Lotus Eldercare

Lotus Eldercare

In the past 5 years, there has been an increasing support for home based care for elderly chronic sick, bed bound patients. The Ministry of Health and Agency of Integrated Care has done much to support the dependent elderly patients through various policies. Primary health care and long term care sectors have been in the news often and are getting the support they deserve from the policy makers.


MEANS testing has been getting less “mean” and much easier to pass in recent years. Hence, MEANS testing dependent programs such as IDAPE has seen an increase in claims in the past few years.  CHAS is another program in recent years to help subsidised patients to see doctors at private GP clinics rather than at polyclinics. CHAS provides subsidies for medical services and other perks, which traditionally only polyclinic holds. One big advantage for CHAS clinics now is the ability to refer patients to Specialist Outpatient Clinic as a subsidised patient.

It has been a heartening 3 years.  Authorities are giving more support to our group of chronic sick, bed bound patients to get treatment in their own homes. Support for home-based care is now given only to home care programs from charities and known social enterprises such as NTUC Health.

Private providers for long-term care services are unable to ride onto this program. Hence, we are only seeing those patients that either failed MEANS testing or non-Singaporean.  There is a special group of non-Singaporeans patients who have been staying in Singapore for the past 50 years but never converted to a Singaporean citizenship or even permanent residency.   For the group of patient who are unable to pass MEANS testing, many of them are actually also HDB dwellers and stays with their unmarried daughter or son with a stable income. Ironically, to pass MEANS testing, it is better for the elderly NOT to stay with their children in order to get maximal subsidies since usually the elderly will not have any active income as they are retired.

In the past, the difference between private and VWO services may not be too great, apart from subsidised consultations. But now, with subsidised medications and Pioneer Generation subsidies, my group of patients are losing out quite a bit. They will not be able to get their prescription subsidized like those in polyclinic or hospital SOCs as PG card holders.  As I do not have a physical clinic, my service is unable to be included in CHAS program.  All my referrals back to hospital SOCs will be treated as private referrals.  It would often be more cost effective to just go to the Emergency department for services such as subsidised referrals! Most of my patients are severely bed bound, hence requiring home based service.  It is very difficult or almost impossible for them to go to a CHAS GP clinics or polyclinic to see doctor or to get referrals.  I see this as huge disadvantage for my patients.  Perhaps, it would be timely for the authorities to come out with new policies to bridge such a gap for this group of patients.

I had been running subsidised home care services with various institutions for the past 7 years. I had witnessed first-hand at the many good subsidized schemes that benefitted patients.  As I had recently stop working for a VWO, some of the patients from the VWO wanted me to follow-up with them, but the difference of cost and benefits between subsidised and private service is too great.  There are also other patients whom I see along the course of my work who would like to continue to be followed up by me.  But as I know they would lose out a lot in terms of subsidized benefits, I had to advise them or refer them to be followed up by VWOs.  It seems that being a good doctor to the patient, thinking for the welfare of the patient will result in a losing situation for my own company.

Lotus Eldercare feels like we are falling through the cracks as well in terms of policy, mirroring those patients we serve.


I am excited to be involved in this year’s Global Ageing Conference in Perth, both as a speaker in the concurrent program and a delegate. This year’s biannual IAHSA event is co-hosted with Aged & Community Services Australia (ACSA), which is also celebrating its 40th year anniversary. We were treated to many good practices and great innovative ideas from our Australian counterparts. The conference lasted 5 days, from 31st August to 4th September, with main conference from 1st to 3rd September 

There were a series of interesting Plenary speeches given by global experts from North America, Europe and Australia talking about global aging trends, housing issues, technologies, policies and laws relating to aged care. I did not remember any Plenary speakers from Asia and Asia is unfortunately not very represented in this conference. One of the most advance groups in Asia doing aged care services well in my opinion will be the Japanese. However, I did not chance upon any Japanese except for a sales person based in Australia selling Paro seals.

