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ACP: As more Singaporeans age with smaller families - end-of-life planning must evolve
As more Singaporeans age with smaller families - end-of-life planning must evolve
The systems and norms continue to assume a central role for family members, even when the reality is often very different.
2026-04-21
https://str.sg/s9tf
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As Singapore advances its vision of ageing well, preparing for end-of-life care must reflect the realities of smaller families, shrinking kin networks and more diverse living arrangements, says the writer. PHOTO: ADOBE STOCK
As more Singaporeans age with smaller families, end-of-life planning must evolve
The systems and norms continue to assume a central role for family members, even when the reality is often very different.
When Emily (not her real name), a healthy woman in her mid-50s, chose end-of-life planning, she was not motivated by fear. It was foresight. She had watched a family member endure prolonged medical uncertainty without clear instructions. Without children of her own and never having married, she wanted to ensure that her values and wishes would be known.
Planning early, she felt, was a way of taking responsibility – both for herself and for those who might one day have to speak on her behalf.
Emily’s story is not unusual. As families shrink and childlessness rises, more Singaporeans will reach later life without spouses or children who can advocate for them during medical crises.
Advance Care Planning (ACP) allows healthy individuals to record their healthcare preferences. For instance, they may wish to receive life-sustaining treatment such as resuscitation. The individual can designate someone to speak for them if they lose mental capacity, typically through facilitated discussions with trained professionals and formal documentation, with some options also available through the recently launched online myACP platform.
However, while Singapore has been at the forefront in Asia in promoting ACP, the system and norms still largely assume that family members will play a central role. As family structures evolve, planning systems must adapt as well.
Ageing without close kin
Much of Singapore’s demographic conversation understandably centres on the country’s persistently low fertility rate and how policies might encourage marriage and childbearing.
Yet demographic change is also reshaping the other end of the life course. About 15 per cent of Singaporeans aged 60 and older are childless, and among women born in the early 1970s, roughly one in four remains childless – placing Singapore among countries with the highest levels of permanent childlessness.
Many have never married and may be ageing without close kin. As families become smaller, more Singaporeans will move into older age with fewer relatives to rely on for support or decision-making.
In a nationwide study of Singaporeans aged 50 and above, my colleagues and I found that childless Singaporeans are often more proactive in end-of-life planning than those with children. Childless individuals in our sample were more likely than parents to have initiated either formal documentation or informal discussions about their end-of-life preferences.
Childless women stood out in particular. They were the most likely to engage in planning – through conversations, formal documentation, or both. Many described motivations rooted in lived experience: having witnessed family crises, having cared for ageing parents, or wanting to avoid burdening siblings and relatives. Like Emily, they often saw such planning as part of a broader ethic of responsibility and self-reliance.
Planning patterns among childless men were more mixed. While some were proactive, others felt little urgency or cited financial strain. These differences partly reflect broader life course pathways to childlessness in Singapore, where women’s childlessness is more often linked to partnership patterns such as delayed and forgone marriage, while men’s childlessness is more closely associated with economic disadvantage.
No one to speak for them
Importantly, the study also highlights barriers that extend beyond individual motivation. A recurring challenge for childless individuals was the difficulty of identifying a trusted proxy decision-maker.
Some hesitated to appoint siblings who were close in age. Others were reluctant to rely fully on friends, reflecting the enduring cultural preference for kin-based decision-making.
Misunderstandings about ACP further complicated matters. Some childless individuals conflated ACP with costly legal procedures, or assumed it was relevant only for the wealthy or the seriously ill. Others associated it primarily with decisions about withdrawing life support, rather than understanding it as an ongoing conversation about values, preferences and care goals.
Such perceptions can discourage engagement or lead to partial planning, where documentation is completed without discussion, or vice versa.
These findings suggest that as family structures evolve, ACP frameworks must evolve as well. The goal is not simply to increase uptake, but to ensure that planning processes are inclusive and responsive to diverse family realities.
