Overview

Hospice and palliative care is a holistic approach to caring for patients going through the last stages of their lives. It aims to meet all needs (physical, emotional, psychosocial and spiritual) so as to alleviate suffering and maximise quality of life for patients and their loved ones. Staff and volunteers work in multi-professional teams to support these patients and their families, and enable patients to live their last days fully.

Definition

Hospices function on the belief that each individual should have a pain-free and dignified death, and that the family of the dying should have support during this difficult period. They provide hospice or palliative care which refers to the holistic care towards patients’ physical, emotional, mental and spiritual wellbeing. Services not only focus on the relief and management of patients’ pain caused by illnesses or treatments, but also facilitate bonding among patients, friends, family and volunteers. While palliative care refers more to hospital-based services, hospice care refers more to hospices’ community-based services.

Situations Covered

Hospice and palliative care is not restricted to any one type of life-limiting illness. Although cancer is the most common ailment of patients receiving hospice and palliative care, patients with any terminal and life-limiting condition can be properly cared for. Palliative care is generally provided for patients who have been diagnosed with just months to live (not years), but it can also be provided for patients in the early stages of their illnesses.

Common Misconceptions

Hospice and palliative care is commonly misunderstood as a service provided for patients staying at the hospice. In fact, most hospice and palliative care receivers are cared for in their own homes. In such cases, a family member is the primary caregiver while hospice staff provide support. Some patients choose to use day care services at the hospice. In such cases, patients are bussed to the hospice, spend the day there involved in various therapies and activities, and are sent home in the evening.

Hospice and palliative care is not as simple as a nurse or nurse aide providing patients with medical and physical care (eg. ensuring patients take their medications, bathing patients, etc). It provides both patients and their families with holistic care and support (eg. pain management, physiological and psychological therapies, coaching on basic caregiving for caregivers, and bereavement counselling). Because of the holistic nature, hospice and palliative care is provided by a team consisting of the patient's doctor, nurses, nurse aides, social workers, counsellors and therapists. Each expertise is called upon as and when their services are needed.

One need not be financially well off to engage the services of a hospice and palliative care team. Hospice and palliative care services are provided at very low costs, and are often covered by government medical care programs in many countries.

Receiving hospice and palliative care does not mean that patients are moving towards death. There have been cases where these patients’ conditions stabilize under the care of hospice and palliative caregivers, and they go on to live normal lives for some years.

Origins

“Hospice” comes from the Latin word “hospitium” meaning “guesthouse”. For many centuries, hospices were known as places of rest for weary travellers. This concept of hospices changed when, in 19th century Ireland and London, a religious order established hospices as places of care for the dying. Then, in 1967, Dame Cicely Saunders founded the modern hospice movement when she set up the first modern hospice, St. Christopher's Hospice, in London.

Around the World

The hospice movement made such great impacts that, today, there are thousands of hospice services in Europe and North America. The modern concept of hospices is also becoming increasingly important in Asia Pacific countries. The Asia Pacific Hospice Palliative Care Network (APHN) was established in late 2001 to link all those who are interested in developing hospice and palliative care services in this region. To date, there are over 800 members representing some 500 hospice services in over 20 countries, including Australia, Bangladesh, Japan, Mongolia, Pakistan and Singapore. The APHN secretariat is based in Singapore.

In Singapore

In Singapore, the Singapore Hospice Council (SHC) serves as an umbrella body that incorporates all voluntary organizations that provide hospice and palliative care. In 1995, SHC was registered with 5 members. Today, it has 8 members whose services include caring and improving the lives of patients with serious life-limiting illnesses, supporting their families, providing caregiver training to family members and volunteers, and raising awareness of hospice and palliative care among public and professionals.

SHC is also actively engaging more doctors in the field of hospice and palliative care. Currently, this is a specialized field practiced by a small group of doctors. Towards this goal, SHC has recently collaborated with Lien Foundation to create the first-ever doctors' and nurses' hospice and palliative care scholarships and fellowships to offer formal training opportunities in this area.