Advance Care Planning discussions ensured that the healthcare team fulfils the personal care goals of palliative patients.
It has been three days since Madam C’s funeral ended and Medical Social Worker (MSW) Goei Wen Yang wondered how her faithful husband was coping with his loss. He could still recall the love they have shown during her stay in the hospital.
When Madam C was admitted to the palliative ward at Outram Community Hospital (OCH), the care team saw the undying love between two souls and helped them on their journey with Advance Care Planning (ACP). These discussions allowed madam C, her husband who is her sole caregiver, and the care team to have a smoother and better understanding of the care desired by the patient. If started early, ACP enables patients to discuss their personal beliefs, values and goals of care with their loved ones and healthcare providers in order to plan for future healthcare options.
Wen Yang has been a part of Madam C’s care team since her admission, and was the point of contact for her caregiver husband. He was extremely touched by their love for each other — it reminded him of the wedding vow “to be together in sickness and in health”. He also remembers vividly the card made by Madam C for her husband. The colourfully decorated card was her last gift to him and in it, she had written the most beautiful words of appreciation and seeking of forgiveness.
“We are glad that we could communicate with Madam C and her family at an initial stage to understand their care preference.”
Madam C was suffering from a condition that caused her to develop a lot of phlegm and left her breathless even with the lightest activity. Because of this, she was constantly having oxygen therapy and was too breathless sometimes to even get out of bed. Despite her symptoms, she remained cheerful to the people around her, especially to the healthcare staff and her
Madam C enjoyed a close relationship with her husband, who visited her daily without fail.
They would engage in meaningful conversations interspersed with peals of laughter, and people around them would wonder why they never ran out of things to say to each other.
And sometimes, they would just enjoy each other’s company, without any words.
But like any other relationship, there would be times of misunderstanding between the two of them, or when Madam C became temperamental due to her condition. Despite this, her husband remained calm and stayed by her side throughout. It was a test of dedication that he passed with flying colours.
Their daily routine went on for a while until Madam C expressed her wish to pass away at home. This caused her husband to worry about the potential difficulties in coping with her care and symptoms as the sole caregiver. He was also uncertain of which equipment was needed to support her when she returned home.
“Although Madam C’s husband was apprehensive, he saw this as fulfilling her last wish and decided to undergo caregiver training to help him be more competent,” shared Wen Yang.
The care team then planned and conducted caregiver training with Madam C’s husband to equip him with the necessary skills to care for her at home, such as bathing and administering medication. The team also made referrals to the home hospice services to support Madam C and her husband while they were at home.
To capture their last memories together, the care team also organised a photoshoot for the couple and the photographs were used for the card that Madam C made for her husband with the help of the therapist. It was her way of showing her appreciation towards him for his patience and care. On 16 July 2021, she was brought home where she eventually passed away.
“We are glad that we could communicate with Madam C and her family at an initial stage to understand their care preference,” said Wen Yang. Most importantly of all, they were able to fulfil Madam C’s last wish.
Photos: Outram Community Hospital