Taking Better Care of the Dying_Dr Loh Ee Chin
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Transcript of Taking Better Care of the Dying_Dr Loh Ee Chin
Taking Better Care of the Dying
Integrating Care in the hospital, hospice and
home
Dr Loh Ee Chin
Palliative medicine physician
University Malaya
The ideal care model
Essential values in integrated C.A.R.E
•C Communication
•A Attitude
•R Responsibility
• E Education
Public health actions to improve palliative care in Germany:
Results of a three-round Delphi study
• The action ranked highest was "close collaboration between specialist palliative care services, general practitioners and community nursing services"
• Health Policy. 2012 Apr 27.
The dilemma of dying
• Ah Ching
• Advanced leukaemia
• Bilateral pleural effusion
Patient’s concern
• What if my symptoms are not control?
• Who can visit me at home?
• How often can hospice come?
• Is it free?
• My mum does not know------
Mother’s concern
• I am only a housewife
• What if she is in pain again?
• How to take care if she is
not eating much?
Concerns from hospice
• Can we off the pigtail for pleural effusion?
• What if patient cannot be manage at home?
• Send to emergency or direct to PCU
Concerns from hospital.
• Availability of beds
• Needs for regular suction of the pigtail
• Patient’s distress, wish to go home
Shared decision making
Strategy for integrated care
Strategy for integrated care
• Patient focus
• Shared resources
• Shared training and education
• Collaboration
• Inter-team meeting and discussion
Quotes from uncle Lim