JUNE – AUGUST 2020 • MCI (P) 052/10/2019

The 3As of Palliative Care: Availability Accessibility Affordability

PLUS: Technology-enabled continual therapy

Launch of new Inpatient Hospice Palliative Care Service

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THE HOSPICE LINK • JUNE – AUGUST 2020 CHIEF EXECUTIVE’S NOTE

Members’ Contacts Contents ost people would agree that “You Only threatening illnesses. Many perceived that this is Live Once” (YOLO) is simply the most something that could wait and be thought about Assisi Hospice St Luke’s Hospital commonly used expression urging one only when crisis happens. 832 Thomson Road, S(574627) 2 Bukit Batok Street 11, S(659674) M T: 6832 2650 F: 6253 5312 T: 6563 2281 F: 6561 8205 to make the most out of the present On the contrary, palliative care is most www.assisihospice.org.sg www.slh.org.sg moment without worrying about the future. effective when there is sufficient time to discuss [email protected] [email protected] Indeed, life is short and at times, the most and understand your and your loved ones’ care precious things can easily become lost too. preferences, financial ability, values, beliefs Buddhist Compassion Relief Tsao Foundation Ever so often, external factors can cause that loss and care goals. The 3As that one can rely Tzu Chi Foundation (Singapore) 298 Tiong Bahru Road or perhaps we could have caused ourselves to on to prioritise in order to achieve holistic 9 Elias Road, S(519937) Central Plaza, #15-01/06, lose things or people we value because healthcare plans are — Availability, Accessibility T: 6582 9958 F: 6582 9952 S(168730) www.tzuchi.org.sg/en T: 6593 9500 F:6593 9505 we procrastinated. and Affordability. tsaofoundation.org Truly, the space of palliative care is still very This can serve as an overview as to what is Dover Park Hospice [email protected] unspoken about even though it provides comfort to currently offered to help you in improving 10 Jalan Tan Tock Seng, S(308436) people of all ages with serious, chronic, and life- your life. T: 6500 7272 F: 6258 9007 Changi General Hospital 10 www.doverpark.org.sg 2 Simei Street 3, S(529889) [email protected] T: 6788 8833 F: 6788 0933 2 Members’ Contacts www.cgh.com.sg HCA Hospice Care AVAILABILITY ACCESSIBILITY AFFORDABILITY 705 Serangoon Road, Block A #03-01 Khoo Teck Puat Hospital 3 Chief Executive’s Note @Kwong Wai Shiu Hospital, S(328127) 90 Yishun Central, S(768828) What financial situation do T: 6251 2561 F: 6291 1076 T: 6555 8000 F: 6602 3700 4 Technology-enabled What is my preferred Am I eligble to use palliative www.hca.org.sg www.ktph.com.sg care mode? care services? I need to be in to have my [email protected] continual therapy preferred palliatve care? KK Women’s and Metta Hospice Care Children’s Hospital 6 Doing more together DO YOU KNOW? DO YOU KNOW? DO YOU KNOW? 32 Simei Street 1, 100 Bukit Timah Road, S(229899) Metta Building, S(529950) T: 6225 5554 F: 6293 7933 T: 6580 4695 F: 6787 7542 www.kkh.com.sg 8 Accessing palliative care • Home Palliative Care • Patients of all ages, from • Costs can be kept affordable www.metta.org.sg • Day Palliative Care babies to the elderly, can through various subsidies and [email protected] Ng Teng Fong General Hospital • Inpatient Palliative Care benefit from palliative care financial schemes 10 What does it take to 1 Jurong East Street 21, S(609606) • Consultative services • Pallative care services are • Government subsidy is available MWS Home Care & Home Hospice T: 6716 2000 F: 6716 5500 have a ‘good death’? available to those with life- through means-testing 2 Kallang Avenue, www.ntfgh.com.sg CT Hub #08-14, S(339407) [email protected] threatening illnesses such as • Other financial schemes T: 6435 0270 F: 6435 0274 13 The essence of care is advanced cancer, chronic (e.g MediSave) are available www.mws.sg/centre-location/mws- National Cancer always affordable illnesses including end-stage home-care-home-hospice Centre Singapore kidney, heart, lung and [email protected] 11 Hospital Drive, S(169610) neurological failure T: 6436 8000 F: 6225 6283 17 SHC@Queenstown Singapore Cancer Society www.nccs.com.sg Public Library, 15 Enggor Street, #04-01, Singapore Hospice Realty Centre, S(079716) Tan Tock Seng Hospital T: 1800 727 3333 11 Jalan Tan Tock Seng, S(308433) Council Turns 25! www.singaporecancersociety.org.sg T: 6256 6011 Indeed, the quality of life is highly subjective [email protected] www.ttsh.com.sg 18 Palliative care services from one to another. Therefore, wait no more to talk, plan and act. SingHealth Community Hospitals in Singapore Woodlands Health Campus You should define your own palliative care (Bright Vision Hospital, 9 Maxwell Road, Outram Community Hospital, needs that aim to relieve your suffering, improve MND Complex Annex A, 19 New Inpatient Palliative The 3As that one can Sengkang Community Hospital) #03-01A, S(069112) your quality of life and that of your family as the 10 Hospital Boulevard, S(547530) T: 6681 5999 Care Service system offers the care for the “whole person”. T: 6970 3000 www.whc.sg Former US President Barack Obama once said: www.singhealth.com.sg/SCH rely on to prioritise in 20 Announcements “Change will not come if we wait for some Lien Centre for Palliative Care other person or some other time. St Andrew’s Community Hospital Duke-NUS We are the ones we’ve been waiting for. order to achieve holistic 8 Simei Street 3, S(529895) Medical School Singapore We are the change that we seek.” T: 6586 1000 8 College Road www.sach.org.sg Level 4, S(169857) Let’s wait no more — your decision will make healthcare plans are — [email protected] T: 6601 2034 / 6601 7424 [Education] the difference. T: 6601 5113 [Research] St Joseph’s Home www.duke-nus.edu.sg/lcpc Ms Evelyn Leong Availability, Accessibility 36 Jurong West St 24, S(648141) T: 6268 0482 F: 6268 4787 Chief Executive www.stjh.org.sg Singapore Hospice Council and Affordability. [email protected]

