Palliative Care Guide
Home Nursing Care for Palliative Patients
jagame-masterhead-img
Image Faq

Caring for Palliative Patients at Home in Singapore

Palliative Care is for patients who are critically ill or have life-limiting diseases. The aim of palliative home care is to provide relief and support for patients, as compared to treating the disease aggressively, in the comfort of their own home. At Jaga-Me, we believe in providing a dignified and comfortable journey for palliative patients so they may live their life to fullest.

Jaga-Me’s Nurses will provide a holistic home palliative care plan for your loved one, ensuring a comfortable journey for your care recipient in the comfort of his or her home.

Palliative and Home Hospice Care in Singapore – Providing Hope for Dying Patients

When death comes knocking, how would you like to spend the last of your remaining life? According to a survey done by Lien foundation, 70% of Singaporeans wish to be cared for in the comforts of their own homes when they reach the end of life – also known as home palliative care.

Palliative and Home Hospice Care in Singapore – Providing Hope for Dying Patients

Differences Between Institutional and Palliative Care at Home

There are certain key differences between home care and institutional care in Singapore. Palliative care at home differs from facility-based care in the way that they are able to provide patients with a greater sense of independent living and comfort in familiarity. Indeed, being taken care of in a familiar environment with access to advanced medical facilities would enable more quality, round the clock care provided by trained and skilled nurses. Professional caregivers can take over laborious tasks such as feeding, bathing and clothing at home while family members can get a peace of mind with the additional help they can get while they are still learning and adapting to being caregivers. Institutionalised hospice care is probably needed if the patient requires more holistic and extensive care that family members are unable to fulfil.

However, for terminally-ill patients already struggling with the news of their pessimistic prognosis, is moving into an entirely different and regimented environment – without the warmth and familiarity of family, really a better option?

How Home Care Services Can Help Alzheimer Patients’ Caregivers

Today, the advent of nursing homes, hospices and elder care facilities that provide professional care and ensure safety standards have greatly made ageing easier. Increasing affluence has also enabled aged care facilities access to proper meals, professional health services, and staff to keep the elderly active with community activities at these facilities.

Yet, most still consider modern old age homes terrifying, bleak, and even an unpleasant place to spend the last phase of one’s life.

This is because the difference between an institutional care facility and a home, is that an institutional care facility “just isn’t home“.

Differences Between Institutional and Palliative Care at Home

When to Consider Home Palliative Care

Living in an institutional care facility in Singapore can feel like a loss of independence and ownership for many patients due to them being subjected to a more structured lifestyle regime in the institution. For example having to adhere to consistent bath timings and having the same variety of meals repeatedly. By relishing control of your own life, you do not get to choose what is good for you, even at your end of life. Losing control and individuality of your own life can feel constricting and suffocating. And think about it, do the elderly in aged care facilities really feel more support being in a community of others “in the same situation”? Or do they feel more negative and pessimistic?

Which is why palliative home care which provides help in activities of daily living and medical care to your doorstep, can provide a hopeful alternative option for terminally-ill patients who wish to be at home at their end of life.

In such home palliative care services, caregivers improve the quality of life of patients by meeting their physical, emotional, mental and spiritual needs all in the comforts of their own homes. Home care aides and nurses provide a range of home palliative care services focused on relieving a patient’s symptoms and pain, to day-to-day activities such as feeding and showering. They also provide caregiver education for family members and counselling sessions to prepare family members in times of need.

There are 6 home hospice providers in Singapore, which serve a total of about 5,500 patients, many of whom enjoy free nursing at home and home medical visits. However, these periodic visits are limited by time. Beyond 3 hours of consultation a week, patients’ families have to find other ways to bear the burden of care. Home care platforms can help provide convenient and fast access to healthcare. There are many palliative home care platforms in Singapore that can provide you with on-demand home care services at the click of a mouse. With a medical professional within reach and guiding you along your caregiving journey, patients and families can then get the assurance they need. Of course, quality of staff and experience with palliative care are factors that make a difference to families’ peace of mind.

