With Singapore’s ageing population, the need for palliative care has been on the rise.

Think palliative care, and oftentimes, the stigma deters patients and their caregivers from seeking this form of help because they perceive it as giving up on life or losing hope.

Dr Ong Wah Ying (pictured below), Senior Consultant, Division of Supportive and Palliative Care, National Cancer Centre Singapore (NCCS), is keen to dispel this misconception.

“Palliative care is a core part of basic care. It is really to improve the patients’ quality of life and help them live life to the fullest. This includes enabling them to spend time with their loved ones meaningfully. I hope that these negative perceptions will change with a greater sense of awareness through education,” Dr Ong said.

Not only for final days

Patients with life-threatening conditions such as advanced cancer can turn to palliative care for support throughout their journey.

The holistic care is provided by a team of medical professionals comprising doctors, nurses, medical social workers and allied health professionals such as physiotherapists, occupational therapists, speech therapists, music and art therapists, and pharmacists.

Care for caregivers

“We do not just care for the patient; we also care for their caregivers or loved ones,” Dr Ong said.

Family members tend to be the main caregivers who provide both physical and emotional care for the patient. This can be a very challenging task.

“We make sure that their needs are also being attended to. Usually, the medical social workers will reach out, but various members of the team can also support them as and when needed,” she said.

Availability of care

Palliative care can be given in a variety of settings, such as at home, day care centres, nursing homes, hospices, specialist clinics, and acute and community hospitals.

Some patients may be admitted to inpatient hospices if they lack a full-time caregiver or have symptoms such as pain or breathlessness that require close monitoring.

“In such instances, it is not safe for them to stay at home. Being at a hospice ensures that holistic care is provided by the palliative care team who can offer the necessary support needed,” said Dr Ong.

With the right environment and support, the burden of illness on the patients and their families can be lightened, allowing the journey in the face of disease and imminent death to be one of grace and dignity.

Indeed, some patients have left an indelible impression on Dr Ong, who has been involved in palliative care for more than a decade.

She remembers a patient who came from a musically inclined family. Her family members set up a gathering and played music in celebration of her life until she took her last breath. “It was their way of saying goodbye to her, in the way she wanted,” Dr Ong said.

New centre

In Singapore, the population continues to age rapidly, with 15.2 per cent aged 65 years and above in 2020, compared to 14.4 per cent in 2019. By 2030, one in four Singaporeans will be aged 65 and above.

In a study conducted by Duke-NUS Medical School, it was found that the proportion of older adults (aged 60 and above) in Singapore with three or more chronic diseases rose from 19.8 per cent in 2009 to 37 per cent in 2017. As a result, the need for palliative care has been on the rise over the years, Dr Ong said.

“The demand is also increasing due to better understanding that palliative care can be sought earlier rather than later,” she said. Singapore has come a long way in the field of palliative care, with courses for healthcare workers and new services offered today. Nevertheless, more needs to be done to raise awareness of the importance of palliative care in managing a patient’s healthcare journey.

The SingHealth Duke-NUS Supportive and Palliative Care Centre, launched in March 2021, aims to meet these rising needs of Singapore’s ageing population, with a focus on clinical service, education, research, and community partnership. It also integrates existing specialist palliative care services within SingHealth, and fosters strategic collaboration with community partners, such as Assisi Hospice, HCA Hospice Care and St. Andrew’s Community Hospital, to achieve coordinated care.

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