Family. We started TriGen, a registered charity, to share the experience of a family with those who may not have one. We envisioned a healthy and inclusive society where every generation in Singapore can experience the protection, care and love of a family.
How it all started
When we (Angeline and Kennedy) were third-year medical students entering the wards for our clinical postings, we were struck by how patients' social backgrounds and interactions had such a significant influence on their health outcomes. Elderly adults living with good social and/or familial support usually had loved ones who acted as their advocates to marshal various resources to maximise their well-being. In contrast, many elderly and vulnerable patients lived alone and were illiterate, preventing their access to these resources.
In addition, we witnessed firsthand the struggles of first-time caregivers as they tried their best to acquire the requisite caregiving skills when family members fell ill. Many of them had limited health literacy, compounded by the fact that many young people have misconceptions of and limited experiences with elderly adults. We wondered if there could be an avenue for young people to learn caregiving and build up their health literacy early.
In light of the above, we envisioned care teams comprising youths and healthcare professionals providing holistic care to vulnerable elderly patients (who are frequently admitted to the hospitals) over the course of sixto 12-month periods. We named this programme TriGen HomeCare as each care team involves three generations: youth volunteers, adult healthcare professionals/students, and the elderly patients. Through this programme, youths are equipped with healthcare knowledge and skills (eg, vitals monitoring, normal process of ageing, the geriatric giants, chronic diseases, social determinants of health), and are encouraged to play an active role in elder care. They are also encouraged to share their ideas on how they can improve the well-being of the elderly through a youth innovation challenge.
Two sites, one purpose
We first discussed the idea with one of our tutors, Prof Gerald Koh, who was immediately supportive and connected us with the National University of Singapore (NUS) Dean's Office and Prof Lau Tang Ching. Separately, we connected with Dr Wong Sweet Fun from Khoo Teck Puat Hospital, General Manager Crystal Lim from North West Community Development Council, and former Mayor Dr Teo Ho Pin. Since 2014, generations of undergraduate students from NUS have continued to lead and contribute to the programme.
Fast forward to 2019, a few TriGen alumni regrouped after having survived our initial years of working life and wondered how we could develop a culture of volunteerism among our fellow healthcare professionals. We decided to incorporate a non-profit organisation to further our vision, and successfully registered as a charity in Singapore in 2020. In this regard, we were grateful to have also met Dr Low Lian Leng from Singapore General Hospital (SGH) Population Health and Integrated Care Office, and we thereafter started the TriGen@SGH HomeCare programme for SGH patients with his guidance and support.
The TriGen HomeCare programme is currently running at two sites (TriGen@ North West and TriGen@SGH), and has touched the lives of more than 200 elderly adults, nurtured more than 600 youths (secondary school and post-secondary school students) and built an alumni of more than 500 healthcare students and professionals. As part of the youth training programme, we have held multiple online modules as well as developed a series of healthcare-themed escape rooms for volunteers to learn in an engaging manner. Hugo, a secondary school student who used to have a fear of public speaking when he volunteered with us in 2015, has returned to speak on the importance of mentorship to NUS healthcare students as they embark on their volunteering journey with TriGen. Another student, Emily, was so inspired by the healthcare students who led her team that she decided to pursue a career in nursing.
The HomeCare programme is only possible because of the dedication of the volunteers, and it has been absolutely inspiring seeing many of them sacrifice their weekends to visit and care for the elderly. Recently, a team led by Dr Loh Kep Yong (an internal medicine resident at SingHealth) found a patient to be hypotensive due to excessive fluid restriction and her hypertensive medications, during one of their visits. The team advised her to increase her oral intake and adjusted her hypertensive medications, the former of which resulted in an improvement in her blood pressure. The timely home visit on Sunday prevented a trip to the emergency department.
Further initiatives: Wire Up and HealthStart
In 2020, the COVID-19 pandemic hit Singapore with unprecedented and devastating consequences. However, out of this adversity, a new initiative was born. The Wire Up programme was conceptualised amid the circuit breaker period, during which we were unable to visit many elderly patients. While some could be reached by phone, many were uncontactable because they had no handphones or landlines. These elderly adults were cut off from many essential services because of the Safe Management Measures (SMMs) - not to mention the fact that they were all but starved of social interaction. Digital technology mitigated many of the restrictions imposed by SMMs and allowed most to carry on with their daily lives with minimal disruptions, but not these elderly adults who were digitally and socially isolated.
Together with SGH, Senior Activity Centres, telecommunication companies and the Infocomm Media Development Authority, Wire Up set out to equip elderly adults with smartphones, and train them to use it to connect with loved ones and the community-based and healthcare organisations. To date, we have had 175 seniors participating in the programme, with 103 phones distributed and 151 volunteers involved in Wire Up. One of the elderly beneficiaries, Mdm T, used to call her family located in Malaysia during the pandemic on her mobile phone, racking up huge phone bills. Through Wire Up, she learned to connect her phone to her home wi-fi and use her phone to perform WhatsApp video calls, saving hundreds of dollars and enjoying better connectivity.
Over the past two years, many elderly adults have embarked on their digital journey, but have yet to harness the full potential of their devices. The HealthStart programme is an improved version of Wire Up and aims to build upon the foundations laid over the last two years to help the elderly improve their health through the adoption of digital applications like HealthHub and Healthy 365, and through a volunteer-led health and digital coaching programme.
Non-healthcare volunteers undergo training sessions covering basic concepts relating to chronic diseases (eg, hypertension, high cholesterol, diabetes mellitus and common cancers), screening modalities recommended for the public, an overview of the Singapore healthcare system, health-related digital applications, and motivational interviewing. In addition, participants engage in simulated encounters with elderly adults (not unlike the objective structured clinical examinations we go through in medical school and postgraduate education). These non-healthcare volunteers are grouped with healthcare volunteers who will provide guidance and professional input when required. Non-healthcare volunteers meet seniors after they collect their health screening results and provide health and digital coaching (eg, teaching older adults about chronic diseases or how they can make their first polyclinic appointment through the HealthHub application). Our vision for HealthStart is that healthcare professionals can train and empower the community to improve their own well-being and health.
How you can help!
TriGen currently has two teams, TriGen@ SGH and TriGen@North West. Both teams have the HomeCare programme while TriGen@SGH also runs the HealthStart programme.
We are always looking for committed and passionate individuals who share our vision and passion for the youth, fellow healthcare volunteers, and for the elderly adults we serve. You can volunteer in the various committees, such as research, operations, volunteer management (recruitment and training), publicity; or you could volunteer in our HomeCare or HealthStart programme. Find out more about our programmes at https://www.trigen.sg!
Finally, we would like to offer our sincere gratitude to the following groups of people: our adult volunteers who contribute their time to care for the seniors and to nurture the youth; our youth volunteers who give their time to care for the seniors; our partners who have been so welcoming and their dedication to the seniors they serve; and last but not least, to our seniors who have shared with us so many insights about life and who have taught us how we can age gracefully too.