As Singapore’s population ages rapidly, the need for appropriate care options for seniors, particularly those in the “missing middle,” becomes crucial. Assisted living has emerged as a potential solution, offering support for seniors who require assistance with daily activities but do not need round-the-clock nursing care. However, the implementation and expansion of assisted living services in Singapore present various challenges, such as cost, regulatory ambiguities, and manpower shortages. This commentary explores the potential of assisted living while considering alternative caregiving options and the importance of preventive measures in eldercare.

Addressing the Care Gap

The “missing middle” represents a group of seniors who struggle with daily activities but do not meet the criteria for nursing home admission. Assisted living facilities, with their emphasis on providing professional assistance and fostering social interaction, seem well-suited to cater to this population. By offering a middle ground between independent living and nursing homes, these facilities aim to support seniors’ physical and mental well-being.

Assisted Living as an Optimal Care Arrangement

Seniors with cognitive difficulties, such as dementia, can benefit from assisted living facilities that enable them to maintain some independence while receiving necessary care. Assisted living facilities provide nutritious meals, exercise programs, and social activities, fostering a holistic approach to healthy aging. The availability of private rooms and the opportunity to live among like-minded seniors make assisted living an attractive option for those who lack adequate family support.

Barriers and Slow Implementation

Despite the pressing need for eldercare options, the development of assisted living facilities has been hindered by factors such as high land costs, labor shortages, and regulatory uncertainties. These obstacles have deterred potential developers, prompting them to explore opportunities in other markets. The absence of clear guidelines and overlapping regulations has further complicated the establishment of such facilities. Consequently, Singapore has seen a slower-than-desired growth in assisted living services.

The Affordability Challenge

Affordability remains a significant concern for many seniors and their families when considering assisted living. The cost of monthly fees, which can range from S$2,900 to S$6,300, coupled with uncertainties about long-term financial sustainability, raise apprehensions. While the government provides subsidies for various caregiving needs, including nursing homes and home care services, these subsidies do not extend to assisted living facilities, leaving a gap in financial support for seniors in such settings.

Alternative Caregiving Options

Foreign domestic helpers and part-time in-home care services are popular alternatives for caregivers, but they come with their own set of challenges. The cultural differences and limited training of foreign domestic helpers may not always provide the desired level of care. Meanwhile, part-time in-home care services, while in demand, face periods of high demand and limited availability, especially during peak periods.

A Shift towards Preventive Measures

To address the growing caregiving needs, a paradigm shift is necessary. A focus on preventive measures, rather than reactive responses, is crucial in the eldercare landscape. Public-private partnerships should play a more significant role, with the government supporting and encouraging the private sector to establish more assisted living facilities. Additionally, the adoption of technology, such as smart living devices and motion sensors, can help alleviate manpower shortages and improve care quality.

Creating a Continuum of Care

Learning from countries like Japan and Australia, Singapore should explore the concept of continuum housing, which provides various levels of care within the same institution. This model ensures that seniors can transition smoothly as their care needs evolve. However, the limited availability of land in Singapore poses a challenge in replicating this approach.

Community Support and Grassroots Initiatives

Enhancing community support is essential for caregivers and seniors alike. Embedding community managers in HDB blocks can provide a valuable point of contact for seniors, offering assistance and support. Furthermore, training retirees as part-time caregivers could alleviate the strain on existing healthcare workers and help address the manpower shortage.


Assisted living holds promise as a viable solution for Singapore’s “missing middle” and their caregivers. However, addressing the challenges of cost, regulatory uncertainties, and manpower shortages is crucial for its successful implementation. A comprehensive approach that combines assisted living facilities, alternative caregiving options, preventive measures, and community support can create a more robust and sustainable eldercare system. By embracing these strategies, Singapore can better meet the evolving needs of its aging population and provide caregivers with the necessary support they deserve.

As a caregiver, we understand that you need all the support you can get. At SG Assist, we provide home monitoring services and a range of resources to help make your caregiving journey smoother. Visit our websites at SG Assist and CareConnect, to learn more about what we offer. Alternatively, you could also visit our Caregiver Resource Centre to find out more. And don’t forget to join our mailing list here to stay updated with the latest news and resources. We’re here to support you every step of the way.