Forum: Time to re-calibrate methods of care for terminally ill

I refer to Health Minister Ong Ye Kung's remarks at a recent Dover Park Hospice event (Palliative care key as population ages: Ong Ye Kung, Oct 16).

Having recently walked with my family through the period of my mother's demise at her home, I cannot agree with him more.

A 2014 study on attitudes towards death by the Lien Foundation showed that 70 per cent of our population wished to be cared for at home at the end of life, and that for 77 per cent, the home is the preferred place of death.

We have a national healthcare vision of one Singaporean, one family doctor, and we want to prioritise ageing in the community. For some, this includes dying at home.

For this to happen, various stakeholders need to be involved in the re-calibration.

Medical schools need to ensure that their students develop the clear understanding that there is one condition that medicine cannot heal - old age.

Doctors need to acknowledge that a good death is no less meaningful than the successful removal of a cancer. They need to know when to shift gears from aggressive definitive care to palliative care in a patient's journey.

Family doctors themselves need to reprise their traditional role of taking care of their patients in the community from cradle to grave.

They need to proactively share the care of their complex patients with allied partners and community services.

They also need to do this in partnership with, and in addition to, hospice services.

Family doctors must be comfortable providing palliative care to their patients who grow old and are dying. They must be ready to make house calls again.

Family medicine educators at undergraduate and postgraduate levels need to re-evaluate and expand their curriculum to produce family doctors who can enable those of us who wish to live and die in the community to do so.

Ng Lee Beng (Dr)

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