How frameworks can be improved
Start conversations about what you want your end-of-life care to look like while you’re healthy, not just when you’re in crisis. Weaving these discussions into regular doctor visits and community programmes could change how people see them.
People sometimes confuse ACP with complicated legal documents and worry it will cost a fortune. Clear public messaging should explain what it actually is – a straightforward, supported conversation. That alone could ease a lot of unnecessary anxiety.
Many people find choosing someone outside the family to make decisions on their behalf difficult, especially those without close family. Better guidance and stronger protections are needed to ensure these preferences are recognised and acted upon.
As more adults find themselves without traditional family support, helping them find trusted decision-makers will matter more than ever.
Men and people balancing caregiving responsibilities with other demands often don’t think about long-term planning in the same way others do. Reaching them through workplaces and community groups – tailored to their circumstances – could bring them into these conversations.
ACP is not about dwelling on death. It is about ensuring that one’s voice is heard at moments when one cannot speak for oneself.
As Singapore advances its vision of ageing well, preparing for end-of-life care must reflect the realities of smaller families, shrinking kin networks and more diverse living arrangements.
Making ACP work for everyone matters. It’s about respecting people and giving them real clarity about what comes next.
Bussarawan Teerawichitchainan is an associate professor of sociology at the Faculty of Arts and Social Sciences, National University of Singapore, and a 2025-2026 Fellow at the Center for Advanced Study in the Behavioral Sciences, Stanford University.
S'pore's 24-hour lifeline for your mental health - Call phone Number 1771 -- Whether you're a student - caregiver or someone feeling overwhelmed - national mindline 1771 provides a confidential space to talk round the clock
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(NHG Health) and 1771 national mindline
*Whether you're a student, caregiver or someone feeling overwhelmed, national mindline 1771 provides a confidential space to talk round the clock*
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2026-04-19
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One teenager called himself a "walking curse". An online screening tool suggested he might have depression, yet he kept the result to himself, afraid of burdening his parents.
Another, a young child, felt "sad and left out" when her parents, deep in conversation, did not notice her trying to speak to them.
These are among the worries that young people share with the counsellors at national mindline 1771, Singapore's 24-hour national mental health helpline and textline service.
Says Calvin Lin*, a full-time counsellor with the service: "Individuals who are feeling vulnerable often struggle to express what they are feeling. We ask open questions to help them articulate their thoughts and understand their emotions more clearly."
During these conversations, counsellors focus on providing a calm, non-judgmental space for help-seekers to speak openly.
They also address mental health queries, share coping strategies or connect help-seekers to appropriate community services or resources. Launched in June 2025 by the Ministry of Health and operated by trained counsellors from the Institute of Mental Health (IMH), national mindline 1771 is a crucial first stop for those seeking mental health support, especially if they prefer speaking to a counsellor over the phone or via text message.
Help-seekers can choose to remain anonymous. Roughly one in four individuals who have contacted national mindline 1771 and chose to reveal their age are younger than 20 years old.
Many of the help-seekers Calvin speaks with are teenagers navigating independence who fear being judged by their peers or hesitate to open up to adults. The issues they raise range from bullying and exam stress to friendship conflicts and parental expectations.
Dr Christopher Cheok, programme director of national mindline 1771 and senior consultant at IMH, says that younger children may hesitate to share their concerns, especially if they feel that their parents are busy with work or other commitments.
"Some parents may be emotionally unavailable due to personal struggles, such as marital difficulties, which can make children hesitant to add to what they perceive as existing family stress," he says.
Young people are not the only ones reaching out for help. Adults also turn to the service when the pressures of work, parenting or caring for ageing parents begin to feel overwhelming.
One woman reached out while caring for an elderly parent with cancer, as sleepless nights and the constant worry of caregiving had begun to take a toll. After listening and talking through her situation, the counsellor connected her with a community partner for longer-term counselling and support.
