Hospice care in Singapore

My friend’s sister passed away a few months ago, 15 years after she first contracted breast cancer. When her cancer returned for the third time and affected her liver, she decided to forgo the chemo treatment which would not guarantee a cure and would have cost $6000 per treatment.

Her sister continued working. Her company supported her throughout her illness, giving her ample time off for medical treatment.

In January this year, the doctor recommended hospice care. My friend’s sister could either be warded in a hospice or remain at home. My friend chose to have her at home, taking turns with the rest of her family to take care of her jaundiced sister.

My friend, like many of us, did not really know what hospice care means. Sure, we all know dying patients live out their remaining time in a hospice but what do hospice care entails exactly?

Immediately after being recommended for hospice care, a nurse, sometimes accompanied by a doctor, made weekly house call. They helped the patient with pain management, teaching the caregiver to look out for symptoms associated with the drugs, thus making the patient as comfortable as possible. They recommended a hospital bed, provided free but was rejected by the patient. In fact, the patient was quite uncooperative and refused to answer many questions pertaining to her pain suffering. The caregivers though, felt comforted by the hospice’s visits and gradually grew more confident in taking care of their love one.

Once in February, the patient grew breathless. It was a Sunday and in a moment of panic, my friend called the ambulance. The patient was put through 4 hours of wait at NUH, the nearest hospital, before transferring to SGH, her usual hospital where she waited a further 4 hours. When she was discharged the next day, my friend learned from the hospice nurse that she could have call the hospice hotline any time, 24 hrs, 7 days a week in any emergency. Sending her dying sister to the hospital would only contribute to her suffering as there is nothing the hospital could do.

The hospice care visits grew more frequent from two to three times a week, as unknown to the family, her sister’s condition had deteriorated. The family was sceptical that the end is near, for her sister could still chat and walk aided.

Two weeks before her death, the patient finally agreed to a hospital bed, which alleviated her breathing from her failing lungs. The caregiver was given a set of notes to look out for sign of impending death. They were thought to count the number of breaths per minutes taken by the patient. They were also told to arrange for any final visits by relatives and friends if they so wish. Thus, during her last days, my friend’s sister, now free of pain, entertained streams of visitors, chatting with long-lost classmates, colleagues, and relatives.

She went to bed after 10pm on 3 March after seeing her visitors off. Four hours later, the family discovered that she has passed on, with a smile on her face.

My friend related the story to me, with deep gratitude to the staff at the hospice care. She was also happy to know that although difficult, taking care of her sister during the last few months was both rewarding and comforting. The family bonded together, from her aged parents to the young nieces and nephews, to ensure her sister’s comfort during the final days.