Executive Summary

Singapore’s Shared Stay-In Senior Caregiving Services represents a transformative approach to eldercare, addressing the needs of a rapidly aging population while respecting seniors’ preferences for community-based living. Launched as a mainstream model in December 2025 after a successful sandbox initiative, this program allows seniors to share residential spaces with peers while receiving professional caregiving support, creating a middle ground between independent living and institutional care.

Background and Context

The Aging Challenge

Singapore faces significant demographic shifts as its population ages rapidly. Traditional eldercare models, primarily nursing homes and individual domestic helper arrangements, have proven insufficient to meet the diverse needs and preferences of modern seniors. Many older adults prefer aging within a community setting rather than in institutional environments, yet require some level of daily living support.

The Sandbox Initiative (2023-2025)

In September 2023, the Ministry of Health launched a sandbox initiative to test innovative care models. This pilot program allowed controlled experimentation with shared living arrangements where caregiving staff provided basic support for daily tasks, meals, housekeeping, and social activities to groups of seniors living together.

The results exceeded expectations. By September 2025, five companies—Red Crowns Senior Living, St Bernadette Lifestyle Village with franchisees BlueAtria and Muein, and GROW—were serving 232 clients collectively. The success of this pilot convinced authorities to mainstream the model.

The Current Situation: Challenges and Pain Points

Pre-Sandbox Operational Barriers

Before the sandbox initiative, assisted living operators faced severe constraints:

Manpower Shortages: Companies struggled to hire sufficient caregiving staff due to restrictive foreign worker quotas and limited source countries for recruitment.

Scalability Issues: St Bernadette Lifestyle Village, which pioneered assisted living in Singapore in 2015, could not expand operations for nearly eight years due to manpower and regulatory challenges.

Regulatory Ambiguity: Red Crowns Senior Living was fined in 2024 for illegally hiring and deploying live-in migrant domestic workers, highlighting the unclear regulatory framework that existed before formalization.

Training Gaps: Lack of standardized training programs meant inconsistent care quality across providers.

Broader Systemic Challenges

Fragmented Care Transitions: Seniors moving between care settings faced repetitive questioning, data collection, and testing, compromising care continuity.

Limited Housing Options: The binary choice between independent living and nursing homes left many seniors without suitable middle-ground options.

Family Burden: Individual domestic helper arrangements placed significant coordination and management burdens on family members.

Cost Inefficiency: Each senior hiring their own domestic caregiver proved economically inefficient compared to shared care models.

Solutions Implemented

Regulatory and Policy Framework

The Ministry of Health’s mainstreaming announcement includes comprehensive support mechanisms:

Enhanced Foreign Worker Quotas: Companies can now access additional foreign worker allocations specifically for caregiving staff, addressing the critical manpower shortage.

Expanded Source Countries: Operators have more options to hire from non-traditional source countries, diversifying the caregiver talent pool.

Training Subsidies: Up to 90% of training fees are subsidized for caregiving staff, ensuring quality standards while reducing operator costs.

Good Practice Guide: An industry-led guide developed by MOH and the Agency for Integrated Care provides clear operational standards and expectations for companies, clients, and families.

Operational Model Design

The shared stay-in model incorporates several key features:

Optimal Staff-to-Senior Ratio: The sandbox established a ratio of one care staff for every three seniors, ensuring adequate attention while maintaining efficiency. St Bernadette, for example, received a quota of 34 staff members, enabling expansion to nine facilities within 18 months.

Professional Caregiving Approach: Unlike live-in domestic workers, care staff are trained employees who may live off-site, creating professional boundaries and better work-life balance.

Standardized Training Programs: New care staff attend the ITE Skills Certificate in Healthcare (Home Care) course, which can be conducted in-house, ensuring consistent competency levels.

Hub-and-Spoke Support Model: St Bernadette demonstrates an effective structure where care staff function independently as care leads at individual facilities but can seek assistance from a central hub (Good Shepherd Loft nursing home) for complex situations.

