Living before leaving
An end-of-life roadshow sheds light about palliative and hospice care in light of the lack of awareness.
Only about half of Singaporeans are aware of hospice and palliative care, and the awareness is particularly low for older Chinese, according to a Lien Foundation survey on death attitudes released in April this year. As such non-profit Nectar Care Service Singapore and the HCA Hospice Care launched its palliative care community outreach roadshow at SOTA (School of Arts). The roadshow, which had booths and talks on hospice and palliative care, will continue on to other parts of Singapore including Bedok, Hougang, Woodlands, Jurong and Central Singapore.
Dr R Akhileswaran from HCA Hospice Care.
Palliative care encompasses care from the early stages of a disease while hospice care is care given towards the final stages of the disease. According to Dr R Akhileswaran, CEO and medical director of HCA Hospice Care, palliative care affirms life and regards dying as a normal process; it neither hastens nor postpones death. “It may be provided simultaneously with other medical interventions that treat the underlying disease process, but the intensity of palliative care services provided accelerates as the illness progresses.” He added that with hospice care, the patient has a limited life expectancy and “the goals for care are exclusively to achieve and maintain comfort, regardless of the symptom burden”.
Death a taboo subject
Shared Deputy Prime Minister (DPM) and Minister for Home Affairs Teo Chee Hean at the roadshow, “… death and dying are often considered taboo topics, which we prefer not to think or talk about. Many people never broach such topics with their loved ones, as they are afraid to talk about end-of-life issues. However, this means that important decisions about end-of-life are often made only after a medical crisis strikes, in an atmosphere fraught with stress and worry. This not only causes distress to patients, but also to their loved ones.”
He said that palliative care helps patients spend their last days in comfort and dignity by providing holistic care which includes pain control and symptom relief, psychosocial care, counselling and bereavement support for families. It also reduces fear and anxiety for both the patient and his family. DPM Teo said that every year, about 5,000 to 6,000 patients receive palliative care and with an ageing population, the number is expected to grow to about 10,000 by 2020. These patients could have the illnesses like cancer, renal disease, neurological disease, respiratory disease, heart disease, debility or dementia.
There were a number of booths at the end-of-life roadshow.
He said the Government is aware of this and the Ministry of Health announced its plans to strength palliative care for Singapore in June this year. MOH will make palliative care more accessible by increasing the capacity of both residential and home-based palliative care services. It will enhance the quality of palliative care through the newly-developed National Guidelines for Palliative Care. MOH is also improving the affordability of palliative care services by increasing the Medisave withdrawal limits for palliative care services from June 1, 2015. HCA Hospice Care has also opened its second day hospice centre at Blk 2 Marsiling Drive so more ambulatory patients can be cared for and given respite to their loved ones who might need to work during the day.
Added Venerable Seck Sian Siang, president of Nectar Care Service, “There is a time to be born, and a time to die. Thinking and talking about death need not be morbid; they may be quite the opposite. Ignorance and fear of death overshadow life, but knowing and accepting death erases this shadow. We can be more prepared if we accept this maxim and realise we can’t prevent death. What we can do for our loved ones is to ensure that their final days are lived with love, comfort and dignity.
Speaking openly to loved ones
Venerable Seck Sian Siang of Nectar Care Services.
In her speech, she shared that it is important to be aware of the emotional aspect of the dying process and for caregivers/family members to speak openly with their loved ones at this crucial state of life. She gave her recommendations:
• Thank the patient for being such a wonderful part of your life, and let him know how he has made you a better person. Tell him how much you have always appreciated him for being there for you.
• Tell the patient you love them, and always will. Tell him exactly what it is that you love about him, and how his love has positively affected your life.
• Ask him if there is anything that he would like for you to do for him – if he is able to communicate – whether before or after he has gone. Assure him that you will try your best to carry out his dying wish and follow though on that wish.
• Tell your loved one that it is okay for him to go and that you will be okay. Let him know you will keep living and will remember all the wonderful times that you had together.
Said Venerable Seck, “Once we are able to recognise and embrace this notion, the direction of care changes. The focus is on symptomatic care and the caregiver takes the cue from the patient and his desires. It is also about empowering the patient and the caregiver so both can walk the last journey of life in a memorable, meaningful way.”
Why is there so much anxiety, worry & even pain for one very sick senior person near or just before death ? The main reason is the unknown after death. So, how does one allay the fear of this unknown ?
I suggest, one should have all the info regarding life after death viz eternity . Everyone should carefully plan for one’s eternity after death. It may be futuristic, extraterrestrial & unlikely concepts to comprehend, but it definitely affects every human being, young & old on this earth, including the ones in Singapore. Everyone has to enter eternity after death, whether one likes it or not. However, what credentials does one need ?
Birth & death is part & parcel of human life on earth, just like spring & winter or planting & harvesting cycle. Life goes on & is replaced by someone else. So, if one has done his/her best in life & has prepared well for his/her eternity, he/she will have no angst at all to talk about death.
However, life on this earth is just a fraction ( 100 yrs ? ) of eternity. Is each one of us prepared for eternity or does death end all & everything in this earth & there is nothing else after death. Is it really so? If it is really so, then be it.
However, common sense, logic, conscience & the awe of the universe suggest otherwise. If this is so, should we not prepare for eternity ? On earth, we are very meticulous in acquiring a career, car, house, marriage, etc, so that we have a satisfied earthly life. Then what about one’s eternity ? Should not one be as meticulous in preparing for one’s eternity, which has no end ? Should not one have eternity with bliss with the Creator, rather than His enemy, who comes in many disguises as angel of light ? Should not one investigate how this can be done in this life, while we have all the time to do so ?
Ancient scriptures point to a Creator & this Creator is the God of Abraham, who has been highly regarded by the Jews, Christians & Muslims alike. Can this long history people be wrong ? This Creator also caused only one sinless person in the whole universe history to be born of a virgin birth, to live & sacrifice his life for the sins of the human race & after 3 days, to be raised from death to be with Him to intercede for us, upon one’s acknowledgment & acceptance. So, should not one get reconciled with Him before it is too late ? It is really one’s choice/decision for the type of life one wants for eternity. If there is no eternity, one has nothing to lose, as everything ends here. But, what if eternity exists, then where will one be found ?
When we came into this world, we had no choice for obvious reason, but now that we are matured & before death, we have a choice to enter the kind of eternity: bliss or torment; heaven or hell in all eternity. Can we afford to squander away this choice/decision eternally with no second chance ? Do we want to regret at all for all eternity ?