When the time comes for you to leave the world, would you prefer it to happen in a hospital or at home?
That’s the question we will be asking dying patients more often, according to Health Minister Ong Ye Kung.
He illustrated the importance of a “good death” by citing the example of his own grandmother.
Source: National Cancer Institute on Unsplash. Photo for illustration purposes only.
He wishes she had passed away at home, the minister said, saying it would’ve been what she had wanted.
Mr Ong said this during a speech at the 8th Singapore Palliative Care Conference on Saturday (1 July).
In sharing his grandmother’s story, the minister wanted to emphasise the importance of palliative care — improving the quality of life of patients with life-threatening illnesses by addressing issues like emotional and spiritual care, rather than just physical symptoms.
This will provide comfort not just to patients, but also to their caregivers, while also honouring the wishes of the patients.
Mr Ong said his maternal grandmother looked after him when he was a kid.
She escaped her hometown in China during the war and came to Singapore. Thus, she led a hard life that made her very feisty and resilient.
That also meant that she continued her usual chores even at the grand old age of 80, despite starting to feel a sharp pain in her chest.
After being persuaded to see a doctor, she was unfortunately diagnosed with end-stage lung cancer.
The illness meant she had to stay in hospital often, and Mr Ong would visit her.
However, she was apparently unhappy in hospital.
Source: Ong Ye Kung on Facebook. Photo for illustration purposes only.
She would tell him that she wanted to go home every time he visited, he said, adding,
She said that staying at the hospital for one night felt like a month.
Sadly, Mr Ong couldn’t be with his grandma when she passed away.
He was living overseas at the time, and only managed to speak to her over the phone before her death.
Fortunately, she was surrounded by loved ones who had gathered around her hospital bed.
However, his grandma’s passing left Mr Ong with many questions, and he admitted having “a tinge of regret”.
Though she had loved ones beside her, “it would have been better if she was at her own home”, he said, adding,
I had no doubt she would have wanted to go home, even if it was to pass on.
However, nobody knew about palliative care at that time — meaning no one asked her about her last wishes and how she would like to go.
Mr Ong also pointed out another obstacle — for his parents’ generation, it was taboo to talk about death.
However, this is not so true now, he said. Seniors today are much more prepared to express how they wish to leave the world.
He noted surveys that show three in four seniors prefer to pass away at home.
Doctors who’ve posed this question to their patients say that the figure is closer to nine in 10.
That’s why MOH will be making several important policy changes with regards to palliative care, Mr Ong said.
They include strengthening financing support for palliative care and identifying patients with palliative care needs early so they can get a “compassionate discharge” — i.e. when they’re expected to pass on in a week.
“Taboo” conversations about death with patients and their loved ones will also start early so that more of them can plan ahead.
Eventually, MOH intends to reduce the percentage of patients who pass away in hospitals from about 60% now to 50% in 2027.
Mr Ong summed up these efforts by saying that when our life journey ends, how we wish to leave this world is even more personal, adding,
I hope that our collective efforts will allow every Singaporean to live well and leave well, according to their wishes.
The minister’s anecdote about this grandma was indeed touching.
Though it’s not possible to change the past, it’s good of him to honour her by ensuring that others can live out their final days in peace at their chosen location.
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Featured image adapted from Asia Pacific Hospice Palliative Care Network on Facebook and Ong Ye Kung on Facebook. Photo on the right for illustration purposes only.
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