Palliative Care: What You Need to Know About Proper End-of-Life Care

Death — it’s a taboo word that most of us try not to think about until the very end. While some of us may be open to having a conversation about it, most of us are likely to avoid the topic altogether if given a choice. But in this day and age when the world is facing a global pandemic, it’s hard to avoid even the mere mention of the word.

If we think about it a little more, death is actually an inevitable stage of our lives and though most of us would prefer to put off the frightful image of ourselves or our loved ones suffering from a life-threatening illness, it is not a bad thing to look at our end-of-life from another perspective — especially when it can help to relieve the suffering as the illness progresses. Palliative care, a term which you may have heard of before, is aimed at supporting and helping to improve the quality of life for patients and their family members through caring for the “whole-person” physically, emotionally, psychologically, and spiritually.

One such organisation spearheading and advocating about palliative care locally is the Singapore Hospice Council (SHC) — a charity organisation and umbrella body that currently represents 20 other organisations that actively provide hospice and palliative care in Singapore. One of their key roles is to promote and create greater awareness about palliative care services while debunking any myths that might be associated with end-of-life care.

WHAT EXACTLY IS PALLIATIVE CARE?

Palliative care, also known as Hospice Care, is a holistic approach led by a multidisciplinary team of doctors, nurses, social workers, therapists, counsellors, and trained volunteers who aim to offer support for terminally ill patients and their families as they manage the complex conditions that surface as their life-threatening illness (i.e. advanced cancer, and chronic illnesses including end-stage kidney, heart, lung and neurological failure) progresses. 

Discuss palliative care plans with your doctor. (Image credit: Singapore Hospice Council)

It should be noted that palliative care is not a service that is only provided at the very end. Discussing palliative care with your doctor now or even in the early diagnosis of a potentially serious illness is more effective as there is sufficient time to understand the values and beliefs while working towards the care goals that you would like to achieve in the later stages of your life.

Palliative care is offered through the following ways:

    • Pain & symptom control
    • Financial counselling
    • Emotional support
    • Grief and bereavement support
    • Counselling
    • Caregiver training
    • Facilitating conversations to help achieve patient care goals
    • Guidance for the family in making and planning for complex decision

WHERE & HOW TO RECEIVE PALLIATIVE CARE?

Palliative care can be provided at home, in nursing homes, hospices, specialist clinics, general and community hospitals — depending on the patient’s needs. The services provided at these locations include home care, day care, inpatient care as well as consultative services. It is always good to discuss and seek advice from the patient’s doctor on the type of palliative care service that would be best suited as they can make a referral to a palliative care service.

It’s not too early to start planning for your end-of-life. (Image credit: Singapore Hospice Council)

While there can be misconceptions that palliative care services are costly, the costs in Singapore have been kept affordable through various subsidies and financial schemes. Government subsidy is available through means-testing where the level of subsidy is determined by the household monthly income per person. Additionally, Medisave can also be used for palliative care services.

THE NEED TO TALK, PLAN, ACT EARLY

Death is a natural part of life. However, the lack of openness within society to talk about death can lead to compromised care and support at the end of life, which leads to things left unsaid, unfulfilled wishes and regrets. This is one of the primary aims behind the Singapore Hospice Council’s efforts in changing the way our society views death and dying by encouraging individuals to ‘Live Well. Leave Well.’.  

 

A 3-Step guide to planning early for your end of life. (Image credit: Singapore Hospice Council)

Through encouraging people to talk openly about what matters to them, and to make plans in advance, the council hopes to potentially help individuals avoid making decisions during a crisis when they are emotional, or pass the burden on to loved ones when they can no longer make decisions.

Most of us are not keen on the idea of having to make our own end-of-life decisions but it is a form of responsibility that we have to shoulder in order to have a sense of assurance in knowing that we still have some control over how we live out our remaining days.

Singapore Hospice Council’s Life Book Series

Understanding that it will still take some effort to normalise the idea of palliative care and end-of-life matters in Singapore, the Singapore Hospice Council started the Life Book series — an initiative that’s aimed at raising awareness and engaging the public with a rich repository of stories told from the different perspectives of patients, caregivers, doctors, nurses, social workers, therapists, and volunteers.

Screenshot of the free book available on SHC’s website.

The stories are inspired by real events and showcase palliative care services in different settings: Home Care, Day Care, Inpatient, and Consultative. Through these real-life accounts, the council hopes to encourage people to seriously consider the idea of acting and planning ahead, while they are still of sound mind.

Palliative Care Service Providers

 

An illustration of a caregiver and his patient, taken from Book One of the Life Book series. (Image credit: Singapore Hospice Council)

Home Palliative Care:

Day Palliative Care:

Inpatient Palliative Care:

The service providers above provide the following aspects of palliative care:

General palliative care: For patients with palliative care needs that require inpatient management. This would include relieving symptoms such as pain and breathlessness through oral and subcutaneous medication, as well as socio-emotional support for patients and caregivers during this difficult time in their lives.

Specialised palliative care: For patients with complex needs that require higher levels of care. This would include the administration of intravenous medication and specialised wound care for complex wounds.

Consultative Services:

CONSIDERING PALLIATIVE CARE

Don’t be afraid to create a conversation with your doctor to talk about end-of-life care. (Image credit: Singapore Hospice Council)

It isn’t always easy to rope someone in especially when you are looking to discuss your thoughts about death, and what you may be looking for in your end-of-life care. This is why the Singapore Hospice Council has set up a hotline that you can call at 6538 2231 if you’d like to find out more about palliative care. Alternatively, you could also reach them via email at secretariat@singaporehospice.org.sg.

In addition to creating conversation to act and plan in advance for palliative care, the council is also constantly on the lookout for volunteers and individuals who are looking to start a career in the palliative care sector. For more information on this, visit www.singaporehospice.org.sg or give them a call at their hotline.

 


Singapore Hospice Council is a registered society and an umbrella body representing organisations that actively provide hospice and palliative care in Singapore. For more information, visit www.singaporehospice.org.sg.

Banner image credit: Singapore Hospice Council