Licensed Service Integration: When clients require specialized licensed care services, operators must engage these services at family request, ensuring appropriate care escalation.

Technology and Information Systems

Health Information Bill (January 2026): This upcoming legislation will govern patient data sharing across both clinical and community settings, eliminating redundant data collection during care transitions.

Integrated Community Care Providers: Service providers within sub-regions will coordinate as unified entities, streamlining care delivery.

New IT Systems: Platforms are being developed to support seamless information flow between providers, enabling better coordination for vulnerable seniors requiring befriending and engagement services.

Expanded Service Options

Enhanced Home Personal Care: For seniors preferring to age in their own homes, MOH is improving this service to provide more frequent support, rolling out islandwide in early 2026.

Diverse Housing Options: The model allows seniors to share HDB flats or private dwellings, providing flexibility based on preferences and financial situations.

Community Care Apartments: These complement shared stay-in services, offering HDB flats specifically designed for assisted living.

Long-Term Solutions and Strategic Vision

Building an Integrated Care Ecosystem

The long-term vision extends beyond individual service models to create a comprehensive, interconnected eldercare system:

Seamless Care Pathways: As Minister Ong Ye Kung emphasized, seniors must be able to transition smoothly between care settings without compromising care quality. The Health Information Bill and new IT systems form the foundation for this integration.

Data-Driven Coordination: By sharing basic administrative data about vulnerable seniors among public agencies, AIC, and healthcare clusters, Singapore aims to create proactive rather than reactive support systems.

Sub-Regional Care Networks: The Integrated Community Care Provider model will create localized ecosystems where multiple service types coordinate within geographical areas, improving efficiency and responsiveness.

Workforce Development Strategy

Multi-Tiered Training Framework: Beyond initial certification, the system must develop career progression pathways for care staff, including specialized certifications for dementia care, rehabilitation support, and care coordination.

Knowledge Transfer Mechanisms: The hub-and-spoke model pioneered by St Bernadette should be formalized across all operators, creating institutional knowledge that survives staff turnover.

Continuous Professional Development: Subsidized training should extend beyond initial qualification to include ongoing education, ensuring care quality improves over time.

Scaling and Diversification

Franchise Model Expansion: St Bernadette’s successful franchising to BlueAtria and Muein demonstrates how proven models can scale rapidly while maintaining quality standards.

Niche Specialization: As the market matures, providers should develop specialized offerings for different senior populations—active retirees, individuals with specific health conditions, cultural or religious communities, and those requiring memory care.

Technology Integration: Long-term success requires incorporating telemedicine, remote monitoring, and AI-assisted care coordination to extend staff capacity and improve outcomes.

Financial Sustainability

Subsidy Framework Evolution: While current subsidies focus on training, long-term sustainability may require client-side subsidies based on means-testing, similar to nursing home subsidies.

Insurance Integration: Encouraging private insurance products that cover shared stay-in care could reduce financial barriers for middle-income families.

Social Enterprise Models: Supporting non-profit operators ensures mission-driven care alongside commercial providers, maintaining diversity in the ecosystem.

Social Impact Assessment

Individual and Family Level

Enhanced Quality of Life for Seniors: The model addresses a critical gap for seniors who desire community living but need support. Early outcomes show improved social engagement, reduced isolation, and maintained independence longer than institutional settings typically allow.

Reduced Family Caregiver Burden: Families no longer need to manage individual domestic helpers, coordinate all care decisions alone, or choose between inadequate home support and premature institutionalization. The collaborative model between families, operators, and care staff distributes responsibilities more sustainably.

Dignified Aging Experience: Seniors maintain greater autonomy and choice compared to nursing homes while receiving professional support that family members cannot always provide. The community setting preserves social connections and normalcy.

Intergenerational Benefits: By preventing premature institutionalization, families maintain stronger connections with senior members, benefiting grandchildren and preserving family cohesion.

Community and Societal Impact

Reimagining Eldercare Norms: Singapore is shifting public perception away from the binary of “independent or institutionalized” toward a spectrum of community-based options. This cultural shift reduces stigma around needing care support.

