Palliative care – meeting the evolving needs of an ageing society

BY 2030, one in four citizens in Singapore will be aged 65 and above, and palliative care becomes all the more crucial in an ageing society.

Bernie Poh, the chief executive officer of Allium Healthcare, a provider in the aged-care sector, said that palliative care plays a significant role in Singapore’s healthcare system, ensuring those facing serious illnesses receive comprehensive, person-centred care that focuses on improving their quality of life, and supporting their families throughout the journey. 

As part of its 2023 Action Plan for Successful Ageing, the Ministry of Health is working with healthcare and community care providers to scale up palliative care capability and capacity, while also providing better support for caregivers at home.

Poh added: “Overall, the focus on palliative care aims to provide holistic and compassionate care for individuals with serious illnesses, ensuring their comfort, dignity, and well-being during their final stages of life.”

Cultural and language considerations, as well as access and availability, are among the challenges patients and caregivers face when it comes to palliative care.

In Singapore’s multicultural society, palliative care services should be culturally sensitive, taking into account the individual’s values, beliefs, and preferences, said Poh.

Noting that access to palliative care services can be limited, especially in certain areas or healthcare settings, he said: “Equitable access to palliative care across different care settings, including hospitals, nursing homes, and community care, is an important consideration.” 

To deliver high-quality and patient-centred palliative care, he said providers should prioritise several key aspects.

These include adopting a holistic approach that addresses the physical, emotional and psychological needs of patients and their families; ensuring effective communication, with a focus on open and compassionate conversations that respect patients’ values; and expertise in symptom management, which is essential to enhance patients’ quality of life.

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An effective way to meet the evolving needs of an ageing population, Poh explained, is to integrate palliative care into medical and nursing curricula, providing healthcare practitioners with the necessary skills and knowledge to offer compassionate and patient-centred care.

Besides this, interdisciplinary collaboration among healthcare teams can also provide holistic care; and investing in research and innovation can lead to new treatments and interventions to enhance the quality of life for patients with advanced illnesses. 

“Integrating palliative care with primary care can ensure patients receive continuous and coordinated care throughout their condition,” he said.

Poh said caregivers also should not be ignored – providing support programmes can alleviate their burden and enable them to offer better care for their loved ones.

To ensure palliative care is within reach of everyone who needs it, Poh suggested that the government could allocate funds and provide support through financial subsidies, grants and incentives to encourage the private sector to deliver “affordable and accessible” palliative care.

The estimated cost for inpatient hospice care is about S$7,0​00 a month, as indicated by government digital health platform HealthHub.

Public-private partnerships can be formed to establish palliative care facilities in under-served areas, leveraging shared infrastructure and resources, he said.

Integrated care networks can also be developed to ensure coordinated and seamless care across different healthcare settings, with effective communication and information sharing between public and private providers.

Providing a high standard of care can be hampered by manpower challenges. However, to overcome this and ensure an adequate supply of trained staff, Poh listed several measures that can be taken to plug existing gaps, such as:

* Increasing education and training opportunities by expanding palliative care programmes, and providing incentives and scholarships to attract professionals;

* Fostering collaboration by encouraging interdisciplinary collaboration through joint training programmes and shared learning opportunities;

* Raising awareness about the rewards of working in palliative care and its positive impact on patients’ lives; 

* Improving work environment and providing support to staff through enhancing supportive policies, manageable workloads, and resources; and

* Attracting and retaining healthcare professionals with targeted strategies, career pathways, mentorship programmes, and competitive compensation.

Allium Healthcare is a wholly-owned subsidiary of investment holding company GK Goh Holdings.

The company is committed to investing in aged care services, said Poh. It currently runs Allium Care Suites, a specialised care facility at Venus Drive that provides personalised care and comfort for those with advanced illnesses.

Its services and approach are aligned with the principles and goals of palliative care, he added. These include comfort and symptom management, holistic care, emotional and psychosocial support, care coordination, family involvement, and enhanced comfort and quality of life.

“These elements contribute to enhancing the overall quality of life for individuals receiving palliative care,” he said.