Such calls are not uncommon, says Dr Cheok, noting that caregivers often juggle multiple responsibilities like medical appointments and clinic visits alongside work and family duties.
"These may create stress, particularly when they conflict with work obligations or family time. Caring for loved ones with cognitive decline, such as dementia, brings emotional challenges including helplessness, grief and frustration."
Barriers to seeking help can include thinking that mental health challenges are something to be endured, not knowing where to find support, or assuming that no one can help, he adds. But seeking help is not a sign of weakness.
Another national mindline 1771 counsellor Idris Othman* says some callers reach out in the midst of panic attacks.
"You hear them hyperventilating, sobbing, expressing distress. I guide them through breathing exercises and by the end of the call, they are calmer, sometimes even laughing out of relief," he says.
At the end of the conversation, counsellors may also guide help-seekers towards appropriate mental health support services based on their needs.
Idris adds: "Some help-seekers tell me they didn't realise this kind of help exists, and that there are organisations they can reach out to. It's a privilege for me to be there for them as they navigate their challenges. I'm glad they have an avenue to share their worries and be heard."
**Counsellors are identified by the pen names they use during conversations.*
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*"Even if someone shares something shocking, we remind them: 'I'm not here to judge you'."*
---- Calvin Lin*, a full-time counsellor at national mindline 1771
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全国心理援助服务1771：匿名求助 随时找人倾诉 national mindline 1771
*全国心理援助服务1771：匿名求助 随时找人倾诉*
本文由心理卫生学院呈献
https://www.zaobao.com.sg/lifestyle/health/story20260420-8727997?utm_source=android-share&utm_medium=app
2026-04-20
全国心理援助服务1771（national mindline 1771）是一项全天候开放的心理支援服务，为任何需要情绪支持的人提供倾诉与求助的渠道。对许多来电者来说，尤其是面对孤独、人生转折或照护压力的年长者与照护者，这通电话往往是迈出求助的第一步。
不只是倾听 也为求助者指路
“哈喽，你吃了吗？”“我已经吃药了。”
这是其中一名经常来电者的通话内容，汇报着每天的琐事。电话另一端的全国心理援助服务1771接线辅导员陈丽丽（化名）发现，这类来电往往有一个共通点——谈的不是大问题，而是从吃饭、服药到日常作息等生活起居事项。
丽丽观察道：“许多年长来电者其实并没有说自己遇到什么问题。他们谈的往往是日常小事。对旁人来说可能很琐碎，但对来电者来说，这意味着有人在凝听与关心。”
全国心理援助服务1771由保健卫生部设立，心理卫生学院负责管理，全天候提供服务。这是我国首个全国心理健康援助热线和短信服务。
热线辅导员经常接到年长者来电，诉说他们在生活转折、健康或经济焦虑，以及孤独感中的情绪压力。
对一些来电者而言，这通电话不只是一次倾诉，也可能成为寻求帮助的起点。辅导员会先了解和评估来电者的需求，再引导他们寻求适当的支援与资源。
乐龄来电揭露3个常见困扰
自2025年6月启用以来，这项服务已处理超过3万9000通电话、短信和线上对话。团队中有超过20名能以华语沟通的辅导员。
丽丽说，自己从小与祖父母关系亲近，这让她在与年长者沟通时更容易建立信任感。许多来电者其实只是希望有人愿意听他们说说话。
她说，从这些来电中，可以看到年长拨电者面对的三类常见困扰：
一、孤独感
“他们不会直接说自己很孤单，但你能感觉得到。”丽丽分享道。这通常可以从来电频率和谈话内容中推断出来。
她表示：“其实，他们只是希望有人回应。”
面对这样的来电，辅导员往往会分享一些简单的自我照顾贴士，例如每天散步、维持均衡饮食等。
二、围绕经济状况与健康的焦虑
一些来电者担心找不到工作，也为医疗费用感到忧虑。
辅导员会向他们提供相关资源，例如转介至社区关怀计划（ComCare）以获取临时经济援助，或转介至医务社工、劳动力发展局等机构，帮助他们寻找工作或获得支持。
三、失去生活目标
“我现在好像也没有什么计划了。生活无聊，......或许看看电视吧。”一名退休来电者这样说道。
离开职场后，一些人因生活失去节奏而感到迷失。辅导员会建议他们立下一些可行的小目标，如建立日常作息规律，或是参与社区活动，以便重新找回生活规律与意义。比如，若是来电者愿意分享他们的邮区号码，辅导员可以帮忙查找他们住家附近的活跃乐龄中心在哪里，以便他们能就近参与活动，扩大社交圈，减少孤独感。。
“孤独是一个复杂的问题。年长者一旦社交少，容易感到生活没有目标、与社会脱节。”——全国心理援助服务1771项目主任兼心理卫生学院高级精神科顾问石清顺医生
热线与短信服务 成第一联系点
对一些来电者而言，这通电话除了提供倾诉的空间，也可能成为连接外部支援的重要一步。这项服务为不知从何求助的人提供匿名情绪支持，并引导他们联系相关服务。
全国心理援助服务1771项目主任兼心理卫生学院高级精神科顾问石清顺医生说：“这些来电反映的是情绪压力，或许还不到需要立刻进行危机干预的程度，却应该受到重视。”
他指出：“孤独是一个复杂的问题。年长者一旦社交少，容易感到生活没有目标、与社会脱节。随着年老力衰，他们更容易变得焦虑和缺乏安全感。”
石医生说，抑郁症是更严重的情况，可能表现为失眠、食欲下降、容易烦躁、出现轻生念头，或感到绝望。
他建议在日常生活中，家人可以通过与年长者保持联系来提供支持，例如多探访长辈、一起活动，或鼓励长者参与社区活动。
他强调：“有需要时，寻求帮助并不代表软弱。你无需独自面对。”
照护者感无助 如何应对？
“我父亲不愿配合，我连他的床单都换不了。”“我真的不知道还能做什么。”“我很累了。”
不少照顾年迈家人或患病父母的照护者，往往在长期承受身心压力后才拨打热线。
有来电者曾反映说：“兄弟姐妹只给钱，但所有事情都是我在做。”
丽丽说：“这些照护者往往只是需要一个安全的空间，把累积的负面情绪抒发出来。”她发现，这类对话中，来电者常常会叹气。
辅导员的角色不是告诉他们应该怎么做，而是先带着同理心倾听，帮助来电者了解自己的感受、梳理自己的想法。在适当情况下，也会提供一些实际支援选项，例如转介至家庭服务中心（Family Service Centre）或社区援助计划，以获得情绪或经济方面的支持。
引导家长与孩子沟通
全国心理援助服务1771服务所有年龄层，来电者年龄从6岁到89岁不等。
来电者包括：
- 年长者
- 照护者
- 青少年（学生、职场新人）
- 在职人士
其中在职人士面对沉重工作量、紧迫期限、长期加班、负面的职场环境或工作不稳定等压力。
丽丽举例说，儿童打来的电话，谈及的往往是与父母之间的关系，而不是学业或朋友间的问题。
她回忆起一次印象深刻的来电：一名母亲致电求助，因为孩子难以适应新的学校环境。通话过程中，母亲将电话调至免提，让孩子也能直接参与谈话。
辅导员在过程中引导双方有效沟通，让他们能开诚布公地表达想法，进而讨论如何应对，让这通电话成为一次有建设性的亲子对话契机。
丽丽说：“这份工作让我觉得很有意义。当来电者说‘谢谢你，我真的需要找个人说说话’时，我就会再次确认自己为什么坚持做这份工作。”
全国心理援助服务1771 提供怎么样的援助？
全国心理援助服务1771全天候开放，为有需要的人提供一个让人安心表达的倾诉空间。
有需要时，可拨打1771*，或从WhatsApp发短信到66691771，以匿名方式，寻求情绪上的支持与资讯。
*此服务免费提供，但可能须承担电讯商的一般通话费用。
【本文由心理卫生学院呈献】
Tuesday, April 21, 2026
Anthropic’s Mythos is a warning shot. Singapore’s banking system needs to be ready*
For subscribers
https://www.straitstimes.com/opinion/anthropics-mythos-is-a-warning-shot-singapores-banking-system-needs-to-be-ready
2026-04-21
By--- Lin William Cong is President’s Chair Professor of Finance, Computing and Data Science at Nanyang Technological University, Singapore, where he serves as the associate dean of Nanyang Business School and is also the founding director of the Global Institute for Finance, Technology, and Society.
