5 Things You Need To Know About Palliative CareJune 6, 2016
Palliative care may sound daunting, especially when you already have plenty on your mind after a loved one falls ill. Here is a guide on the most pertinent information about palliative care in Singapore.
Sometimes, life pulls the rug from under your feet, leaving you scrambling to regain some balance. When 42-year-old Anthony Lim’s mother suffered a heart attack that left her in a vegetative state at 68 years old, the family had to quickly make a decision about caregiving. He says, “When my mum was hospitalised, we were approached by the hospital’s palliative care team. Through the whole experience, we began to see that Singapore’s palliative care infrastructure or, for that matter, the overall elder care system, needed reform. First, the demand outstrips supply. We found out that many of the subsidised homes have an extremely long waiting list and the wait can stretch into years. Even for private homes, there are not many vacancies.”
He adds, “While there is a need to ensure that the system is not being abused, means testing must be applied in such a way that families with genuine need should receive the help required. Means or needs cannot simply be measured numerically, so other non-measurable factors should also be taken into account. However, it is heartening to note that many of the hospitals now have palliative care teams set up to help families who need such services.”
So, what exactly does palliative care entail?
According to Dr Shirlynn Ho, Head of Medical at Assisi Hospice, “Palliative care is an approach that aims to improve the quality of life of patients and their families facing the challenges associated with life-limiting illnesses. This approach aims to prevent and relieve physical and psychosocial suffering, as well as offers a support system to help patients live as comfortably as possible until death. For families, it offers a support system to help them cope during the patients’ illnesses and in their own bereavement.”
Dr Ho shares with us five other must-know facts about palliative care.
1. Palliative care is not just for patients who are dying.
“People often think palliative care is only for patients who are dying, and that choosing palliative or hospice care means giving up hope or appropriate treatment. In fact, palliative care is applicable early in any life-limiting illness, in conjunction with other investigations and treatments that are intended to prolong life, such as chemotherapy or radiation therapy. Palliative care not only enhances quality of life, but may also positively influence the course of illness.”
2. Financial support is available for those who need it.
“Upon admission, a medical social worker will meet with the patient and their family. The social worker will conduct a means test, required by the Ministry of Health, to determine the patient’s financial position and the subsidy that will be provided. These subsidies could be as high as 75 percent of the total cost.”
In addition, home palliative care service by some hospices is generously supported by donations. The patient or family only needs to pay when they buy medication (usually from restructured hospitals) or buy/loan medical equipment for the patient. Day care and inpatient palliative care services are charged to patients, but they can use their Medisave as well as apply for government subsidies to fund these. Some charity hospices will also support needy patients who have exhausted all avenues of help, so that all patients receive the care they need.
3. Palliative care is not just for the patient; it’s for the family too.
“A palliative care team not only manages the patient’s symptoms and distress but also provides for the family. Help can come in the form of information sharing, caregiver training, and emotional support. The challenging experience of advanced illnesses in the family often increases the level of distress in family members. But if well supported, the experience of caring for a family member as an expression of their love can give them meaning and strength to continue their journey.”
4. Patients don’t necessarily need to live in a hospital or nursing home in order to receive palliative care.
“Palliative care is an approach to care and is not site-specific. Patients can receive palliative care whether they are in the hospital, at home, or even in certain nursing homes. We will respect and try to fulfil patients’ wishes if they want to remain at a certain site for their care or passing.”
5. Palliative care doesn’t have to be depressing.
“Palliative care is comfort care. It is not about giving up; it is about living well despite the physical and psychological demands of advanced illnesses. Open, culturally sensitive discussions about death, dying, and palliative issues can facilitate a dialogue on the values and needs of the patient and their caregivers. This will help patients and caregivers cherish precious time in the final journey.”
For more information on palliative care services, you may visit the following links: