Personalized support program for new dementia patients launched in Singapore

The Lien Foundation, a private philanthropic organization which focuses on early childhood development and eldercare issues in Singapore, has partnered with the Alzheimer’s Disease Association (ADA) to strengthen support and services for those who are newly diagnosed with dementia. The hand-holding, done through one or two initial home visits and regular phone calls by a dedicated case worker, will continue for at least a year.

The S$2.6M program, also known as Post Diagnostic Support (PDS), aims to proactively equip persons with dementia and their caregivers with information, care connections and a customized care plan to ease the confusion and sense of helplessness they face when first told of their impending journey in coping with the condition.

Currently, a total of 186 people are on the program, including 126 from the Tan Tock Seng Hospital (TTSH) Memory Clinic and 60 from the Khoo Teck Puat Hospital (KTPH) memory and dementia care service. Referrals are received via the two hospitals. All newly diagnosed patients who consent to the program are eligible, but referrals are made based on the discretion of the healthcare professionals.

The National Neuroscience Institute (NNI) is the latest healthcare institution to have confirmed participation. Around 600 persons are diagnosed with dementia and other cognitive disorders at NNI every year, which includes about 250 persons who have Young Onset Dementia (YOD), which refers to the onset of dementia between the ages of 35 to 65 years.

ADA is reaching out to other hospitals to extend the reach of its program. The program is expected to benefit around 1,400 clients and 1,300 caregivers over four years.


Singapore is one of the fastest aging countries in the world, with the numbers of seniors expected to soar to close to 25 per cent of the resident population by 2030, up from 14 percent today. With a significant increase in the pace of ageing here, the prevalence of dementia for those aged 60 or older is estimated at 10 percent – or potentially 86,000 people as of June 2019.

Despite a proliferation of new services and more healthcare workers, the dementia care system in Singapore remains stretched, with hospitals bearing a heavy load. A key aim of the PDS program is to ease the burden on hospitals, where the vast majority of cases are diagnosed, and enable persons with dementia to be looked after in the community.


The PDS program focuses on some key areas. Firstly, it proactively establishes contact with newly diagnosed persons with dementia and their caregivers and provide continuous support to them throughout the year. The program also draws up collaborative, customized care plans together with persons with dementia and their families to identify early the current and future needs and link them to community support programs, where necessary.

It also develops caregiver peer support network to provide social and emotional support. Ultimately, the main aim of the PDS program is to maximize quality of life and help the person thrive, despite dementia.


Dementia is difficult and expensive to manage, exacts a high caregiving toll, and currently has no cure. By providing dementia patients and caregivers early intervention resources and customized care plans based on their family and social situations, it allows them to cope better with up-to-date information and community support.

In October 2018, the Dementia Friends mobile app was launched, which allows users to easily access information about dementia, receive updates on upcoming events on caregiving, and most importantly, use it to search for loved ones who have lost their way home, Healthcare IT News reported.


“Early planning and community support for families living with dementia are essential to lessen the chance of care crises and institutionalization further down the road,” said Lee Poh Wah, Chief Executive, Lien Foundation. 

Senior Consultant Philip Yap, from KTPH’s Geriatric Medicine department, whose patients were the first to try out the program, said: “Extant research has found that caregivers have expressed the need to access information about dementia and the attendant services in a timely and tailored manner. They also appreciate support that is continuous and responsive to ad hoc needs.”

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