The speakers are exciting and give very good insights in global trends and practices. In summary, my take home point is the world is ageing, in 2030, 1 in 8 of Earth citizens will be above 65.  There are not enough frontline care workers and the more advanced countries are taking in many of these frontline staff from the surrounding developing or still third world countries. There is no global system and checks on these care migrations. There is no prefect funding system for aged care and many are still figuring out what is the best method without bankrupting the coffers. Technology is very much involved in aged care and aged care should try to adopt technology or risk being obsolete.

There are many concurrent sessions by speakers globally sharing their practices and experiences. There were 3 concurrent sessions in the course of the conference, and 9 - 10 groups with 3 presentations in each grouping. In total, perhaps about 90 to 100 presentations. I am one of the presenters in these concurrent sessions.

I have met many new friends in the conference, notably those from Africa and on a scholarship by CommonAge. CommonAge is a Commonweath Association for the Ageing. They aim to build and support relationships in smaller Commonwealth countries. Their website is www.commage.org , twitter @CommonAgeAssoc and fackbook.com/commage.org 

Those interested in this conference may still view all the recordings. Just download from www.evertechnology.com or e mail Ed at This email address is being protected from spambots. You need JavaScript enabled to view it.

MIT and SMART came up with a pre-MIT Hacking Medicine workshop to introduce to us the concept of the Hacking Medicine and what it encompasses. Many people suggested better ways for technologies to help patients navigate the complexities of both the services and the available funding schemes.


Chronological age is definitely not a determinant of the services required. A 90-year-old marathon runner and a 55 year old bed bound stoke patient will require totally different set of services. However, a 90-year-old bed bound from advance dementia and on nasogastric tube feeding will likely to be requiring similar services to that of the 55-year-old stroke patient.

As a primary care as well as long term care physician practicing in the community, part of my work is to advise patients and their families with regards to the possible services they would require; how to get maximal benefits out of our complex health system and also perhaps to relieve some of the work in our congested polyclinics.

There are already informative portals such as Agency of Integrated Care (AIC) site which is very useful but still focus on services rather than the client.

As such, I will be proposing a new portal perhaps via AIC or other aging issues related statutory board, to come out with a portal with the patient in mind. To explain further, this portal will be divided into 9 categories in accordance to the clinical fragility scale. Under each category, there will be subdividual into different sections such as health, financial and social support information. For example, the 90-year-old marathoner will be clicking onto Category 1 pages, perhaps telling him on chronic diseases screening and exercise prescription information, socially on the SG 50 sponsored courses etc. The 90-year-old stroke patient will have information on home medical and nursing services, and financially advised on IDAPE, PG-DAS, FDWG and SMEF funding schemes if eligible.

As the Clinical Frailty Scale is easy to understand and categorize, with useful information stack behind these more patient orientated headings, services can be groups and organized in a more functional way for the users.

Bringing Technology and Fund to You


We would like to invite you to our networking event (below).


Project Yangon June 2015 with medical students from Yong Loo Lin School of Medicine, Singapore:



Here are the links for further information on the student's project in Myanmar!

This is the link to our website: 


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Dear Business Users,

IDA, would like to invite you to attend the Pre-MIT HackMed@SG Workshop to be held on 1 July 2015. This is a run-up to the Massachusetts Institute of Technology Hacking Medicine in Singapore (MIT HackMed@SG) event, which will be held on 25-26 July 2015.

As part of the aging industry, I have been invited to many conferences and listened to many speeches on eldercare services, especially retirement homes or real estates for the aged.

These are usually in large countries whereby the older persons increasingly require help in their instrumental activities of their daily living.  This group is unlike those dependent on activities of daily living,  who needs more intense nursing care and supervision.

We do have some sort of such system present in Singapore, although not obvious, already integrated into Singaporean life. For example, in retirement villages, the dwellers will go to the lobby canteen for their meals, either a short walk from their apartments or at the ground level of their block. In Singapore, especially in older estates, our older persons can easily take a lift down their block and have a meal of their choice. For those more dependent, there are private meal delivery services or meals on wheels run by charitable organisation.

