Assisi Hospice is extending palliative care to non-cancer patients in order to improve their quality of life.
When Dame Cicely Saunders first pioneered the modern hospice movement in the UK in 1967, she started by caring for dying cancer patients. Similarly, the late Professor Cynthia Goh began the first hospice service with the Canossian Sisters at St Joseph’s Home in Singapore, by caring for terminally ill cancer patients. Over time, palliative care has become an integral part of cancer care.
In 2022, only 23.9% of deaths in Singapore were from cancer, whereas 57.7% were from chronic, non-cancer serious illnesses, such as end-stage organ failures in particular (source: Ministry of Health). These include end-stage kidney disease, end-stage lung disease, end-stage liver diseases and advanced neurological conditions (especially advanced dementia). It is only in the recent decade that the role of palliative care has been increasingly recognised for non-cancer conditions. Last year, about a third of admissions into Assisi Hospice’s three services — Inpatient, Home Care and Day Care — were for non-cancers and this is expected to rise in the near future.
Non-cancer patients are often referred earlier in their illness trajectory, so there are more opportunities for Assisi Hospice’s Home Care and Day Care services to improve their quality of life. Last year, Assisi Hospice started to accept selected patients on dialysis into its Home Care and Day Care services, some of whom are struggling with dialysis but are not quite ready to stop. Nevertheless, they benefit from the interdisciplinary team approach to addressing their needs holistically – a few have even improved and have been discharged from Assisi Hospice’s service.
Assisi Hospice also took in more patients with advanced lung disease. This story of Haslina Wannor is a good example of how community palliative care can help such patients live life fully with meaning and joy.
Forty-three-year-old Haslina Wannor used to work as a phlebotomist in a hospital, drawing blood from patients for tests. When she was 27 years old, she was shocked to be diagnosed with systemic sclerosis, which is a rare and chronic autoimmune disorder with no cure. Her condition deteriorated and she developed advanced pulmonary hypertension. Over the years, the disease caused severe scarring of her lungs, and her breathlessness continued to worsen. Currently, she needs additional oxygen supply from an oxygen concentrator around the clock.
In January 2021, Haslina came under the care of Assisi Hospice Home Care service and started receiving regular visits from the doctors and nurses. The Care team adjusted her medication to control her symptoms more effectively. In 2022, she started attending Assisi Hospice Day Care Centre where she benefitted from clinical care and therapy sessions, maintaining her strength as much as possible through strength and endurance exercises.
Being dependent on continuous oxygen therapy, it has been challenging for her to go out on her own, but she enjoys the outings organised by staff and volunteers as she gets to explore different parts of Singapore in a safe manner.
Art therapy sessions and the leather craft interest group at Assisi Hospice Day Care Centre bring the joy of learning new skills into her life. Last Christmas, she created a series of postcards that were printed with her watercolour designs, accompanied by a short sharing of her perspective on hope, resilience and the unexpected wisdom gained through living with a chronic terminal condition. Proceeds went towards Assisi Hospice’s patient care. It gives her great joy to be able to give back. She said, “I receive more than I give.”
Photos: Assisi Hospice