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When the US Treasury Secretary and the chair of the Federal Reserve convene an unscheduled meeting with Wall Street’s most senior executives, markets pay attention.
And when the catalyst is not a liquidity crisis or a sovereign default, but the capabilities of an artificial intelligence model that its own maker considers too dangerous to release publicly, the rest of the world’s financial centres should pay attention too.
On April 15, the Cyber Security Agency of Singapore issued an advisory to local organisations, urging them to strengthen their cybersecurity measures and patch critical vulnerabilities.
The model in question is Claude Mythos Preview, announced by Anthropic in early April. The company says Mythos has discovered vulnerabilities in major browsers and operating systems, including weaknesses in foundational digital infrastructure. Rather than release the model broadly, Anthropic is reportedly offering it first to major technology and infrastructure firms so they can patch their systems before adversaries acquire similar capabilities.
Reasonable people can debate whether Anthropic is overstating what Mythos can do. The company plainly has incentives to dramatise its own products. But for policymakers, the key issue is not whether every claim about this model is fully proven, but that the possibility was taken seriously by government officials and major financial institutions.
This tells us something important: frontier AI is no longer just a story about productivity tools or consumer applications. It is becoming a question of critical infrastructure, cyber resilience and, potentially, financial stability.
A different class of threat
As a major financial hub and a regional base for global banks, Singapore needs to act early as it would not be insulated from a serious AI-driven cyber incident affecting international finance.
If more powerful AI tools make it easier to find software weaknesses, automate attacks or exploit common digital systems used by many organisations, the effects will not stop at banks or regulators. They could reach the public in ordinary but increasingly costly ways.
In Singapore, phishing scams involving fake DBS and POSB e-mails were reported in 2026, with at least 72 cases and losses of some $484,000. Already, scams led to $913 million in losses in Singapore in 2025. AI could make such attacks even more convincing, allowing criminals to mimic bank alerts, tailor scam messages and imitate the authorities with far greater realism.
In a more serious scenario, a cyberattack on shared digital infrastructure could delay digital payments or disrupt access to banking services. Trust in finance is built in everyday transactions such as when a person expects a salary to arrive on time, a card payment to go through, or a banking app to open safely.
To its credit, the Monetary Authority of Singapore (MAS) has been among the more forward-looking regulators on AI governance. It has introduced frameworks to guide the responsible use of AI in finance, including the FEAT principles on fairness, ethics, accountability and transparency, and the Veritas initiative, which helps financial institutions test and assess their AI systems.
Recent efforts like Project MindForge show that Singapore is also beginning to grapple with newer and more complex AI risks, so the nation is not starting from scratch. But the Mythos episode suggests that the next gap may lie elsewhere.
Much of the existing policy framework, in Singapore and globally, has focused on how financial institutions use AI internally: model risk, fairness, explainability, and accountability. Those remain important concerns. Yet different threat vectors are now emerging: increasingly capable AI systems or AI agents developed outside the traditional financial sector, but potentially deployable against it.
Banks and regulators already invest heavily in cybersecurity, but much of their defensive architecture has been built around known vulnerabilities, known signatures and adversaries operating within relatively familiar bounds.
An AI system that can autonomously discover previously unknown weaknesses in widely used software represents a more demanding class of threat, especially in a financial system built on shared cloud, software and communications infrastructure.
