins/_/R-400000000000001096871

Kobo: http://www.kobobooks.com/ebook/Where-I-Was-Memoir-Margins/book-orkpST97sUOiCn9lu5Tubg/page1.html?s=xvyu2v2fDES6KOPWM7K9kg&r=1

Diesel: - http://www.diesel-ebooks.com/item/SW00000338492/Singam-Constance-Where-I-Was-A-Memoir-from-the-Margins/1.html

Amazon:                US: http://www.amazon.com/dp/B00EO1U6KK

UK: https://www.amazon.co.uk/dp/B00EO1U6KK

DE: https://www.amazon.de/dp/B00EO1U6KK

FR: https://www.amazon.fr/dp/B00EO1U6KK

ES: https://www.amazon.es/dp/B00EO1U6KK

IT: https://www.amazon.it/dp/B00EO1U6KK

JP: https://www.amazon.co.jp/dp/B00EO1U6KK

IN: https://www.amazon.in/dp/B00EO1U6KK

CA: https://www.amazon.ca/dp/B00EO1U6KK

BR: https://www.amazon.com.br/dp/B00EO1U6KK

 

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