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The development of advanced practice nursing has evolved globally over the past decades and has become an important component in the contemporary healthcare system. The term 'advanced practice nurse' is used to refer to nurses practising at a higher level than traditional nurses and is defined as a registered nurse who has acquired the expert knowledge base, complex decision‐making skills and clinical competencies for expanded practice. In 2003, Singapore embarked on the development of advanced practice nurses as an initiative to improve the nursing professional image, retain excellent clinical nurses and fill the gaps in the provision of healthcare services for the ageing population. This paper documents Singapore's journey of advanced practice nursing development and shares our unique learning experience in the aspects of education, certification, registration and scope of practice. [ABSTRACT FROM AUTHOR]

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Policy Points:In Singapore, long‐term services and supports (LTSS) are financed through a mix of public and private sources comprising tiered means‐tested public subsidies and government grants to care providers, charitable donations, voluntary long‐term care insurance, and other private resources.Singapore's high take‐up rate of voluntary long‐term care insurance is explained by plans offering partial coverage, medical underwriting, early automatic enrollment, direct debit of insurance premiums, and defined cash benefits.Singapore's experience in long‐term care financing is relevant to the US debate, as it provides policy ideas that may be transferable to the American context.We recommend maximizing the population's total contribution to voluntary long‐term care insurance by striking the right balance between coverage adequacy and take‐up rate while targeting subsidies to low‐income individuals. Context: Financing long‐term services and supports (LTSS) for the elderly is a pressing issue in the United States with reforms of long‐term care insurance (LTCI) presently being explored. Singapore, with 65% of residents aged 40 to 83 covered by basic LTCI, including 22% with supplementary LTCI plans, has the highest voluntary LTCI rate in the world. This article contributes to the discourse by presenting the case of LTSS financing in Singapore. Methods: We first reviewed Singapore's LTSS policies through a comprehensive search of academic papers, governmental reports, parliamentary debate transcripts, print media, and official websites of LTSS providers. We then estimated the LTSS financing mix, conducted an in‐depth analysis of the main policies, and illustrated the financial protection they procure for the elderly using realistic hypothetical scenarios. Findings: The main principles governing Singapore's LTSS policies are shared responsibility for long‐term care financing, targeted assistance for the poor, centralized governance and administration, separation from other income and housing policies, and limited intergenerational cross‐subsidizing. We estimate the financing mix to consist of out‐of‐pocket spending (40%), government spending (42%), long‐term care insurance (9%), and charitable donations (9%). Assuming a monthly LTSS bill of US$1,545 to US$2,575, between 11% and 19% of LTSS expense is offset by LTCI for severely disabled individuals with basic coverage. Overall, 63% of care recipients are eligible for public subsidies that amount to 20% to 80% of their expenses. Conclusions: The high take‐up of voluntary LTCI in Singapore is explained by the high prevalence of plans offering partial coverage, medical underwriting, early automatic enrollment, direct debit of insurance premiums, and defined cash benefits. We recommend setting the coverage of voluntary long‐term care insurance plans at levels that maximize the population's total contribution by striking the right balance between coverage adequacy and take‐up rate while targeting subsidies to low‐income individuals. [ABSTRACT FROM AUTHOR]

Singapore represents an instructive case study in responding to rapid ageing, growing inequalities, and significant relative poverty. Unlike other high-income Asian countries, it has relied on single-tier mandatory savings to finance retirement, housing, and to a lesser extent, healthcare. To address the low fertility rates, it has permitted the share of the non-citizen population to triple between 1990 and 2005 to nearly 30 per cent. This is subtly altering Singapore's socio-political dynamics, while assisting in sustaining growth and competitiveness. The paper argues that Singapore has the fiscal, institutional, and organizational capacities for a modern multi-tier social security system. Singapore is, however, determined to continue with current inadequate and inequitable arrangements, requiring individuals and their families to bear disproportionate risks in financing retirement, healthcare, and short-term income support. This reflects conscious policy choices arising from a Darwinist vision of society, and the need for socio-political control. [ABSTRACT FROM AUTHOR]

Growing demand for direct care workers to assist care-dependent elderly people has created an opening for migrant workers from low- income nations to sell their services to middle and high-income nations. Using Singapore as a case example, we draw on capability theory to make the case that receiving nations that import direct care workers should be held to global justice standards that protect workers' floor level human capabilities. Specifically, we (1) show that Singapore and other receiving nations fail to protect human capabilities at a threshold level required by dignity; (2) identify specific human capabilities placed at risk; and (3) recommend standards for receiving nations that support central capabilities. As populations in both developed and developing nations are rapidly aging, these concerns could not be timelier. [ABSTRACT FROM AUTHOR]

ABSTRACT Social theory generated in and about Singapore lies in psychic depths and archive fevers of an immigrant society subjected to accelerated social changes that devalue the lives of those marked by aging. Drawing on ethnographic fieldwork in Singapore, weaving together four kinds of data sets-gerontology psychiatric research and intervention; changing ritual forms; analytically phenomenological, paraethnographic theater and stories; and student video and drama projects-I argue that new literacies, pedagogies, and practices can foster enriched community life in posttraumatic, aging societies. Focusing on meaning and affect, and referencing Derrida on hauntology, archive fever, sur-vie, and grammatology (as syntax of social configurations within which aging occurs, or, sociocultural texts, narratives, and symbols), I build on the ethnographic literatures on aging and explore strong metaphors of monstrous history (taowu), ghosts (hantu), obliviousness brought by prosperity (fat years), and intercultural repetition compulsions of unfilial children (Lear). [ABSTRACT FROM AUTHOR]