Photo above: Volunteer Heidi Pigott-Irwin arrives at cancer patient Patrick Maher's side with the "happy cart" - a trolley with goodies like liquor and chocolates to brighten up the day for patients - at Sydney's Greenwich Hospital.
SYDNEY - Mr Patrick Maher, 81, is dying of lung cancer but, each day, he looks forward to the arrival of the "happy cart" with goodies from hard liquor to chocolates.
He is also cheered by the visits of chirpy volunteers like Mrs Heidi Pigott-Irwin at the 25-bed palliative-care wing of Greenwich Hospital in Sydney.
Dr Andrew Broadbent, director of palliative care there and a lecturer on the subject at the University of Sydney, tells the patients' families: "Everything you shouldn't eat, they can. So if they want a Mars bar or three, let them have it. Chocolates make them feel good and do them no harm."
This is one tip that Dr Amy Khor, Minister of State for Health, wants to share with providers of elder-care services here, as Singapore ramps up its capabilities in the coming years.
Another is making residential care for the elderly look more like someone's home rather than an impersonal centre.
And in some cases, the patients will be allowed to cook or walk on their own if they are willing and able.
These concepts were among the takeaways for Dr Khor when she visited a couple of elder-care facilities last month while in Sydney for a malaria conference.
She visited facilities earlier in the year, too, during a trip to New York to celebrate Singapore Day with Singaporeans there.
Some things impressed her during the trips and she is keen to introduce them here.
At a dementia facility in Sydney run by Christian charity HammondCare, for instance, the nurse station is disguised as a kitchen counter. This is an approach some new nursing homes here might adopt, she said.
She also liked the way the Australians empower patients. "If they want to cook, let them cook," she said. "We're always concerned about safety."
She added that instead of worrying about falls, carers should let patients walk in the garden if they want to. "Even in high-rise buildings, it's not impossible. We can have sky roofs, if not on every floor, then on alternate floors."
Dr Khor said that like Australia, Singapore is eyeing technology to cut manpower needs and make the job more attractive.
A constant worry is frail patients whoget up on their own at night to go to the toilet. To cope with this, the Lucy Chieng home in Sydney uses a A$600 (S$760) sensor mattress that sends an alert to a carer's mobile phone when the patient gets up.
To give the carer time to get to the patient, the bed is lowered to almost floor level at night so it takes a longer time for the user to get off.
There are also some simple ways to help the elderly better. Associate Professor Andrew Cole, chief medical officer at HammondCare, which provides a range of elder-care facilities, said many older people who wake up at night to use the toilet can have difficulty finding the toilet bowl.
Having the bed face the open toilet door helps. So does having a dark toilet seat - instead of the standard white seat on a white bowl, which may sit amid white floors and walls. This has reduced the need for residents to wear night pads, he said.
Dr Khor said land-scarce Singapore is unlikely to emulate some features, such as an attached toilet and bathroom for each patient's room.She also noted areas in which Singapore performs better, such as the many activities run by community centres and clubs to promote socialising among the elderly.
While she found integrated care to be interesting - whereby a facility provides a range of care for inpatients and those who just come for the day - she said it might not be that important in a compact city like Singapore.
But some of the new nursing homes hereare likely to offer both residential and non-residential services, she added. By 2030, one in five people will be 65 or older - or almost triple the 350,000 in that age group today.
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