Round-the-clock care and it's free

Round-the-clock care and it's free

SINGAPORE - Retiree Martin Tay suffers from Stage 4 lung cancer.

After undergoing several rounds of chemotherapy and radiation, he decided on palliative care.

But instead of being in a hospital, the 71-year-old chose to be cared for at home in Yishun.

Apart from his wife, who is his main caregiver, a team comprising two nurses and a doctor from the Singapore Cancer Society (SCS) visits regularly to provide palliative care.

Such care focuses on providing patients relief from pain and stress of a major illness such as cancer. It is provided by a team of doctors, nurses and social workers within a hospital, nursing home, hospice or the patient's home.

"I always thought palliative care meant there would be someone constantly there, holding my hand throughout. There was no one until the SCS team (came)," said Mr Tay, who admitted he was a "chronic smoker".

He said he chose to have palliative care at home so he could be close to loved ones and in familiar surroundings.

Mr Tay was diagnosed with lung cancer in 2010, after he had a lump in his right lung checked.

In January last year, another lump was discovered in his left lung and he became breathless.

He opted for palliative care at home after surgeons removed 1.6 litres of fluid from his lungs, allowing him to sleep better. "That was when Nurse Hazel (Chua) and a Dr Goh from SCS turned up to provide home hospice care," Mr Tay said.

Nursing support

Set up in 1987, the SCS Home Hospice Care team, which depends on public funding, provides homecare assistance and nursing support to patients diagnosed with advanced-stage cancer in their home environment.

Comprising six full-time nurses, an occupational therapist, a full-time and three locum doctors and two administrators, the team provides regular home visits to patients to give palliative care such as pain management, caregiver bedside training, counselling and psychosocial support.

This service is free, and teams are on call round the clock. Resident doctor at SCS Rina Nga, 50, said the team, which works very closely with hospitals, gets about 300 referrals a year and sees between 80 and 100 home care patients at any one time.

They have also made more than 31,000 home visits since starting out in 1987, reaching out to close to 7,000 patients. "We are divided according to zones. For example, both nurses Hazel Chua and Joel Tham, who take care of Mr Tay, cover the north zone," she said.

SCS is not the largest organisation providing home hospice care.

Hospice services

The biggest is HCA Hospice Care, which has around 800 to 850 patients under its care at any point in time. More than 49,000 patients have used its services since it was set up in 1989.

Dr Nga said the six SCS nurses were trained to be clinicians and to make decisions on the spot whether to increase or decrease medication for patients, and these include morphine that alleviates pain.

And with a fast-ageing population and cancer cases on the rise in Singapore, SCS is looking to develop its home hospices services in the next three years.

This includes boosting its capacity to serve up to 1,000 patients a year.

Cancer cases rising

Cancer is not just the top killer in Singapore, it is also on the rise.

And much of this has to do with bad habits associated with a modern lifestyle including smoking, drinking and eating too much, say doctors.

In 2012, 12,123 people were diagnosed with cancer, a 15 per cent increase from 10,576 in 2008.

Lifestyle cancers, such as prostate, breast and colorectal cancers, contributed to this rise.

Prostate cancer cases, for instance, went up by 52 per cent from 2003 to 2012, and breast cancer cases rose by 25 per cent.

Smoking is also a factor that increases the chance of getting cancer and while the rate of smoking is decreasing, there is a trend of more younger people here picking up the habit.

Other factors contributing to the rise of cancer here are poor diet, lack of exercise; and among women, having fewer children and having them later.

Cancer cases to hit 21.6 million a year by 2030


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