To meet the challenges of the ageing population, the development of a humane, effective and financially sustainable system for the care of older people has been moved to the top of policy agenda in many countries. This book primarily focuses on the health-care challenges and end-of-life decisions associated with Singapore's ageing population. Drawing on an inter-disciplinary expertise of work in sociology, anthropology, medicine, law and other fields, the book aims to understand the implications of ageing on health, challenge approaches to end-of-life issues, and provide suggestions for elderly care policy formulation in Singapore. Readers are challenged to debate the ‘what’ and ‘how’ of services, in terms of end-of-life care in particular, that meet not only the needs but also the preference of the older people and their carers.

The book is based on papers produced for a meeting in Singapore on health-care challenges for its ageing population. Chapter 1 is a general introductory chapter highlighting the key topics in the subsequent ten chapters. Chapter 2 provides a broad overview of demographic trends in the Asia-Pacific region and sets the stage for the later chapters, which focus specifically on Singapore. The functional status and quality of life of elderly Singaporeans is described in Chapter 3 using data from the Singapore Longitudinal Ageing Studies. Chapter 4 focuses particularly on men's experiences of ageing in terms of how they manage later life and health. The burden of care-giving in different aspects is explored in Chapter 5, and Chapter 6 focuses specifically on elder abuse in Singapore. Chapter 7 analyses where deaths occur and what influences dying at home for Singaporean elders. Health-care decision-making, legal and end-of-life issues are addressed in Chapters 8 and 9. Chapter 10 evaluates the primary reasons for and against decriminalising physician-assisted suicide of terminally ill patients. The final chapter discusses major ethical issues in research on older people and terminally ill patients.

One of the strengths of the book is the diversity of inter-disciplinary contribution to approach health and end-of-life care. Some of the chapters draw on empirical research, both qualitative and quantitative, while others apply legal arguments. The chapters on end-of-life care and assisted dying are more developed than other topics in this book. Yet, the materials in these chapters would benefit from the additional contribution of moral philosophers or ethicists. Ethical dilemmas arising from health-care decision-making, end-of-life care and physician-assisted suicide are indeed equally relevant, if not more important. Ethical debate can extend legal argument from what is permissible and lawful to better reflect the dynamic nature of these topics. It is important, for example to be clear that it is not ‘being older’ per se that brings special concerns with decision-making and end-of-life care.

Whilst a variety of topics are included in the book, there is not an over-arching framework to organise all these topics into a coherent focus or perspective so as to allow readers to reflect on how health-care and end-of-life issues are deliberated in Singapore, or perhaps in other countries. There is also relatively little comparative analysis and interweaving of international and theoretical literature in each chapter. Analytic integration of this literature would certainly enhance the academic content for a more thought-provoking read and to enrich policy analysis in Singapore in the various topics chosen for consideration in this book. In gerontological literature, it is important to consider the use of language to correct the effects of negative label so that ‘the elderly’ is not regarded as a discriminated group of the population. Better attention could have been paid to the use of such language in this book.

However, considerations of the needs of an ageing society often come across as addressing those of Western societies. This collection should provide a resourceful databank and a useful guide for students and scholars working on Asian gerontology, and for policy makers and service practitioners in elderly care planning and delivery in this region.