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Physically present with patients are The hospital has used technology their assigned occupational therapists. for speech therapy since 2016, with Music therapist Isabel Tan says of these telemeeting software to help patients who colleagues, “They are our eyes, ears, hands are home-bound. “Such patients can still and legs. They are critical to ensure the receive therapy while saving time, effort effectiveness of the programme as they are and money on travelling to the hospital on-site to attend to patients.” and back home. By reducing barriers of Occupational therapist, Batrishya Binte time and space, the desired frequency Dol Rani, is glad that music and art therapy of therapy can continue and patients could continue, “It is worth the effort when may improve their ability to swallow, we see our patients enjoy the activities.” eat and speak, for example, after stroke,” St Luke’s Hospital cares for the whole said Kenneth Lam, Deputy Director of person, as patients have more than just Rehabilitation Services. physical needs. They also have social and Kenneth added, “Being evidence-based emotional needs. For example, serious in our approach, we will review the Making music — a patient with music illness may lower a patient’s spirit, which effectiveness of the medium in music and therapist Isabel Tan. in turn will affect appetite, sleep, and art therapy to see if it can be a long term Opposite page: An occupational therapist willingness to partake of medication and alternative to help more patients who and a physiotherapist therapy. Art and music therapy can help lift have ambulatory constraints, even when are physically present with patients to their mood and hence facilitate recovery or we are back to DORSCON Green and facilitate music therapy, improve quality of life. distancing is no longer a requirement.” attending to patients’ needs at their bedside

afety first,” said Ms Kang Technology- who wished only to be “S known by her surname. Her mother, 81, was taking part in art and music therapy enabled using remote technology for some ‘engagement’ and ‘motivation’. As physical distancing helps reduce continual the risk of COVID-19 infection, St Luke’s Hospital staff work in different zones. The use of therapy teleconferencing technology has helped the art and music therapists to In times of necessity and for the health be with patients virtually. Patients can see and hear their therapists, and vice and safety of patients, sometimes it is best versa. The music therapist can still for caregivers to be physically distant, sing along with patients, motivating them to respond and follow, and the but this does not mean they will not be art therapist can still demonstrate and emotionally present for them. guide patients in art.

