With death being a taboo subject in Singapore, conversations about palliative care for the terminally ill tend to remain off-limits until they are absolutely necessary. Dr Andy Lee, acting head of MWS Home Hospice, debunks five common misconceptions his team encounters:
- A hospice is a medical facility to care for patients at their end of life.
The term ‘hospice’ is a concept of care that focuses on improving the quality of life for terminally-ill patients, which can be delivered at home or in long-term care facilities, such as nursing homes. Its aim is to provide a better quality of life by helping patients with their physical, psychological, and spiritual needs.
- The end is near because the doctor and nurses are coming to my home.
Many patients and their families lose all hope and fighting spirit at the sight of the medical team visiting them in their homes. They assume this means that the patients are merely waiting out their days. In fact, the support of the team can help to allay the anxieties of home-bound patients – especially if they are no longer able to visit the hospital.
- The administering of morphine should be started only when the patient is about to pass on, and the drug will make the patient drowsy.
Morphine belongs to the opioid class of medications and is very effective in the management of severe pain and breathlessness. However, bad press related to diamorphine (heroin) has made many patients and their family members very hesitant about morphine. The truth is that morphine, when used at the correct dose, can help to relieve pain and breathlessness effectively without causing undue drowsiness and side effects.
- A patient may get addicted to pain medications, which will lose effectiveness after a while.
Controlling symptoms as a terminal condition progresses often involves increasing doses of pain medications. For example, a growing tumour may cause increasing pain and thus require increasingly higher doses of medications as the condition worsens. This does not mean the patient is addicted, or that the medication is no longer working as well.
- An unconscious patient may feel hungry because he cannot eat.
Our culture views feeding our loved ones and having meals together as acts of love. There is often a lot of guilt within the family as they watch their loved ones deteriorate and eat or drink less. As a patient gets sicker, the organs start to shut down and are no longer able to process and regulate food and fluids. As such, the patient loses his appetite and does not experience hunger pangs.
Debunking these common misconceptions can help relieve the anxiety of patients and their families in accepting home hospice care to improve their quality of life.
By The Methodist Welfare Services (MWS) Communications Team
Photo courtesy of the Methodist Welfare Services