Terminally-ill patients often lose their sense of pride and dignity when they fall too sick to be living independently, causing them to have to depend on others for the simplest of tasks such as bathing and eating. Yet, it is this dignity that patients seek most as they conquer the final lap of their lives.

As Dr Chong Poh Heng wrote on Channel NewsAsia, “Death is real, but so is hope. When one struggles with unrelieved pain from progressive disease, the will to live can only wane.”

Therefore, home palliative care improves the quality of life for terminally ill patients by giving them the option to lead the rest of their lives at home freely, and with dignity. We’re glad, that the advent of home care services really do provide hope and comfort for patients with the wish to be home at their end of lives.

When to Consider Home Palliative Care

Pain Management

Our Jaga-Me Nurses (JagaPros) will administer medication to patients based on the level of pain they are experiencing. The administration of non-opioids/opioids medication will be tailored to relieve the level of pain the patient is experiencing. Opioids are drugs that act on the nervous system to help relieve pain. Our JagaPros can step in to administer drugs that are injectables (injections) when the patient can no longer take medications orally.

 

Managing Effects of Strong Opioids

  • Constipation – Use Appropriate Dosage of Laxatives
  • Nausea – Anti-nausea drugs can be used to combat nausea symptoms
  • Drowsiness – Reduce dosage of opioids. Just inform our nurse!

 

Seek advice from your nurse or doctor on how to manage and alleviate discomfort for your loved ones. The effects of opioids can vary for different individuals.

Pain Management

Wound Care Management

Our JagaPros will assess the wound before taking the necessary action to address the wound. Wounds can become chronic if it is not healed properly. Chronic wounds cause discomfort when it develops into an infection caused by other medical conditions such as diabetes or poor nutrition. It is imperative for caregivers to understand that wound care is vital to prevent infection and discomfort in palliative patients. Wound care management improves quality of life as it eliminates discomfort and pain for your loved ones.

 

Wound Dressing Products We Use

Wound Dressing Set

  • 1 Tray with built-in gallipots
  • 4 Non woven swabs
  • 3 disposable forceps
  • 2 patient drapes
  • 6 cotton balls
  • 1 hand towel
  • 1 Limpet bag

Saline Solution

  • A cleansing solution for wound dressing
Medication
  • Recommended medicine by doctors to promote healing

 

Adhesive Tapes

  • To secure the wound dressing

 

Our JagaPros will select the type of wound dressing based on the assessment of the type of wound the patient has. Be assured that every care received by the patient is personalized and tailored to suit the caregiver and patient’s needs.

 

Wound Care Tips

  1. Ensure hands are washed thoroughly before commencing wound dressing.
  2. Loosen patient’s dressing. After loosening the patient’s dressing, wash hands again.
  3. Open the clean dressing set. Hands should be washed again after opening the set.
  4. Dry hands using the hand towel from the dressing set.
  5. Use the disinfected forceps without touching the ends of it that hold the gauze.
  6. Pour the recommended amount of cleansing solution on the gauze.
  7. Use the forceps to pick up the old dressing. If the old dressing is dry, soak the dressing with saline water before proceeding.
  8. Use only 1 gauze for every stroke of cleansing and throw the gauze after each use.
  9. Observe the gauze for any blood, pus and odour. Check the colour of the blood and pus as well.
  10. Observe the wound size and depth of the wound.
  11. Apply dressing to the wound.
  12. Secure the dressing with adhesive tape.
  13. Throw all dressing products wrapped in a plastic bag into the bin.
  14. Inform your nurse/doctor if the patient is experiencing fever, excessive pus, blood, odour or experiencing pain.

Pressure Ulcer Management

Pressure ulcers are a common occurrence for palliative patients who are immobile. Palliative patients are prone to dry skin and this encourages the development of pressure ulcers. Thus, pressure ulcer management is key to ensure the comfort of your loved ones. Our JagaPros will ensure that preventive measures are taken to avoid the development of pressure ulcers.

 

Ulcer Prevention

 

 

Ulcer Treatment

Our JagaPros will set and personalise treatment goals for the patient. Our nurse will conduct an assessment and a reassessment of the pressure ulcer wound before each dressing change. Our nurse will also determine the level of pain and administer pain medication accordingly.