St Luke’s Hospital cares for the whole person, as

patients have more than just physical needs. Art and HOSPITAL ST LUKE’S music therapy can help lift their mood and hence

facilitate recovery or improve quality of life. AND PHOTOS WORDS

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“For patients like Mr Low who travel back Opposite page: Dr Sumayyah (second Doing more together and forth for appointments every day, from left) with her ambulance fees are a major concern,” said team at SKCH Palliative care offers various aspects of care, especially for elderly Dr Sumayyah. patients, by relieving symptoms, pain and stress of serious illnesses To ease Mr Low’s financial burden, the care team worked together to find alternatives. TEAMWORK IN PALLIATIVE CARE to improve their quality of life. Members of the care team from Together with the rehab team, they began The needs of patients suffering from life- Sengkang Community Hospital look at what defines palliative care. to provide caregiver training to Mr Low’s son. threatening illnesses vary and it is rarely Within three days, they equipped him with skills possible for just one professional to on how to transfer Mr Low by vehicle so that provide adequate care. A support team he can accompany his father for appointments is required in order to help patients like instead of engaging an ambulance service. Mr Low. While that was going on, the Medical Social “The team often goes beyond the call Service (MSS) team assisted Mr Low in fulfilling of duty by offering assistance to patients his wish of spending his remaining days with his as some of them might be reluctant to wife. Knowing that it is very important to him, ask for help,” explained Dr Sumayyah. the team worked closely with Mr Low to identify Family members are also part of the possible solutions to make his wish come true. care team. They have a role in caring for In the end, the Medical Social Worker helped the patients, direct their plan of care and his family with relevant information to apply for take part in any decision making. a domestic helper to aid his family members in It really takes great effort from caring for him when he returned home. everyone to achieve a common goal. Thanks to the team’s commendable effort, Palliative patients can benefit as there is Mr Low’s needs were addressed promptly and he cooperation and understanding among was able to return home after the helper arrived. the team members. “We were filled with joy and satisfaction The quote by the late deaf-blind because we were able to provide appropriate American author is so apt here: “Alone, care to Mr Low and fulfil his wish!” said we can do so little; together we can do Dr Summayah. so much!”

The“ team often goes beyond their ife is a gift and every single moment everyone’s mood. He cultivated this liveliness should be cherished. Happiness can within the hospital and maintained it till the call of duty by L come in many forms — even as far day he was discharged to spend the rest of his as giving joy to others. days at home. For Mr Low (not his real name), his life was full offering assistance of positivity. The Sengkang Community Hospital FULFILLING A LAST WISH (SKCH) palliative patient remained cheerful Mr Low would keep himself active without to patients as some

despite suffering from metastatic prostate cancer. fail. He derived joy from reading newspapers, HOSPITAL SENGKANG COMMUNITY

“He would greet everyone with a broad and watching television and socialising with ERP/PIXABAY VAN SABINE uplifting smile. It always made my day,” said other patients, or by simply appreciating the of them might be Dr Sumayyah Omar Bin Talib, a Resident greenery at the Hospital’s garden. Physician treating Mr Low from the SKCH Post- In between all of these activities, Mr Low Acute and Continuing Care (PACC) team. participated in therapy sessions and reluctant to ask Dr Sumayyah revealed that Mr Low’s smile attended his specialist appointments at WORDS AND STAFF PHOTO AND STAFF WORDS was contagious too, spreading to help elevate the acute hospital. PHOTO PAGE OPPOSITE for help.”

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Accessing Step 2: Get a doctor’s referral Admission to Assisi Hospice’s Inpatient, Home Care and Day Care services is by doctor’s referral. The patient’s palliative care doctor (either a general practitioner or one from a hospital) will need to complete a referral form available Assisi Hospice offers a four-step guide to finding the most on Assisi Hospice’s website suitable type of palliative care for your loved ones. (https://www.assisihospice.org.sg/wp-content/uploads/ SHC-Common-Referral-Form_20-Jan-2020.pdf)

Step 1: Choose a suitable service Step 3: Wait for Assisi Hospice’s update

Assisi Hospice provides care for patients across the spectrum of Inpatient, Home Care and Day Care palliative care services. This allows patients and family members to journey with a clinical Upon receipt of the referral form, our doctor will team they are familiar with, and to receive the care they need. assess the patient’s suitability for palliative care and will contact the referring hospital or doctor on Our Inpatient Care is for patients of all admission arrangements, such as bed availability, ages who need specialist palliative care date of first assessment visit, and so on. in an inpatient environment. The cost of inpatient stay will depend on the level of government subsidy based on a means test. This government subsidy, together with MediShield Life and a subsidy from Assisi Hospice will help lower the cost to patients. Prospective patients and their Step 4: Arrange for transfer of patient families can speak with the Medical Social (for Inpatient service) Workers regarding any concerns about the cost of stay.

