Helping People Walk the Last Mile with Dignity

Apair of fighting fish sits in the doctors’ room at St Andrew’s Community Hospital. The fish were the prized possessions of a former patient – who entrusted them to the staff before he died. “It’s the most unusual gift we’ve ever received, and a reminder to the team that in the end, it’s the individual lives we touch that matter,” says Dr Angel Lee.

It’s this reminder that drives the work of Dr Lee, who started her career at Tan Tock Seng Hospital – helping to lay the foundations for end-of-life care there (the first for an acute hospital here) – before moving on to Dover Park Hospice. Currently, she’s the director of palliative care at St Andrew’s, and chairman of the Singapore Hospice Council (SHC) – which coordinates and promotes hospice and palliative care in Singapore. For Dr Lee, the passion to provide quality palliative care is personal. She witnessed it first-hand with her father who, prior to his death in 1982, had a medical team who went the extra mile. The doctor paid home visits when his condition deteriorated, prepared the family for what to expect, and the team comforted them when he died. “As a 17-yearold, I was sad, but never helpless. But I also did not realise then that this standard of care was not the norm, but an exception,” she added.

It’s why Dr Lee and her SHC colleagues, Dr Patricia Neo and Dr Ong Wah Ying, are helping to drive a three-year campaign (a collaboration with the Ministry of Health which started last year) to improve standards of palliative care here. The aim is to help organisations within the sector meet the national guidelines for palliative care. It’s a particularly urgent task, given Singapore’s rapidly ageing population, and the increasing prevalence of cancer. “With more services providing palliative care, it’s important to ensure that the quality of care provided is consistent and comparable across services,” says Dr Neo.

The other aspect of the campaign focuses on getting people to talk about endoflife care at an earlier stage. This includes training health-care workers so they’re better equipped to start that conversation, and developing information kits relating to endoflife care, such as the importance of advance care planning. “Death remains one of the biggest public health taboos that needs to be overcome,” says Dr Lee. Doing so might mean fewer people will die alone and in distress, and instead, have a more dignified death.