End-of-life taboos hinder treatment

End-of-life taboos hinder treatment

SINGAPORE - With Chinese New Year round the corner, doctors are expecting a dry spell in house calls to treat terminally ill patients.

The reason? Many patients avoid treatment during the period due to taboos surrounding death and dying, said Dr R. Akhileswaran, chairman of the Singapore Hospice Council.

He said: "We need to ensure that patients are not denied the treatment they need because of fears."

Dispelling misconceptions and promoting acceptance of end-of-life care are among the recommendations in the first National Strategy for Palliative Care, a study commissioned by the Ministry of Health (MOH) in February last year.

The report was coordinated by the Lien Centre for Palliative Care at the Duke-NUS Graduate Medical School.

The key recommendations were revealed by Health Minister Gan Kim Yong at the opening of the revamped Dover Park Hospice in Novena yesterday.

MOH will appoint an Implementation Taskforce over the next few weeks to study the report. Mr Gan said: "It is important to recognise that more needs to be done, as the demand for palliative care is expected to increase in coming years."

He added: "To prepare for this, we need to expand our hospice-care services and workforce to make end-of-life care more accessible to Singaporeans."

Dr Akhileswaran explained that the palliative-care sector will have to expand to meet demand from the country's ageing population.

There are currently eight hospice bodies running standalone institutions, providing day-care and home-care services.

Another recommendation made is to encourage greater involvement of family physicians in end-of-life care of patients at home.

To support general practitioners (GPs) in this aspect, the report suggests having nursing teams to provide specialised palliative care when the "complexity of the case exceeds that of the family practitioner's capability".

Over at Dover Park Hospice, health-care professionals have been working with family doctors to manage discharged patients, said its medical director, Dr Angel Lee.

She explained that a GP can be the primary person caring for the patient, and that the GP can tap on the hospice for advice.

On why GPs would make a good touch point for such patients, Dr Lee said: "The patients are more familiar with their family doctor as they already have a bond."

If these new initiatives are adopted, they would help patients like Madam Khoo Cheng Geok, 90, who can then spend time at home with her family.

Her daughter, Ms Cindy Chia, 59, praised Dover staff for taking good care of her mum, but said: "I hope she can get better in time for Chinese New Year, so we can have her home."


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