"1. How would you describe palliative care?"

  Answer:

Palliative care is supportive care for patients, who are often suffering from life-limiting or life-threatening conditions (e.g. cancer) but they are not necessarily facing imminent death. Palliative care is delivered by specially trained healthcare professionals, including doctors, nurses, social workers, allied health therapists, as well as a community of volunteers. The general aim is to build a supportive network surrounding the patient, in or out of the hospital, to improve the quality of life for the patient and their family.

"2. How does palliative care improve the quality of life for patients?"

  Answer:

The hallmark of palliative care will always be about what matters the most to patients, as quality of life means different things to different people. We listen to understand the patients and work on an individualised care plan for them.

Although the patient is stricken by a disease, we aim to take the focus away from the disease, and instead, turn to the other possibilities in life. Because life is always greater than the disease itself.

 
"3. How does a patient/caregiver know that palliative care is suitable for them?"

  Answer:

Palliative care is suitable for anyone who is suffering from a life-limiting or life-threatening condition, because it is a form of supportive care that can be received alongside active treatment or at the end of life. This is best assessed by the patient’s hospital care physician, family General Practitioners (GP), or the hospice assessment team.  

"4. How does a patient come under your care? What is the process of getting treatment like?"

  Answer:

Patients are mostly referred to our home hospice service by their hospital care physicians (e.g. oncologist, renal physician, neurologist) or by Community Care providers (e.g. family GP, nursing home). 

We take a whole-person approach in our care. Sometimes this can be about adjusting medications and relieving pain, and other times it can simply be sitting down to listen and share their burden. 

 "5. How often do you visit a patient and their family in their homes? What are the standard procedures for each visit?"

  Answer:

The common frequency of visits is fortnightly, or minimally once a month. This is based on the patients’ needs. HCA also has a 24/7 hotline, so patients and their families always have access to professional medical advice. 

During a home visit, these are some of the things that we may do:

• Check in with the patient and the family to hear their concerns
• Perform physical examination and other assessments
• Administer and titrate medication
• Discuss treatment/care options 
• Educate patients and caregivers on medication and strategies to manage symptoms 
• Recommend suitable home care aids 
  Observation of caregivers (to spot signs of burnout)

 "6. Have you seen cases of patients who live beyond their doctors’ prognosis? Are such cases uncommon?"

  Answer:

Yes, there are patients who live beyond their prognosis. As the prognosis advised by any doctor is largely based on research data and is an indication of the average length of survival, it may not apply to every patient.

At HCA we have had cases who were discharged from our service because their condition stabilised and they were able to resume normal activities. In such instances, the patient will return to see their primary doctor at the clinic or hospital for follow up. Such cases are not common, but we wish to witness more of these, which will mean more hope for patients to live longer.

 "7. What kind of support do you provide to caregivers?"

  Answer:

Providing support to caregivers is an important element of palliative care. We offer a comprehensive list of services. Some examples are arranging for respite care to offer caregivers a break, and sharing self-care strategies to prevent caregiver burnout. Our 24/7 hotline assures caregivers that help is just a phone call away. 

 "8. What are some tips you can share for caregivers looking after a loved one approaching the end of life?"

  Answer:

Adequate rest will help them to be more physically and emotionally resilient to better care for their loved one. We suggest that caregivers always take short breaks to rest and reset. It would also be helpful for caregivers to reach out to their support systems to share the care responsibilities and prevent burnout. They must always remember that they are as important as the patient. 

 "9. It’s never easy talking about death, especially when it’s about their loved ones. How can one start such a conversation, and what should be discussed?"

  Answer:

Without an open discussion about end-of-life matters, we lose the opportunity to recognise the needs and wants of our loved ones most, and also deprive them of the chance to make their wishes known. Conversations can be spontaneous. There are also online resources, such as books and card games to help families talk about death and dying in a heart-warming manner. Such difficult conversations can also be facilitated in an advanced care plan discussion with a palliative care team.

It is important to cover topics on preferred care, preferred place of care and death, and the patient’s unfinished business or regrets. This information will make it easier for caregivers to know how best to care for their loved ones and prevent unnecessary regret and guilt.