Our Home Care service is for patients who The ambulance transfer will be arranged by the prefer to be cared for at home, if their referring hospital or doctor. A family member will condition allows. Regular home visits by need to accompany the patient during the transfer our care team support families in caring and facilitate his or her admission process. for patients by helping them manage the symptoms of advanced illnesses and provide psychosocial and other practical support. Our Home Care service is offered free to all patients, regardless of location in Singapore.

Our Day Care service provides a warm and interactive environment for patients who require care during the day. It is made accessible by ferrying patients to and from their homes. Our Day Care fee The patient will be cared for by is a nominal $10 per day and it covers our team of specialist doctors, two-way transport, meals, medical nurses, allied health and pastoral consultations, nursing attendance, ASSISI HOSPICE care professionals. When faced psychosocial support, occupational with life-limiting illnesses, our IMAGES IMAGES therapy, physiotherapy, as well as all patients receive medical care, as therapeutic and recreational activities, well as psychosocial, emotional including outings. and spiritual care. WORDS AND WORDS

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PALLIATIVE CARE IS NOT LIMITED TO A HOSPICE AND IS APPROPRIATE AT ANY STAGE OF A SERIOUS MEDICAL CONDITION Contrary to popular belief, a hospice is not just a medical facility for patients to receive care at the final stage of their lives. The term “hospice” actually refers to a concept of care that focuses on improving the quality of life for terminally-ill patients and their loved ones. This care can be delivered at home or in long- term care facilities such as nursing homes, or inpatient hospices. Palliative care is appropriate at any stage of a serious medical condition. A patient can still receive curative treatment while undergoing palliative care. The aim of palliative care is to provide a better quality of life for patients by helping them with their physical, psychological

Dr Andy Lee (first and spiritual needs. In fact, starting palliative row, third from care as early as possible after diagnosis has left), Head of MWS Home Care proven to be beneficial to patients in offering a & Home Hospice higher quality of life. with his teams The MWS Home Care & Home Hospice team provides a suite of home-based care for patients so they may continue to live in the comfort of their own homes. Beyond providing care, we also coordinate care services and What does it take A patient can still receive financial options in the community and with hospitals for our patients. Our services accept referrals from hospitals, private curative treatment while general practitioner clinics or other home to have a ‘good death’? care agencies through the online Agency for undergoing palliative Integrated Care portal, through email or fax. Head of MWS Home Care & Home Hospice Dr Andy Lee addresses common concerns about the accessibility of palliative care. FOR HOME-BOUND PATIENTS, PALLIATIVE care. The aim of palliative HOME CARE CAN BE BENEFICIAL Although there are limitations to the care is to provide a better diagnostic tests that can be done at home, or many Singaporeans, death It is important to explore the underlying palliative home care is still beneficial for is viewed as a taboo subject, ideas and previous experiences that may quality of life for patients patients, especially those who are home-bound F and family members worry have given shape to their current concerns. and are unable to travel to the hospital for that raising the topic will affect There may be deep-seated beliefs that have their regular follow-ups. With good clinicians METHODIST WELFARE SERVICES METHODIST WELFARE the patient’s will to live. They also have the been built up over many years based on what by helping them with their tending to patients, diagnosis and medication impression that end-of-life care is unaffordable they have seen or heard from trusted friends can still be administered effectively. This also and difficult to access, causing them to think or family members. In this article, we look at supports those with advanced diseases who about it too late. Conversations about palliative some of the concerns expressed by patients physical, psychological need palliative care to manage pain, and fulfil care for the terminally ill tend to remain off- and their caregivers, and how palliative care their wish to spend their final days at home. limits until they are absolutely necessary. can be made accessible to them. AND PHOTOS WORDS and spiritual needs. At MWS Home Hospice, our teams of doctors,

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THE HOSPICE LINK • JUNE – AUGUST 2020 THE HOSPICE LINK • JUNE – AUGUST 2020 ACCESSIBILITY AFFORDABILITY The essence of care is always affordable St. Joseph’s Home holds true that care can remain affordable with creativity, conversation and compassion applied to the mix.

