April 25, 2026

In 2026, Singapore will cross a demographic threshold few countries have reached as quickly – becoming a super-aged society with at least 21 percent of its population aged 65 and above. The focus is no longer just on how long people live, but on how well they age and who will care for them and speak on their behalf when they no longer can. In ‘As more Singaporeans age with smaller families, end-of-life planning must evolve’ (Straits Times, April 2026), Associate Professor Bussarawan Teerawichitchainan (NUS Sociology and Anthropology) highlights how trends of rising childlessness and shrinking family sizes are reshaping end-of-life planning, and how individuals without immediate family members are increasingly taking responsibility for their future medical decisions.

Although Singapore has been proactive in promoting Advance Care Planning (ACP), its frameworks still largely assume that family members will act as decision-makers. However, more people are ageing without close kin, with about 15 percent of older Singaporeans being childless and even higher rates of childlessness prevalent among younger cohorts. Research finds that childless individuals, especially women, are often more proactive in planning, driven by past caregiving experiences and a desire not to burden others. In contrast, childless men show more lacklustre engagement, often shaped by economic constraints and life-course differences. Nevertheless, barriers persist as many struggle to identify a trusted proxy decision-maker, given cultural preferences for kin-based decisions. Misconceptions about ACP, such as it being costly, legalistic, or only relevant for the seriously ill, also discourage meaningful engagement and can lead to incomplete planning.

Assoc Prof Teerawichitchainan makes the case that ACP must evolve alongside these demographic changes. This includes normalising conversations earlier in life, improving public understanding, supporting non-family decision-makers, and tailoring outreach to under-engaged groups. At its core, ACP is not about life or death, but about ensuring one’s voice is heard and that individuals can age with dignity, especially in a society where traditional family support structures are no longer guaranteed.

Read the Straits Times opinion piece here.