Doing more for the terminally ill
IN TAN Tock Seng Hospital, palliative-care doctors do their rounds alongside intensive care unit (ICU) staff.
Their aim is to relieve suffering and make sure patients die with dignity, even when they are beyond all medical help.
Since a pilot project involving both departments was started in October last year, 123 ICU patients have received palliative care. In the first nine months of last year, there were just 46.
"When treatment turns out to be futile - when we have really tried our best - a lot can still be done to make sure the patient passes on in comfort," said Poi Choo Hwee, a consultant in the palliative medicine department.
The Health Ministry has stepped up efforts to improve end-of-life care in hospices and public hospitals. In July, Health Minister Gan Kim Yong announced a set of guidelines spelling out standards for care, including how caregivers and families should be supported.
At Tan Tock Seng Hospital, many ICU patients are no longer able to communicate their wishes. Instead, doctors speak with family members to understand what they would want.
One cancer patient's family decided to stop aggressive treatment after learning from doctors that such intervention was unlikely to change the final outcome.
"At the end of it, when there's nothing much you can do...the best thing is to give them more comfort," said the man's 38-year-old son-in-law, who wanted to be known only as Mr Lim.
He said that palliative care also helps families come to terms with the death of their loved ones.
The palliative-care team is currently working with the staff at two ICU wards, and has plans to expand the scheme to two more such wards eventually.
It also set up a new 13-bed palliative-care ward in January, in which patients are cared for in single rooms.
Staff there receive training in end-of-life care.
When asked if some families resist palliative care and urge doctors to try and do more, Dr Poi said this was "definitely" the case, adding: "We pace ourselves slowly with these families."