Palliative Care in Singapore: Where, When and How to Get the Right Palliative Care

1. Palliative Care in Singapore

Palliative care is a relatively young care practice in Singapore. Despite being first recognised as an official medical subspecialty in 2006, there has been remarkable progress in making palliative medicine accessible and affordable to Singaporeans. Patients and families can now receive palliative treatment at all government acute care hospitals, a large number of community hospitals, day-care hospices and at home from private palliative care specialists. Patients can also tap into MediShield Life, MediSave, or apply for MediFund and other subsidies for their palliative care needs. 

As the population ages, the need for palliative care is expected to increase. Yet, research revealed that public awareness of palliative care in Singapore is one of the hurdles to receiving adequate palliative care. In our earlier blog article, we covered the basics of palliative care and how it helps with various conditions and stages of illnesses. In this article, we are sharing practical knowledge on what palliative care is and what it is not; where, when and how to get the right palliative care in Singapore, through an interview with Dr. Michael Chong - an experienced palliative care doctor. 

Dr. Michael Chong is the founder and principal doctor of Livewell Medical Clinic, an established family practice GP clinic in Singapore. With intensive medical experience at Raffles Medical as a Physician Leader for the A&E and at HCA Hospice as a palliative care physician, Dr. Chong is well-versed in the palliative care field. 

2. What is Palliative Care? 

Dr. Chong: Firstly, it is a care approach involving a team of medical practitioners which can be extended to include volunteers, not just one doctor or one nurse or one caregiver. Its goal is not only to improve the quality of life of the patient but also that of the patient’s family who deal with an array of problems related to the patient’s illness. The most common problem palliative care addresses for the patient is treatment and management of pain. But there are also many other physical, psychological and spiritual issues that can be prevented and relieved through palliative care. 

Secondly, palliative care is broader than hospice care or end-of-life care. It is true that the need for palliative care service increases as life-threatening illnesses progress to terminal stage, and that palliative care medicine has been developed from hospice care practice. But it is not true that it is only needed for patients with terminal illnesses and approaching end of life. Palliative care can be beneficial for the well-being of patients and their families at every stage of illness; for children, adults as well as elderlies; in hospital as well as at home. 

Palliative care involves a team of medical practitioners including palliative doctors, specialists, nurses, caregivers, even volunteers. It is not just one doctor or one nurse or one caregiver.

Learn more about the distinction between palliative care, hospice care and terminal care and which one is best suited to your situation here.  

3. What are the Benefits of Palliative Care? 

Dr. Chong: Palliative care is not to prolong the patient’s life. The main benefit of palliative treatment is to improve the quality of life. It also aids in the reduction of stress among family members and caregivers. Another objective of palliative care is to help prevent symptoms and complications. The advantages of incorporating palliative care in standard care are well documented and proven

With the main goal of improving patient’s quality of life, palliative care is highly patient-centered. Palliative care team always makes a careful assessment to ensure the benefits the patient receives from palliative treatment outweighs the burden, through collaborative discussion with the patient and family to find out what their care goals are and how best to achieve them in a reasonable way. 

4. Why is Palliative Care Needed in Addition to Standard Treatments? 

Dr. Chong: Palliative treatment is necessary in addition to standard treatment for 2 main reasons.

The first reason is flexibility and timeliness in symptom and discomfort management. Let me take the example of a cancer patient who receives standard care such as chemotherapy or radiotherapy. He or she may develop symptoms or side effects unexpectedly. To see their oncologist, the patient needs to make an appointment which might not be immediate. By the time of the appointment, the side effects may have gotten worse. However, with palliative care, the patient can get access to a health specialist within a short notice. The symptoms can be assessed and managed quickly at their home and prevented from worsening. In short, we co-manage the patient with the doctor-in-charge.

The second main reason is facilitating home care. Some patients prefer to be treated at home. Some might not want to go to hospital at all costs. For this group of patients, home palliative care service is the best option. The palliative care doctor or specialist will come once or twice a week to assess the patient's condition and adjust their prescription. 

5. What are the Different Palliative Care Solutions for Different Conditions?

Dr. Chong: Palliative care solutions are highly personalised. As such, there are different palliative treatments for different patients, depending on their conditions, stage of illness, and their care goals. Palliative care can be provided for patients with serious conditions such as cancer, heart disease, liver disease, kidney disease, or Alzheimer's disease. It can also be offered to the frail elderly who have chronic chewing and swallowing difficulty to mitigate the risk of malnutrition. It can also benefit individuals who are bedridden or suffering from strokes and in need of sympathetic or acute treatment. 

For each patient, we will first evaluate the patient's condition and discuss care goals with the patient and family. Only necessary palliation is provided according to their wishes. For patients with pneumonia or an acute infection, for example, we have basic treatment such as antibiotics and other medications. For patients with advanced cancer, as another example, we can provide painkillers if they are in pain, medicine if they are constipated (both are common cancer symptoms), or recommend oxygen therapy if they are feeling breathless. 

Apart from that, we assist patients with any advice or support they need such as recommendations for daily activity support equipment for the patients or home care services. We can also conduct an assessment to determine whether they are eligible for government subsidies to help with their financial burden, or refer them to other social care services. If counselling is needed, counsellor from the palliative team is available. 

Ninkatec_Conditions that may need palliative care

Find out more about palliative care for specific conditions from our specific articles:

6. What's your Advice for Patients and Families with regards to Palliative Care?

Dr.Chong: Firstly, the patient and family need to understand the underlying condition they are dealing with. For terminally ill patients, coming to terms with the prognosis can be extremely challenging. Secondly, talk to your loved ones about how they want to be cared for, whether they want to receive palliative care at home or in a hospice or in the hospital. Such decision needs to be made before you start looking into palliative care options. If you feel overwhelmed and uncertain whether palliative care suits you, it’s advisable to talk to the doctor in charge or a palliative care specialist. 

Ninkatec and Livewell Clinic collaborate to provide palliative care at home for patients with various underlying conditions. With our remote monitoring technology and extensive palliative care experience, you can be assured you and your loved ones are palliated with the highest quality and attention. Feel free to drop us a message or chat with our care team for any palliative care related questions. 


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