A second life, thanks to home therapy

Administrative officer Zulkifli Boh got up before sunrise and took the MRT train from his Woodlands home to his workplace in the east one day in July 2012.

He cannot recall the exact date, but it was the first time the father of two daughters had wheeled himself to the MRT station and travelled to work on his own, after his right leg was amputated in 2009 because of diabetes. "Before that, I was always escorted. I was excited to go to work, and happy that I could manage."

Mr Zulkifli, 49, is one of the success stories of Tan Tock Seng Hospital's (TTSH) Community Rehabilitation Programme, which provides home therapy to get needy patients back on their feet. More than 3,000 patients have benefited from the programme since its start in 2004, said the hospital, which hosted a media visit last week.

The number of patients in the scheme is expected to rise steeply in the next few years, said a TTSH spokesman, as a result of increased awareness of such home therapy services as well as new subsidies for these services announced by the Ministry of Health in March.

Already, more low-income patients from TTSH have been referred for such home services, which help 70 to 80 patients at a time. Some 65 per cent of patients in the home rehabilitation scheme were from TTSH last year, from 58 per cent in 2012.

Programme coordinators see a growing emphasis on community-based health care. Allied health manager Doreen Yeo, who oversees TTSH's home therapy programme, said: "You cannot just provide care within the hospital and think you can discharge (patients) without problems. They will usually require some hand-holding as they go out into the community."

Ms Yeo said TTSH "may be able to cope with a 20 to 30 per cent increase in capacity". It is also considering offering scholarships to polytechnic students in therapy courses to boost staff headcount. The programme's seven staff each visit five to six patients a day, including amputees, stroke victims and those with spinal injuries.

Sessions outside a hospital mean therapists often have to improvise. "What we have are door grilles and windows," said senior occupational therapist Tan Hui Ting. These fixtures are often used as supports to help build up patients' strength, sense of balance, and endurance.

But it is not all just about the physical. Many patients have psychological and social issues that need to be addressed. One might say "I just lost my job", said Ms Tan. "Therapy may be the last thing on his mind."

In cases like this, staff are trained to refer patients to social workers if necessary.

Mr Zulkifli started out reluctant about therapy, but the turning point came when he was told he might have to leave the programme if he did not make enough progress.

He started to take it seriously and slowly built up leg muscle strength with the help of physiotherapists, who visited him one to three times a week.Now, he is having his "second life".

This article was published on May 19 in The Straits Times.

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