More being done to help terminally ill, caregivers

Efforts include siting childcare centre within nursing home and hospice, study on grief

A caregiver pushing an elderly on a wheelchair. PHOTO: ST FILE

Singapore is taking big strides to improve end-of-life care, especially in getting the community involved in supporting the dying.

On the cards are co-locating a childcare facility within a nursing home and hospice, conducting a study on grief and bereavement to find out how to support caregivers better, and getting neighbours in estates to befriend and give emotional support to grieving relatives of those who have died.

The moves come three years after the national guidelines for palliative care were introduced in 2014, and updated a year later.

Last Wednesday, the Singapore Hospice Council flew in an expert on palliative care from Britain - Professor Allan Kellehear - to share with key stakeholders here how Singapore can work towards becoming a "compassionate city".

There are hundreds of compassionate communities in the world, defined as places that enlist major sectors of the community to support the dying by reducing the impact of serious illnesses, caregiving and bereavement.

A spokesman for the Ministry of Health (MOH) said: "We are taking some steps in this direction... (We support) a whole-of-society approach to end-of-life care. We want to jointly partner the people and private-sector organisations to promote awareness of end-of-life issues and build a compassionate society together."

In the 2015 Quality of Death Index released by the Economist Intelligence Unit, Singapore was ranked the 12th best place in the world to die. It did well in affordability and quality of care, but fared the weakest in community engagement.

Latest data also showed that many Singaporeans do not die at home, though surveys indicated that most wish to. Only about one in four who died in the first three months of this year did so at home. Most of them - 63 per cent - died in hospitals.

Two of Singapore's regional health systems - the Eastern Health Alliance and National Healthcare Group - will be running pilot programmes to provide palliative home care for non-cancer patients, targeted to reach out to about 3,000 patients over the next five years, said Health Minister Gan Kim Yong at the Asia Pacific Hospice Conference last Thursday.

Prof Kellehear said terminally ill people and their caregivers often face issues of loneliness, isolation and mental health conditions because they are hidden and disenfranchised from the wider society.

To embrace and support this group of people within the community, the palliative-care sector has come up with some initiatives.

Next month, St Joseph's Home in Jurong West Street 24, which serves both hospice and nursing- home residents, will open a childcare centre on its grounds to encourage inter-generational interaction and bonding, and meet the needs of back-to-work parents.

"Back-to-work adults can leave their infants or children at the centre while visiting their elderly parents, and the inter-generational programmes are aimed at instilling in our children compassion and respect for our elders," said St Joseph's administrator Geraldine Tan.

It is believed to be the first such facility to have a childcare centre on-site. The children can mingle with the elderly at a playground on its grounds or visit their seniors upstairs and have tea with them.

Other efforts to bring the community closer to the terminally ill and their caregivers include getting residents and volunteers in the neighbourhood to reach out to those in their midst.

Said the MOH spokesman: "We have started discussions with HCA Hospice Care on working together to support the caregivers of those who pass on, with befriending and emotional support."

HCA Hospice Care is the largest provider of home palliative-care services in Singapore.

Separately, in the next few months, the Singapore Hospice Council is commissioning a study to find out how people deal with loss in their lives, including bereavement, and whether current services are adequate in meeting their needs.

Dr Angel Lee, who chairs the Singapore Hospice Council, said: "We have set up a grief and bereavement work group, comprising health- and social-sector people, to look into this area.

"All of us experience many losses in life, be it relationships or our identity or roles in life, and we don't deal with those losses very well."

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A version of this article appeared in the print edition of The Straits Times on July 31, 2017, with the headline More being done to help terminally ill, caregivers. Subscribe