More On This Topic
White House and Anthropic CEO discuss working together amid rising fear about Mythos model
IMF chief warns global monetary system not ready for AI cyberthreats
The challenge becomes sharper as finance itself becomes more automated. Stablecoins, tokenised assets, digital payment rails and software-mediated financial intermediation are expanding the role of code, automation and machine-speed execution.
As autonomous AI agents increasingly participate in trading, treasury operations and on-chain finance, the speed of both innovation and disruption rises, while advances in quantum computing could over time threaten the cryptography that underpins digital finance.
In such an environment, a vulnerability may not remain an isolated technical flaw. It can become a system-level event. That is why the next stage of financial governance cannot rely only on more rules or better compliance. It also requires better ways to test what could happen before a real crisis occurs.
Beyond a siloed strategy
This is where what I call economic world models come in. These are simulation tools that go beyond testing a single bank’s defences. They model how markets, institutions and people actually behave – how a shock at one firm spreads to others, how customers react when a payment app goes down, how attackers and defenders change tactics as incentives shift.
Think of it as a flight simulator for the financial system: a safe environment to rehearse crises before they happen. This matters because financial shocks do not unfold like a machine part snapping without warning. They spread more like panic in a crowd, through watching, reacting and adjusting, and conventional cyber testing was not designed to capture that.
Such tools have already been developed in prototypes at Nanyang Technological University, and Singapore is well placed to develop them further.
A practical next step would be for MAS and its partners to use market-scale and agent-based simulations for risk monitoring and stress tests that go beyond today’s cyber exercises, which focus mainly on whether a single firm can recover from a defined attack.
The bigger question now is how disruption would ripple through payment rails, settlement systems such as MEPS+ and FAST, and the many regional banks and corporates that route transactions through Singapore.
That matters because Singapore is not just another domestic market. It is a regional treasury, payments and clearing hub.
MAS has described it as one of the world’s top offshore renminbi centres, and DBS joined ICBC Singapore as an RMB clearing bank in December 2025. A serious disruption here could therefore spread well beyond Singapore into the wider region’s trade and settlement flows.
AI-driven shocks will not stop at borders and Singapore is in an ideal position to convene an open, cross-border simulation platform, bringing together banks, regulators, researchers and technology providers across the region to share scenarios and stress-test them together.
In an AI era, watching for system-wide risks can no longer be siloed within each country.
Even then, Singapore should build its own AI capability in this space rather than rely entirely on foreign-built systems.
More On This Topic
With AI, cyberattacks come fast; it’s time firms patch faster
Cyberdefenders urged to use AI to counter AI threats
Local universities and research institutes already have strong foundations in AI and financial modelling. Multilingual AI models, scenario sandboxes and digital twins of the financial system should become part of the country’s core governance infrastructure, as essential as its physical infrastructure.
None of this requires accepting the most alarmist reading of what Mythos can do today. Healthy scepticism is entirely appropriate. But prudent governance does not wait for the worst case to be conclusively established. It responds when the direction of risk becomes clear.
AI capability is beginning to intersect with financial infrastructure in ways that may be faster, more adaptive and harder to contain than before.
For Singapore, the question is not only how banks should use AI responsibly, but how the country should prepare for a world in which more powerful AI may be used to test, probe or disrupt the systems that people rely on every day.
That may sound abstract until something goes wrong. Then it becomes concrete very quickly. It could be a salary that does not arrive on time, a transfer that cannot be made, a bank account that has been compromised, or a customer who no longer trusts what appears on their mobile screen.
In that sense, preparing for AI-related financial risk is not just a technical exercise or a regulatory concern. It is part of protecting the reliability on which modern economic life depends.
Lin William Cong is President’s Chair Professor of Finance, Computing and Data Science at Nanyang Technological University, Singapore, where he serves as the associate dean of Nanyang Business School and is also the founding director of the Global Institute for Finance, Technology, and Society.
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