ina was in tears, “My mother comfort during the remaining days of was very poor. She couldn’t someone’s life. The comfort of a tender G afford to send me to school. companion and respect for human dignity She didn’t have enough money is always affordable. for food. She loves me so much. Now, she’s gone.” Gina choked on her own tears. Gina A MEASURE OF CREATIVITY is one of our Residents. She has advanced The COVID-19 situation has pushed our dementia and today, she was missing her creative limits and challenged what we mother more than usual. Sitting beside her, thought was impossible. Before the circuit I had the privilege of sharing in her life as breaker started, volunteers hosted a slew a daughter. of art, music and dance programmes at Her heartache of growing up in a poor the Home. Now, with a webcam and a family brought to mind some questions: portable TV, our volunteers zoom into our What determines whether something is Residents’ clusters to host spontaneous available to you? Is it your pay check or virtual activities. While the warmth of Residents of how luxurious the place looks? touch is not easily replaceable, technology St Joseph’s nurses and medical social workers daily activities such as bathing, moving An MWS Home In essence, the heart of hospice care is to can help to bridge the physical distance Home enjoy a Care & Home performance by make regular home visits and provide around, dressing, transferring, toileting Hospice patient provide physical, emotional and spiritual between us and nurture our relationships. band Jamspiration round-the-clock support. If a problem and eating. receives holistic care in the comfort crops up in the middle of the night Grief and bereavement are also of his own home or at weekends, the patient and their important aspects of palliative care. caregivers are assured that help is only When patients pass away, it is essential a phone call away and that a doctor will to support their families with a team that visit the patient if necessary. is able to assess their psychosocial and This support from home care doctors spiritual needs. Through bereavement and nurses helps to allay a lot of follow-ups and counselling, they can help anxieties of home-bound patients, family members to cope with grief and especially if they are no longer able to receive closure. visit the hospital for their usual follow- ups. Many of our patients actually look forward to the visits even when they are well because of the companionship and camaraderie. Our team uses a person- HOLISTIC PALLIATIVE CARE ALSO SUPPORTS CAREGIVERS, EVEN AFTER centred approach which THE PATIENT PASSES AWAY Holistic palliative care takes into consideration the patient and caregiver’s entails engagement with needs. Our team uses a person-centred approach which entails engagement each patient and the with each patient and the family to understand their total needs. These may include medical care, nursing care, home family to understand personal care, as well as housekeeping, errand-running and assistance with their total needs.

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To care for Residents as persons, not patients, we need to start with having real conversations with them, and getting to know them.

To care for Residents as persons, not Before the circuit breaker started, Youth volunteers who could no longer visit patients, we need to start with having youth volunteers visit the Home to send photos and write real conversations with them, and befriend our Residents. To continue letters to keep in touch with St. Joseph Home getting to know them. these relationships and create new Residents. Opposite Our pastoral team tends to our ones, our Residents and youths page: St Joseph’s Home Residents enjoying a Residents from their first day at exchange postcards and digital virtual live performance our Home. The team welcomes hellos instead. by band Volunteer Guitar Connection Residents at the front door, befriends Our staff are honoured to share in them during their stay here and the stories of our Residents and to accompanies them when they take cultivate hope and resilience with their last breath. them. In difficult times as these, Aside from our staff team, our supporting one another becomes volunteers have different but valuable more important than ever. For roles in Residents’ lives. Volunteers caregivers and volunteers who are provide a listening ear to Residents, now homebound, a care that inspires not only to share their burdens, but hope can continue to be available and also to share in their years of lived affordable with creativity, conversation experiences and wisdom. and the heart of care.