Efficient Resource Utilization: The shared care model makes better use of housing stock (HDB flats and private residences) and caregiver capacity compared to one-to-one arrangements, addressing Singapore’s space and manpower constraints.

Employment Creation: The sector creates meaningful employment opportunities for both local and foreign workers, with clear career pathways and professional development—transforming caregiving from informal domestic work to skilled employment.

Social Cohesion: Shared living arrangements foster peer support networks among seniors, reducing social isolation that contributes to depression and cognitive decline. The 232 clients served by September 2025 represent not just care recipients but emerging communities.

Aging-in-Community Infrastructure: By enabling seniors to remain in familiar neighborhoods rather than relocating to distant institutions, the model maintains community fabric and allows continued participation in local activities.

Healthcare System Benefits

Preventive Care Orientation: Professional monitoring in shared settings can detect health issues earlier than isolated home living, potentially preventing acute episodes and hospitalizations.

Reduced Hospital Burden: By providing appropriate community-based support, the model may reduce unnecessary emergency department visits and hospital admissions by seniors who lack adequate home support.

Efficient Resource Allocation: Nursing home beds, which are more expensive and resource-intensive, can be reserved for seniors with complex medical needs rather than those primarily requiring daily living support.

Care Continuum Completion: The model fills a critical gap in Singapore’s care continuum, creating smooth pathways from independent living through various support levels to advanced medical care.

Economic Impact

Cost-Effectiveness: Minister Ong Ye Kung noted that shared care “makes more sense” than individual domestic helper arrangements, suggesting significant cost efficiencies at both family and system levels.

Market Development: The formalization creates a legitimate, regulated market for assisted living services, attracting investment and innovation to the sector.

Reduced Public Healthcare Spending: By maintaining seniors’ health and independence longer, the model may defer expensive institutional care and reduce overall healthcare system costs.

Property Market Dynamics: Potential new uses for HDB flats and private properties as shared care residences could impact housing markets and provide property owners with alternative income streams.

Long-Term Societal Transformation

Demographic Resilience: As Singapore becomes a super-aged society, diverse eldercare options will be essential for maintaining economic productivity and social stability. This model contributes to that resilience.

Innovation Ecosystem: The sandbox-to-mainstream approach demonstrates Singapore’s willingness to experiment with social policy, potentially encouraging innovation in other policy areas.

Regional Leadership: Singapore’s model may influence eldercare policy across Asia, where many nations face similar demographic transitions.

Intergenerational Equity: By creating sustainable eldercare systems now, Singapore reduces the burden on future generations while improving current seniors’ lives—addressing long-term intergenerational fairness.

Outlook and Future Considerations

Near-Term Outlook (2026-2027)

Rapid Expansion Phase: With regulatory barriers removed and support mechanisms in place, expect significant growth in both provider numbers and client capacity. St Luke’s ElderCare plans to expand from 189 beds to over 650 beds by end-2026, indicating sector-wide growth momentum.

Market Consolidation: Some smaller operators may struggle with operational complexity, leading to mergers or acquisitions by successful providers. The franchise model may accelerate.

Enhanced Home Personal Care Rollout: The islandwide launch in early 2026 will provide comparative data on shared stay-in versus enhanced home-based care, informing future policy refinements.

Health Information Bill Implementation: The January 2026 legislation will begin transforming data sharing practices, though full implementation may take several years.

Medium-Term Evolution (2028-2030)

Quality Differentiation: As the market matures, quality variation will likely emerge between providers. Government may introduce quality ratings or accreditation systems to help families make informed choices.

Technology Integration: Expect increasing adoption of smart home technologies, wearable health monitors, and telemedicine platforms within shared residences, enhancing care quality and staff efficiency.

Specialized Offerings: Providers will likely develop niche services for specific populations—dementia-friendly residences, culturally-specific communities (e.g., Malay-Muslim, Chinese-speaking), activity-focused communities (arts, technology), and LGBTQ+-friendly spaces.