The wound dressing will be selected based on:

  • Keeping the wound area moist
  • Chance of bacterial growth
  • Presence of odour
  • The condition of the skin tissue
  • The size, depth and location of the wound
  • The presence of wound tunnelling
  • The individual patient’s need of care

In addition, our JagaPros will inform the patient and family about what skin condition changes to look out for, and how to map the plan of care accordingly.

Pressure Ulcer Management

Simple Home Oral Care Management

Many palliative patients suffer from poor oral health because of the misconception that oral care should only be maintained when food is consumed. In our experience, we believe it is important for palliative patients to maintain their oral hygiene. The mouth region is the gateway to our internal organs. Therefore, it is necessary to keep the patient’s mouth clean and bacteria free. Although saliva helps to clear bacteria from the mouth, saliva flow might be affected due to consumption of medication. This will result in bacterial decay in the patient’s mouth. Thus, oral care is vital for palliative patients as it helps prevent pneumonia and gum diseases.

 

Oral Health Tips

Check with our friendly JagaPros when you engage our services if you have any queries about the necessary oral care for your loved ones. Alternatively, clarify any doubts you have about oral health with your nurse/doctor.

 

 

Oral Care Products

Simple Home Oral Care Management

Active Dying Phases

Dying is a natural process in life. Thus, we always strive to ensure that our loved ones will have a comfortable journey towards the end. It is vital for caregivers to recognize the symptoms of a patient actively dying.

 

Not eating/drinking

Many caregivers often panic and force feed their care recipients when they stop eating/drinking. This is a natural process of the body shutting down. 

 

Swallow reflex affected

If a patient starts to cough when given food/fluids, it shows he has little to no swallow reflex. It is important to call your nurse/doctor when your care recipient shows signs of this. This indicates that the patient needs to have their medication (e.g. pain medication) injected by a professional nurse/ doctor instead of taking them orally. Jaga-Me provides professional service for injections. If you need professional help to administer injections for your palliative patient at home, check out our Jaga-Me website for more information on how you can engage our nurses to perform these procedures.

 

Breathlessness

Patient breathing becomes shorter and he/she may start to pant. This is known as Cheyne Stokes breathing. It is where a patient’s breathing may suddenly stop and restart again. Do not panic when this happens as it is a normal symptom of a patient dying.

 

Sleeps more often

The patient might sleep more and may even be drowsy when awake. This might be a result of opiates being administered to the patient. Check with your doctor/nurse in regards to medication.

 

Skin colour & body temperature changes

The skin around the patient’s fingers and toes might look blue (known as cyanosis). This happens because the body is conserving energy for core functions instead. The colour of the patient’s skin might turn grey as well. The temperature of the patient’s body will be cold and there might be some swelling on the patient’s hands and feet. This is known as oedema.

 

Hallucinations

Your loved one might experience hallucinations. This is caused by the body’s chemical imbalance. Ensure that family members are there to reassure the patient. Holding your loved one’s hands or gentle stroking will help him/her feel calm and assured. Putting on soft music in the room will also be helpful.

Emotional Support

It is imperative for caregivers to understand the procedures and treatments used in palliative care. Our nurses will be there to explain the treatment and care procedures to you every step of the way. It is also important for caregivers to understand their own limitations and seek help. Our JagaPros will provide you with companionship and a listening ear. We will be there to relieve any sense of helplessness you experience on this journey.

Jaga-Me Can Help

Caring for an end-of-life loved one is not an easy task. Let Jaga-Me ease your burden. Book our services or call us to find out more about our dementia day and home care services in Singapore.

Why get caregiving services at home?

Post-hospitalisation care
Post-hospitalisation care
Receive expert care during this crucial time to ensure a proper transition from hospital to home
Alternative to nursing home
Alternative to nursing home
Spend extra time with your loved one by getting the necessary care in the comfort of your own home
Caregiver support
Caregiver support
Let our professional JagaPros care for your loved one while you rest and recharge
When the helper is away
When the helper is away
Get the professional support you need when your domestic helpers are away
Get Care Now!