THE report, 'Living the good life, dying a good death' (ST, Sept 8), is a timely reminder to patients and their families that they must prepare to face the final moment of their last journey on earth.
Health Minister Khaw Boon Wan has the onerous duty of making health care affordable in view of the ageing population and ensuring that palliative care is available so the elderly can die with dignity.
A good palliative medicine programme cares for people with a variety of needs. Patients most commonly treated include those with:
Pain or unrelieved cancer symptoms;
Nutritional problems caused by progressive disease;
Psychological distress related to life-threatening disease;
Aids or cardiac failure; and
All stages of life-threatening illness.
Palliative care is the active, total care of patients whose disease does not respond to curative treatment.
The Association for Palliative Medicine of Great Britain and Ireland, formed in 1986, is an association of doctors who work in hospices and specialist care units in hospitals.
It seeks to represent palliative medicine's viewpoint and concerns to the government. The Singapore Medical Council can take a leaf from its book.
The American Board of Hospice and Palliative Medicine was formed in 1995 to establish and implement standards of certification of doctors practising hospice and palliative medicine.
Singapore's School of Postgraduate Medical Studies could introduce an MMed degree for doctors who want to practise hospice and palliative medicine.
Palliative medicine is now recognised by the World Health Organisation. A growing body of literature, the development of national organisations and recognised expertise have given credence to the value of palliative medicine.
Palliative medicine incorporates six major skills: communication, decision making, management of disease-related complications, symptom control, psychosocial and spiritual care, and care of the dying.
When a patient is near or in the throes of death, good communication between clinician and patient helps reduce psychological distress, encourages better compliance and instils realistic expectations.
The family is the primary caring unit for patients with life-threatening illnesses, and patient and family education, counselling and assessment of family dynamics are particularly important.
Nurses giving palliative care should be trained to assess patients' fears and anxieties, provide insight into family dynamics and console the family when death occurs.