Workforce Professionalization: As the sector grows, expect development of specialized qualifications, professional associations, and career pathways that elevate caregiving from entry-level work to skilled profession.

Cross-Border Potential: Singapore’s model may attract regional seniors seeking high-quality care, creating medical tourism opportunities and potentially offsetting costs for local residents.

Long-Term Transformation (2031+)

Paradigm Shift in Aging: If successful, shared stay-in care could become the preferred option for a significant portion of Singapore’s elderly population, fundamentally changing how society conceptualizes aging and eldercare.

Multigenerational Integration: Future models might integrate seniors with other populations—co-living with students, young families, or persons with disabilities—creating truly inclusive communities.

Preventive Health Focus: As data accumulates, providers may shift toward preventive interventions and healthy aging programs that maintain independence even longer.

Policy Replication: Other aging societies will study Singapore’s approach, potentially adopting similar models with local adaptations.

Challenges to Monitor

Quality Assurance at Scale: Rapid expansion risks quality dilution. Maintaining standards as operators grow from single facilities to multiple locations requires robust oversight.

Caregiver Retention: Even with improved working conditions, caregiving faces retention challenges globally. Singapore must ensure compensation, working conditions, and career prospects remain competitive.

Affordability: Without adequate subsidies, shared care may remain accessible only to middle and upper-income families, failing to address needs across the socioeconomic spectrum.

Regulatory Balance: Overly restrictive regulations could stifle innovation, while insufficient oversight risks client safety. Finding the right balance requires continuous policy refinement.

Family Expectations: Managing family expectations about care scope, decision-making authority, and communication will be crucial for operator success.

Cultural Adaptation: Some families may resist shared living arrangements due to privacy concerns or cultural preferences for family-based care, limiting adoption.

Recommendations for Stakeholders

For Policymakers

• Implement tiered subsidies based on means-testing to ensure affordability across income levels
• Develop robust quality monitoring frameworks before problems emerge
• Create clear escalation pathways when operators fail to meet standards
• Invest in workforce development beyond initial training
• Monitor outcomes rigorously to enable evidence-based refinements

For Operators

• Prioritize staff training and retention over rapid expansion
• Develop strong family communication protocols to manage expectations
• Invest in technology that enhances rather than replaces human care
• Build community among residents to maximize social benefits
• Maintain transparent pricing and service scope documentation

For Families

• Visit multiple facilities and understand different operational models before committing
• Maintain active involvement in care decisions despite professional support
• Set realistic expectations about the balance between independence and safety
• Plan for potential transitions to higher care levels as needs evolve
• Advocate for quality improvements when needed

For Healthcare Professionals

• Develop protocols for integrating licensed services within shared care settings
• Train providers on recognizing when escalation to medical care is needed
• Participate in the developing IT systems to ensure clinical utility
• Share best practices across the integrated care ecosystem

Conclusion

Singapore’s Shared Stay-In Senior Caregiving Services represents more than a new service option—it embodies a fundamental reimagining of how societies can support aging populations with dignity, efficiency, and compassion. By learning from the sandbox initiative’s successes and challenges, Singapore has created a scalable model that balances seniors’ desires for independence and community with families’ need for support and society’s resource constraints.

The model’s success will depend on continued policy support, operational excellence from providers, appropriate quality oversight, and cultural acceptance by families and seniors. Early indicators are promising, with 232 clients served and multiple successful operators demonstrating viability.

As Singapore moves toward becoming a super-aged society, this innovation in eldercare infrastructure will prove critical. The social impact extends beyond individual quality of life to encompass workforce development, healthcare system efficiency, community cohesion, and intergenerational equity.

The true measure of success will emerge over the coming decade as the model scales, challenges are navigated, and outcomes are rigorously evaluated. If successful, Singapore will have demonstrated that aging societies can innovate beyond traditional institutional models to create care systems that honor seniors’ humanity while meeting practical needs—a lesson with global implications as the world’s population ages.