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Easing the pain at the end

Published on Jul 2, 2014 5:52 AM

So strong is the leaning among health-care professionals towards treatment and prevention that palliative care is often seen as a poor cousin. In essence, the management of dying through symptom relief and tending to emotional needs, it is work suited to few personality types.

There is not much investment by private hospital groups and little training time allotted to end-of-life management in Singapore's medical schools. All of 46 doctors are trained in this medical sub-speciality out of the 11,000 doctors in practice. As for nurses, fewer than 700 out of 36,000 are trained in such care.

In another astonishing survey finding, three-quarters of doctors and half of nurses said they did not know enough about hospice palliative care. For a country with a health-care system that ranks among the best in the developed world, the gap in professional care for the terminally ill is a deficiency that cries out to be fixed, as the ageing rate is accelerating.

The scope for remedial intervention by the Health Ministry is huge and the challenges are no less daunting. The ministry estimates that 10,000 people will require such care by 2020. As for care facilities like hospices, nursing homes and public hospitals with dedicated departments, the numbers are just too small. Besides institutional care, home-care services for the terminally ill need to be ramped up as surveys have consistently shown a cultural predilection among Asian people to die at home. At present, 5,000 people receive home care each year.

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