Joanna Chan is a Family Medicine-trained Registrar in the Palliative Care Team of St. Luke’s Hospital in Singapore. She has an interest in research pertaining to
Family Medicine and has many publications in the local Family Medicine Journal in Singapore.
A rapidly ageing population and rising chronic disease burden in Singapore translates to a higher demand for aged care services
, including End-of-Life services. Community hospitals have been recognized as an under-recognized resource with potential to provide the mainstay of support to patients nearing the end of life and their families. St. Luke’s Hospital is a 240-bed community hospital in Singapore. Most of our patients are elderly aged above 65 with multiple medical issues, with a significant number having
life-limiting illnesses. It is also the first community hospital in Western Singapore to have a dedicated Palliative Care Team (PCT).
Aim: We aim to show, via a case series of four patients, examples of how our PCT delivers care to our patients in the setting of a community hospital.
Methods: Our team comprises various medical professionals and allied healthcare providers who work together to provide palliative care services in various settings.
Our Case Series demonstrates that palliative care in the community is varied and meaningful, from managing symptoms such as pain, to dealing with sepsis in end-of-life. At times, psychosocial elements are important as well. They also show that the community hospital’s population of mostly geriatric patients
and location within the community, with ample resources from our
allied health partners, allow us to deliver holistic, patient-centred care in line with patient and family’s goals of care.
We hope to extend our services to include an after-office-hours telephone and home-consult service, partner other healthcare providers such as hospitals and nursing homes to expand our capacity, and to train Geriatric and Family Medicine
residents to be confident of providing End-of-Life care.
Conclusion: The nation's future healthcare plans have recognized the importance of primary healthcare and has committed to building more primary care facilities in the community. This means that citizens will be able to enjoy the comfort of receiving care in familiar surroundings with a supportive community. The Palliative Care Team in St. Luke's Hospital hopes to demonstrate with our model and case series that a palliative care service anchored in the community hospital setting in Singapore can meet the changing
population healthcare demands by delivering, in the context of the patient's bio psychosocial-spiritual context, care that prioritizes quality of life and respects the dignity in dying.
Thomas K. Caring for the Dying at Home. Companions on a Journey. Oxford: Radcliffe, 2003
Engel GL: The need for a new medical model: a challenge for biomedicine. Science 1977;196:129-136. https://www.moh.gov.sg/content/dam/moh_web/PressRoom/Highlights/2016/2020%20Healthcare%20Manpower%20Plan.pdf