By Assoc Prof Dr Yau Weng Keong and Dr Liong Siok Fuang

A demographic revolution is sweeping across Malaysia, poised to redefine our society and challenge our healthcare system.

By 2030, more than 15 per cent of Malaysians will be aged 60 and above as we face a critical crossroad where the traditional hospital-centric model of care is no longer sufficient. However, this shift is not a crisis. Instead, it’s a powerful opportunity to reimagine how we care for our older Malaysians and build a society that honours aging with dignity, independence and purpose.

The geriatric gap: a wake-up call for healthcare

Geriatrics, the branch of medicine focused on older adults, is no longer a niche specialty. It’s a national priority.

Older adults face a unique blend of physical, cognitive, emotional and social challenges. These often manifest as complex “geriatric syndromes” such as frailty, falls, incontinence and cognitive decline, which require coordinated, interdisciplinary care.

Yet, Malaysia currently has only 67 geriatricians, far short of the estimated 700 needed to meet growing demand. This shortage is compounded by a healthcare workforce stretched thin, unattractive financial incentives in geriatrics, and longer training pathways compared to countries like Australia and Singapore. The consequences are severe: long waiting times, delayed diagnoses and overburdened hospitals.

But this gap also presents a chance to invest in a better future. By training more geriatricians and empowering primary care doctors with geriatric knowledge, we can build a healthcare system that truly supports aging well.

The unspoken challenge: end-of-life care and autonomy

One of the most delicate, sensitive and often-avoided topics, which is a vital aspect of elderly care, is end-of-life planning.

Nearly 70 per cent of deaths in Malaysia occur among those aged 60 and above, yet conversations about care preferences are often avoided. Without legal tools like advanced directives or durable power of attorney, families and doctors are left guessing what their loved ones would have wanted.

Advance Care Planning (ACP) empowers older adults to make informed decisions about their treatment and care. It ensures that their wishes are respected, even in their final days. Normalising these discussions is not just compassionate, it’s essential for a healthcare system that values dignity and autonomy.

Community innovation: lighting the way forward

Despite the challenges, Malaysia is already seeing progress. The National Policy for Older Persons (Dasar Warga Emas Negara) promotes holistic well-being, covering health, social engagement, environment, economy and spirituality. Programmes like Pusat Aktiviti Warga Emas (PAWE) help seniors stay socially connected and active.

Social enterprises are also stepping up. Teman MY Ventures PLT, for example, pairs older adults with trained companions called “Temanions” who assist with daily tasks and provide emotional support. This model not only improves quality of life but also creates meaningful jobs in the caregiving sector with growing demand.

Affordable care: a legacy worth preserving

Malaysia’s public healthcare system has long been praised for its affordability.

Outpatient clinic visits cost just RM1, ensuring access for all. But with two-thirds of outpatient visits occurring in public clinics, this policy is under pressure.

To sustain this legacy, we must find ways to balance affordability with quality. Strengthening community clinics, investing in geriatric training, and integrating public-private partnerships can help maintain access while improving care.

Legislation, technology and the road ahead

Big changes are on the horizon.

The upcoming Senior Citizens Bill promises to protect older adults from abuse, neglect and financial scams. It will also enshrine their rights to healthcare, safety and dignity, bringing Malaysia closer to international best practices.

But legislation alone isn’t enough. Care for older persons in Malaysia is still fragmented. A unified, cross-sector strategy is needed to ensure consistent, effective care.

Technology can play a key role in this aspect. Telemedicine, wearable health devices, and digital platforms can connect patients with doctors, monitor health remotely and educate caregivers. But tech must enhance and not replace the human connection. Community engagement and volunteer programmes remain vital to combat loneliness and promote holistic health.

A call to action: building a compassionate future together

The future of care of older Malaysians depends on all of us to create a united, multi-sectoral approach. Healthcare providers, policymakers, social enterprises, families and communities must come together to bridge the geriatric gap and create a system that values aging as a stage of life filled with potential, not decline.

We must invest in training, reform policies, embrace innovation and foster empathy and compassionate culture. As Malaysia’s older population grows, so must our commitment to honouring their dignity and lifelong contributions. Aging should not be seen as a burden, but as a stage of life worthy of respect, innovation, and empathy.

By shifting from a hospital-centric model to a community-integrated system, Malaysia can ensure its elders live with independence, dignity and comprehensive care.

-- BERNAMA

Assoc Prof Dr Yau Weng Keong is the Director of the Active Ageing Impact Lab at Taylor’s University. Dr Liong Siok Fuang is a Senior Lecturer & Family Medicine Specialist at the Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya.