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Public understanding of palliative care still lacking

While the vast majority of Singaporeans correctly identify palliative care as relieving the suffering of people with a serious illness, a recent survey found that many still mistake it as primarily care of the dying.

Less than half of those surveyed understood the full scope of palliative care, which is to improve the quality of life and provide relief to anyone suffering a serious illness that is not necessarily terminal.

The Pulse on Palliative Care commissioned by family foundation Lien Foundation included a quiz to test public knowledge of palliative care here.

While over 80 per cent of respondents correctly identified the aim of palliative care as to maximise quality of life, and to help whole families cope with serious illness, less than half had a full understanding of its scope.

Some 62 per cent had the misconception that palliative care is restricted to the last six months of life, and 56 per cent held the belief that it is exclusively for the dying. Additionally, 48 per cent had the misconception that choosing palliative care would mean giving up on other medical treatment.

Data and analytics firm Kantar conducted the online survey in July 2024 on a nationally representative sample of 1,000 Singapore residents. It comes as Singapore ramps up national palliative care capacity, with the number of palliative medicine physicians almost doubling from 47 in 2014 to 88 in 2024.

The findings were shared with the media at an event held at Lien Foundation’s office on Oct 9, where doctors also engaged in a panel discussion on palliative care.

In Singapore, palliative care is often started very late in an illness, with the overall median duration of palliative care from referral to death being 22 days. Non-cancer patients tend to access such support much later than cancer patients, with just nine days of care, compared to 33 days for those with cancer, according to data from the Singapore Hospice Council.

While seven in 10 respondents had heard of palliative care, only 31 per cent claimed to know what it is about, with another 39 per cent saying they knew little about it. The most common source of information was through personal connections, followed by the mass media, and medical professionals.

The 2024 survey, which was also conducted in 11 other markets in the Asia Pacific region, found that overall awareness in Singapore still lagged behind countries such as Thailand, Australia, Vietnam and Japan.

In spite of this, most of those who received palliative care have had positive experiences. Of those who knew someone who has experienced palliative care, 71 per cent rated the service as good or extremely good.

Additionally, 64 per cent of all respondents in Singapore found palliative care moderately to highly accessible.

There are growing efforts to ramp up palliative care earlier in the disease trajectory. For instance, the Lien Foundation partnered Tan Tock Seng Hospital to launch the Air Master service in November 2023, which includes cardiopulmonary rehabilitation sessions.

The service has helped more than 70 people with chronic heart and lung conditions manage their breathlessness, anxiety and other symptoms, enabling them to remain independent, slow functional decline, and avoid unnecessary hospitalisation.

Mr Lee Poh Wah, chief executive of the Lien Foundation, said: “People often associate palliative care with care for the dying, overlooking its broader scope to relieve symptoms and enhance quality of life throughout an illness trajectory.

“Patients and caregivers may hesitate to seek palliative care because of stigma and the mistaken fear it is akin to giving up on treatment and hope.”

He added that palliative care is often underutilised and not well integrated with other medical specialties, except for oncology.

“More value can be unlocked if we apply palliative care early, alongside life prolonging or curative treatment, as an extra layer of support for patients to prevent unnecessary suffering.”

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