Palliative Care Guide
Home Nursing Care for Palliative Patients
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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.

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
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