One example is the live bands that Every morning, Mr Tee reads The Straits perform during our weekly coffee corner Times, not only to catch up on the news, sessions. In the past, live bands would hook but also to learn English. Last year, Mr up their portable sound systems to busk Tee attended volunteer-run computer for Residents. Residents can make song lessons and learnt how to get on requests, sing and clap along, while YouTube and Google Translate to learn enjoying the company of other Residents conversational English. and volunteers. Mr Tee now spends more of his time in his Today, our live band sessions look slightly living area, where there are neither computer different. With Zoom, Residents can make units nor volunteer teachers around. To song requests live like before. The playful encourage continual learning, staff at banter between the musician-host and that cluster have made notebooks and Residents adds vibrance and laughter to newspapers available to him. He would then the Home. More importantly, the volunteers diligently jot down the English phrases that who are zooming into the Home also bring he picks up from the newspaper and enlist a semblance of community life when they the staff around to help with translation. share nuggets about what is happening in their own households. A MATTER OF CONVERSATION For Residents who move into our Home, A MODE OF CARE they need to bid goodbye to parts of their SHEREEN NG, COMMUNITY PARTNERSHIPS, ST JOSEPH’S HOME ST JOSEPH’S PARTNERSHIPS, COMMUNITY SHEREEN NG, One of our staff members once commented, lives that they might have grown familiar “It is not the outcome that matters. It is with. A new environment can bring whether Residents are proud of themselves elevated anxiety. When we are anxious, we after the activity.” As much as possible, our either fight the feeling with ‘uncooperative staff arrange the physical space and materials behaviour’ or flee from it by insisting on so that Residents are empowered to engage. returning to the old life. AND PHOTOS WORDS BEEN CHANGED NAMES HAVE RESIDENTS’

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THE HOSPICE LINK • JUNE – AUGUST 2020 THE HOSPICE LINK • JUNE – AUGUST 2020 HAPPENINGS

SHC @ Queenstown Public Library Explore and learn more about palliative care and end-of-life matters through stories, digital resources, a photo-documentary and more at the exhibition!

Venue: Queenstown Public Library, Level 1, 53 Margaret Dr, Singapore 149297 Date: Sunday, 16 Aug – Monday, 31 Aug 2020

*In view of the COVID-19 situation, please check our website www.singaporehospice.org.sg for updates.

his year marks the 25th anniversary of the founding of the Singapore Hospice Council. It is therefore timely, that the 7th Singapore Palliative Care Conference (SPCC 2020) held from 8 to 11 July 2020 at the Sands Expo & Convention Centre invites everyone to embrace our rich history and discover for ourselves the core values of compassion, strength and resilience that lie deep within our roots. It is pertinent that we reach out beyond our traditional boundaries to engage professionals outside the fraternity, as well as community services and industrial partners in relevant fields. It is only through bridging the divide amongst specialities, services and interest groups that we may extend holistic and comprehensive care to patients and their families. As we celebrate who we are and what we have achieved together, we 16 continue to reach out with open hearts and 17

THE HOSPICE LINK • JUNE – AUGUST 2020 THE HOSPICE LINK • JUNE – AUGUST 2020 SHC MEMBER SERVICES ANNOUNCEMENTS Palliative Care New Inpatient Services in Singapore Palliative Care Service

On 1 April 2020, the Ministry of Health (MOH) launched the Inpatient Hospice Palliative Care Service (IHPCS) to provide patient-centric and seamless care to patients receiving inpatient palliative care. This new service is HOME PALLIATIVE CARE INPATIENT PALLIATIVE CARE in line with MOH’s ongoing efforts to improve the quality, accessibility and affordability of palliative care.

• Assisi Hospice • Assisi Hospice • Buddhist Compassion Relief • Bright Vision Hospital Tzu-Chi Foundation (Singapore) • Dover Park Hospice AVAILABILITY: ACCESSIBILITY: • Dover Park Hospice • St Andrew’s Community Hospital MEETING PATIENTS’ ADMISSION AND REFERRALS PALLIATIVE NEEDS Patients can be admitted to IHPCS • HCA Hospice Care • St Joseph’s Home With the IHPCS, a common service from acute hospitals and direct • Metta Hospice Care • St Luke’s Hospital framework will be introduced to referrals from the community, • MWS Home Care & Home Hospice • Yishun Community Hospital ensure that all service providers are able to such as from General Practitioners and Home • Singapore Cancer Society provide a standard scope of services to meet the Palliative Care providers. The expansion • Tsao Foundation (Hua Mei needs of palliative patients in two tiers.1 of referral pathways will improve the Mobile Clinic) 1. General palliative care is for patients with accessibility of inpatient palliative care for CONSULTATIVE SERVICES palliative care needs that require inpatient patients who require it and facilitate the right- management. Examples include relieving siting of patients. symptoms such as pain and breathlessness • Changi General Hospital through oral and subcutaneous medication, • Khoo Teck Puat Hospital DAY PALLIATIVE CARE as well as socioemotional support for patients • KK Women’s and Children’s Hospital and caregivers during this difficult time in • Ng Teng Fong General Hospital their lives. • Assisi Hospice AFFORDABILITY: 2. Specialised palliative care is for patients • National Cancer Centre Singapore EXTENSION OF SUBSIDIES • Dover Park Hospice with complex needs that require higher levels • National University Hospital Singapore residents admitted • HCA Hospice Care of care (compared with general palliative • Tan Tock Seng Hospital into IHPCS are eligible for means- care). Examples include the administration of tested government subsidies of intravenous medication and specialised wound up to 75%. To better support patients who care for complex wounds. require inpatient palliative care, MediShield Life coverage will be extended to all IHPCS Patients will be assigned to the appropriate patients, and MediSave withdrawal limits will tier based on their goals of care and needs. Each be increased for patients with more complex patient’s assigned tier will be regularly reviewed needs. Singaporeans who cannot afford their and updated by doctors as needed. bills after subsidies, MediShield Life and The framework will also allow patients with MediSave, may apply for MediFund. fluctuating care needs due to changes in their health condition to be cared for in the same MediShield Life limits location. This promotes continuity of care and General palliative care $250/day

