A multidisciplinary approach to end-of-life care

With official estimates of more than 10,000 Singaporeans expected to require end-of-life care by 2020, end-of-life issues have become even more pertinent in our society today (3 questions to ask on end-of-life care choices; March 6).

More needs to be said concerning the needs of patients at the end of life, and the different services provided by nursing homes and hospices.

A hospice provides more than nursing care. A hospice provides palliative care that requires a multidisciplinary approach to look after the medical, psychosocial, emotional and spiritual well-being of patients and their family members.

Care should be holistic and should aim to improve the quality of life of patients with life-threatening illnesses.

The article had accurately pointed out that "coping with impending death can be emotionally draining and dramatic for the patient and his family members".

Palliative care looks beyond pain control and is also concerned about the well-being of patients as well as their family members from the time of diagnosis to death, and even post-death matters in grief and bereavement.

Journeying with the family, keeping watch, is a mark of palliative care. Such work often involves a team of doctors, nurses, social workers, therapists, caregivers and volunteers.

It is correct that "a hospital can provide palliative care for serious conditions such as advanced cancer, for example, to help patients manage pain".

But it is also possible for such serious conditions to be managed by a home palliative care team working with the family, or in-patient palliative care in a hospice or community hospital.

This allows patients to choose their own home as the final resting place, which in contrast, will be challenging to manage in a nursing home without the support from a palliative care team.

We hope to offer a few tips to help the public better understand palliative care:

First, consult your doctor and get recommendations for the most appropriate and suitable palliative care services for the patient and the family. There are home care, day care and in-patient care services.

Second, discuss with your loved ones and plan ahead about your care. Having such conversations early can prevent loved ones from making conflicting decisions that differ from the patient's care wishes.

Advance Care Planning provides a set of tools to help patients and their loved ones talk about their end-of-life care preferences.

Members of the public can visit Singapore Hospice Council's website to read about the power of conversation and the misconceptions of palliative care: http://www.singaporehospice.org.sg

For Advance Care Planning, they can visit the Living Matters website: https://www.livingmatters.sg/

Yeo Tan Tan (Ms)

Chief Executive

Singapore Hospice Council

A version of this article appeared in the print edition of The Straits Times on March 12, 2018, with the headline 'A multidisciplinary approach to end-of-life care'. Print Edition | Subscribe