September 7, 2016

For Caregivers

1. Symptom Management
Active, progressive and far-advanced conditions come with a variety of symptoms (eg. nausea, bowel irritation and fatigue) of varying intensity. Managing these symptoms can be difficult for both you and the patient. Hospice and palliative care can help to ease these symptoms through medications, nutritional changes and self-help techniques. Receiving experienced help in managing such symptoms can significantly increase the quality of life for the patient, and reduce the burden of caregiving.

2. Pain Management
A patient with a far-advanced condition usually experience a significant amount of pain which may be caused by surgery, treatment, injuries or the condition itself. Each type of pain needs to be specifically treated to ensure maximum effectiveness of treatment. Treatments can be a combination of medications and other therapies, or just one method.

Pain management is a complex matter. Hospice and palliative caregivers have the know-how to best relieve the patient of his pain. By choosing to receive hospice and palliative care, the patient has better chances of experiencing effective pain relief.

3. Low-cost Medication & Checkups
Hospices can provide the patient with some of his medication at low costs. The patient can also receive regular checkups at his home free of charge. This means he can be cared for in the comfort of his own home without going back to the hospital for minor checkups.

4. Socio-emotional Support
Upon diagnosis, the patient and his family will be in emotional turmoil. It is difficult for you to comfort the patient or vice versa. Hospice and palliative caregivers are trained to cope with such situations. They can offer sound advice to you and the patient on how to handle all the emotions, and help the patient focus on more important matters. While creating a cheerful environment is unrealistic, it will be helpful to have a trained hospice and palliative caregiver put things into perspective.

5. Caregivers Training
Aside from helping patients directly through home care, day care and in-patient care, hospices also run regular training programs to train you in caring for patients in the right manner. Such training will increase your confidence in caring for the patient, and reassure the patient about the quality of care that he is receiving. These training will empower you to provide the best care for your loved ones.

Palliative Caregivers Programme by HCA Home Hospice

Agency for Integrated Care Silver Pages

6. Home Care Equipment Loan
Different equipment may be needed at different stages of care. Instead of purchasing expensive equipment, there is an option to loan wheelchairs, commodes, walking frames, pressure-relief air mattresses, hospital beds etc. often requiring only a deposit which is refundable upon return. Speak with your hospice and palliative care professionals.

I have a dying friend. Would it be insensitive for me to suggest hospice care as an option?

As a friend, you have your dying friend’s best interests in mind. It would not be rude to suggest hospice care if it is done in a sensitive manner. Pick up some brochures at a hospice and talk to your friend about the importance of receiving the right type of care. You can also direct your friend to this website to explore the options and services available, and to put any doubts and fears to rest.

Do all hospices provide the same type of hospice and palliative care?

Singapore Hospice Council members provide a range of services and facilities for patients to cater to the needs of different families. For example, some hospices provide home care, some day care, and others in-patient care.

What type of support does the hospice provide for the patient’s family members?

Besides respite care and additional help (for home care), hospice volunteers and counsellors are able to help family members deal with their grief over the patient’s imminent death. Such support is also available after the patient’s death.

How do I know at what stage should a person resort to hospice and palliative care?

Hospice and palliative care is most commonly provided at home by a hospice home care service. Most patients die at home and never need to go to an in-patient hospice. The time to initiate an in-patient hospice referral is when the doctor tells you that the patient’s disease is not curable and the patient has symptoms that are not under controlled or the family is unable to cope with caring for the patient at home. Hospices are very experienced in dealing with such situations.

Should one wait for the doctor to suggest hospice and palliative care first?

Most doctors know about hospice and palliative care. You do not need to wait for your doctor to bring up the topic. You can ask your doctor whether you or your family member can benefit from hospice and palliative care.

How difficult is it to care for a dying person at home?

It is not easy to care for a dying person, especially when the person is a loved one. You have to tend to the needs of the person while managing your own health and emotions. And the demands of caring for a dying person will grow over time, as the person gets closer to death. Long nights will become common, and can get lonely for a single caregiver. Home visits by hospice staff at regular intervals during such times will help you manage the dying person’s needs while maintaining your own wellbeing.

Hospice staff is easily contactable when advice is needed during office hours. Additionally, hospice home care services have a patient care helpline available after office hours during the week, weekends and public holidays.

How can the hospice and palliative caregiving team help a patient and his family through home care?

Different members of the hospice and palliative caregiving team have different skills. Doctors and nurses help the patient with advice on medications, and maintenance of personal hygiene and comfort. Counsellors help the patient and his family in dealing with emotional turmoil. Trained volunteers serve as respite caregivers, temporary caregivers that allow the primary caregiver to get some rest or run errands).

Is there any special equipment that needs to be installed in the patient’s home before hospice and palliative care begins?

In general, the requirement for special equipment only extends to the physical and medical needs of the patient, and will be recommended by the patient’s healthcare team upon discharge from the hospital. Additional equipment may be required at later stages of the patient’s disease. Hospice staff will be able to advise on what is required and how to obtain such equipment.

If a patient is admitted into a hospice, does it put him on a one-way road to death?

Most hospice patients begin receiving hospice and palliative care knowing that they have to live life to the full with whatever time that is left. However, some patients manage to improve and leave the hospice to receive home-care. The hospice is not a death house. One of the aims of hospice and palliative care is to ensure quality of life. To keep the patient as well as possible, for as long as possible.

I am the primary caregiver of a patient and am considering hospice and palliative care. What do I need to do to apply for admission to a hospice?

You should discuss this with the patient’s doctor who will advise you on the patient’s eligibility for hospice care. If appropriate, the doctor will then fill the Hospice Common Referral Form, and fax or mail it to the relevant hospice service. The hospice service will then contact you.

What do I need to do to prepare for my relative / parent / friend’s admission?

You need to keep the patient’s NRIC ready. You also need to be prepared to give the patient’s detailed history to the hospice staff. The hospice staff will guide you on any documentary evidence that may be required to complete the patient’s admission process.