ASSISI HOSPICE minimises the need for transfers to different Specialised palliative care $350/day care facilities. As all providers will be required

PHOTO PHOTO to provide a standard scope of services, patients also have the option of a wider range MediSave limits For referrals to service of providers and can be more assured that their General palliative care $250/day providers of inpatient care needs will be fulfilled regardless of setting. Specialised palliative care $350/day care, home care and day care services, visit https://singaporehospice. org.sg/shc-common- For more information on IHPCS and other Intermediate and Long-Term Care Services, patients and their caregivers can referral-form/ or scan visit the Agency for Integrated Care’s website or approach their regular doctors or medical social workers. SINGAPORE HOSPICE COUNCIL COUNCIL SINGAPORE HOSPICE the QR code above 2020 MOH’S PRESS RELEASE ON 31 MARCH FROM EXTRACTED (for healthcare 1 WORDS WORDS professionals’ use). WORDS With the exception of St Joseph’s Home, which only provides general palliative care.

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SingHealth Community Hospitals Singapore Hospice Council welcomes SingHealth Community Hospitals (SCH) as our new member on 1 April 2020. SCH oversees the management of Bright Vision Hospital, Sengkang Community Hospital and the new Outram Community Hospital, which opened on 18 November, 2019. Download Caregiver The focus at SCH goes beyond patients’ Resource Booklets length of hospital stay, aiming to provide a homely environment in community hospitals Singapore Hospice Council’s booklets, for patients to receive well-paced, personalised which aim to better support and empower care. The multidisciplinary team helps caregivers, are now available for download patients to not only recover from their medical in 4 languages — English, Mandarin, Malay conditions, but also regain abilities to integrate and Tamil. into the community. SCH wants to shape the Learn more about Caring for Yourself way they deliver person-centred care across After a Death, Nutrition in Advanced healthcare settings, and beyond the hospital to Illnesses and Understanding the Final Hours the community. at https://singaporehospice.org.sg/caregiver/

EDITORIAL COMMITTEE

Editor Christina Wee Associate Editor Anne Loh

Assisi Hospice Angela Yeo Buddhist Compassion Relief Tzu Chi Editorial Team Tzu Chi Foundation (Singapore) Changi General Hospital Rasidah bte Alias 1 Lorong 2 Toa Payoh #07-00 Dover Park Hospice Jenny Goo HCA Hospice Care Toh Wei Shi Braddell House Khoo Teck Puat Hospital Tricia Tan Singapore 319637 Lien Centre for Palliative Care Jessica Goh Siew Hong T: 6538 2231 Metta Hospice Care Sandy Lim E: [email protected] MWS Home Care & Home Hospice Nicole Andrea Tan www.singaporehospice.org.sg Singapore Cancer Society Kumudha Panneerchelvam

Singapore Hospice Council Sheena Koong SingHealth Community Hospitals Muhammad Azhar bin Contents are not to be quoted or reproduced without the prior Abdul Rahim written permission of the Singapore Hospice Council. St Andrew’s Community Hospital Peh Lay Koon St Joseph’s Home Shereen Ng St Luke’s Hospital Chua Hwee Leng Tan Tock Seng Hospital Candice Tan Tsao Foundation Desiree Lim

Design Christian Subrata Printer Yung Shung Printrade Pte Ltd

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