Ultimate wish: To die peacefully at home, free from pain & surrounded by loved ones

SINGAPORE – The number of nurses trained to look after terminally ill patients rose in recent years as palliative care is increasingly integrated into mainstream care.Across the public healthcare sector, there are currently 337 nurses trained in palliative care – a 31-per-cent increase compared to 2010, when there were only 257. Last year, there were 300 nurses trained to look after terminally ill patients.

These numbers were released yesterday as palliative nurses were lauded for playing a “critical role” in supporting both the patient and family in managing end-of-life issues.

Speaking at the Tsao Foundation Experts Series, Minister of State (Health) Amy Khor said Singapore’s ageing population coupled with a rise in chronic diseases “will be a strong driver for healthcare demand, including that for geriatric and palliative care services in the community”.

Besides being able to recognise “multiple complex needs”, nurses who are trained in palliative care also facilitate access to other supporting services, she said.

With ageing-in-place as one of the key objectives to help the elderly “live long and live well”, Dr Khor said the Government wants to ensure that community-based services will be readily available. “Ultimately, when the time comes, many of our older people would also wish to die peacefully in their own homes, free from pain and surrounded by their families and loved ones,” she added.

At the forum, results from a three-year pilot programme by the Tsao Foundation’s Hua Mei Mobile Clinic were presented.

The pilot showed that a patient had a “good death” if he underwent Advance Care Planning, where an elderly patient and his family work out an appropriate care plan that would allow the patient to be cared for at home in accordance with his other care preferences at the final stage of his life. For example, a patient may wish to have more visits from the doctor or more communication with the family.

Besides nursing care for the terminally ill, the pilot programme – which served 55 patients – also provided support to their caregivers in the form of grief counselling and bereavement care.

“Most people want to die at home,” said Hua Mei Mobile Clinic’s Senior Medical Officer and Assistant Director Ng Wai Chong.

“It’s about the community’s resource to help them and also about people being able to communicate about it, and that both the family and the patient are able to come to terms with it and decide that that is how they want to be cared for.”