I spent last week in Singapore, where an excellent breakfast of noodles and teah o ais limau (Malaysian-style iced tea with lemon) costs about $2 and is served at an open-air hawker center in under 10 seconds. Observing this Singaporean balance of efficiency, quality, and cost, made possible by the unstinting hard work of the hawkers and also by a system that plans and regulates these complexes of food stalls throughout the city, was good daily preparation for a week of discussions about the social values of this aging society as they are translated into policies and practices benefiting aging, chronically ill, and dying people and their families.
Singapore is the fastest-aging society in the world. Being ranked number one is usually a matter of local pride, but in this case, it means that this highly developed city-state of 5.5 million is ahead of other nations in grappling with the reality that if your society is aging, it includes a lot of people facing dementia. Our team, led by Singaporean bioethics scholar Jacqueline Chin, has begun these discussions with local physicians, nurses, social workers, program administrators, and policy-makers as background for the second edition of the Singapore Casebook, which will focus on the ethics of care transitions in aging societies.
Some of the definitions and questions we began to tackle are familiar across aging societies. For example, the common metaphor of population-level aging as the “silver tsunami” is problematic. By suggesting that the oldest old, as their health deteriorates, become a natural disaster, the metaphor presents older people as a threat to society rather than members of society.
The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.