There are activities for older persons in these retirement villages. In Singapore, there are community centers, day activity centers (increasing in numbers), Resident Corner Centers, even elderly gyms in the pipeline to support the older persons. All these are options for the older persons, although they are less coordinated and more cumbersome to navigate at times for the less educated.

There may or may not be monitoring services in the apartment in these retirement villages. In Singaporean versions, studio apartment purposefully built to house older persons has call buttons in the living area and the toilet. New smart homes initiative with bulk of the apartments wired can in future be fitted with ambience monitor for falls and activities monitoring non-invasively such as Sound-eye. There can be a 2 way intercom for the older persons at home to reach out from their abode easily.

There are initiatives such as EASE program to renovate and remove barriers and improve access to the older persons. Those with more resources have no issues doing up the apartment for the older persons to live in comfortably as I had frequently observed.

The only lacking component in the whole scheme of this structure is a central person or service in charge. For retirement villages, there are staffs that will supervise and support this group of older persons. In Singapore, this task falls onto the children or close relatives who may not be trained to maximise this support structure. Some cases without such social network are either supported by befriender services or getting volunteers or neighbours to check on them daily.  There are charitable organisations that provide cluster support for more needy clients. Ironically, for the bulk of middle to upper class of Singaporeans, they do not have such support.

Both retirement models and the Singapore models have its good and bad points. One of the downside of retirement village is residents are all aged, and there will be depressing periods that friends passes on in the village. In Singapore model, the older persons walking in the markets will see toddlers, school children, youths and just about everyone with every age group. There  will be more vibrancy in their lives.

For those who are less supervised, with less ability to lead an active life without assistance, many helping hands approaches can be introduced. The family, the private or voluntary welfare organisation and the government all can chip into this model. Family can and should usually act as the central coordinating and monitoring persons, supported by either private or volunteer welfare organisations (VWO)  in terms of service linkage.  Those with more resources can hire a private case coordinators if family in not keen to be involved. Those more needy ones can be supported by VWO such as cluster support programs. On the government side, policies to fund VWOs for such programs and manpower planning to allow trained carers especially from overseas to work here would be crucial.

Due to Singapore being a city state with limited land mass, services are already being clustered together unlike bigger countries. Instead of building and running so call retirement villages, we can integrate the services of these retirement villages into our current housing arrangements. Those older persons identified to require more such support can still be housed in their own home, renovated and monitoring installed, daily activities sorted and meals provided for either through hawker centers/food courts or meal delivery. A regional virtual elder service centre housed in nearby community centres, RC centers or day activity centers can provide trained manpower or service linkage.


In my opinion, Singapore may not require such retirement village as we can seamlessly integrate services in our system.

How We Operate

Our doctor is available from 9.00 am to 5.00 pm. Mondays to Fridays, excluding public holidays, strictly by appointment only.  Please call to arrange for an appointment.

Our charges range from about $250 to $300 per doctor visit per patient for a routine visit for patients under our long term home care service, including procedures and reviews. Medications and expendables will be charged separately if required. All visits are strictly appointment based only. We are not a medical clinic service and will not support services such as immunizations or review urgent hyper-acute conditions. We also only sign CCODs for patients under our long term care.

For referrals, kindly call us at 9800 4828 or E mail the request to us at info@lotuseldercare.com.sg and we will get back to you as soon as possible.

Technology companies please e mail us at technology@lotuseldercare.com.sg  or use this LINK to set up appointments with Dr Tan Jit Seng

Get in touch with us!

Our care coordinator will advise you on the possible options available to cater to your unique needs.

1 Raffles Place #19-61, Tower 2, Singapore 048616

Handphone: +65 9800 4828 WhatsAPP, Direct Call or SMS available. 

Office line : +65 6808 5664  Fax line: +65 6808 5801