APHN Mini Interview Series – Dr Ong Wah Ying, Singapore

September 5, 2017 by Leave a comment

Dr Ong Wah Ying

Dr Ong Wah Ying

This interview is the first of the mini interview series featuring members of the 17th Council of the Asia Pacific Hospice Palliative Care Network (APHN).

In this issue, we are interviewing Dr Ong Wah Ying, the appointed council member[1] from Singapore.  Dr Ong is also the Medical Director of Dover Park Hospice (DPH) and a council member of the Singapore Hospice Council (SHC), the national umbrella body.

What is something about you that will surprise people?

I used to be the squash captain back in high school! People find it surprising because I hardly exercise nowadays. But I still have a lot of hidden energy in me!

You learnt how to cook when spending 6 months (under the Ministry of Health’s Health Manpower Development Plan) with Southern Adelaide Palliative Care services. What was the experience like?

There was a smoke detector in the apartment and the fire engine will arrive if I do any heavy cooking. So I learned how to cook rice using the microwave oven and that is an achievement! I will mix it with my canned tuna and sometimes hard boiled eggs too!

If you were to choose an object to represent the journey in palliative care, what will it be and why?

I would think it will be a rubber band! Sometimes we need to stretch like a rubber band in order to tie things together. But at the same time, we need to be careful not to overstretch till we snap.

In order to do our line of work, we must try. We must go all the way. We are passionate people. Especially during the training years, most of the time we feel like we can do everything. But we really have to learn to find our own limits along the way and find out when to ask for help from team members. Sometimes we do not even recognise that we are fatigued. Many of us, including me, learned this the hard way.

A rubber band will return to its original shape after stretching. So my experience is to do more when it is time to do more and come back to the original shape. Look for more rubber bands if you need strength and learn to shoot if your target is far away!

Do you see any synergies in the roles you play at DPH, SHC and APHN? What are some areas you think Singapore can be more involved on a regional level?

Yes, definitely. I think APHN needs a greater presence in Singapore. It is important for us to be part of the collective voice for important issues, like stating our stand against euthanasia. The local community needs to know that we cannot be isolated. A lot more can be done in terms of bringing information and ideas across and back. We can collaborate to further extend our local education arms.

Having more involvement from medical students, trainees and various levels of staff will give them greater exposure and broaden their horizon. By being part of a common interest group, we can learn from each other, and be more aware of the updates of developments in services, education and research around the region. We can also leverage on existing knowledge and research to share with other countries, such as by hosting people for attachments and visitors from the region.

I believe that Singapore can contribute by sharing our experiences in non cancers like dementia, how we start-up services as well as new discoveries in the field through the APHN dialog platform. In addition to coordinating sharing by experts in our country, we can learn from experts in the region too. This is something I hope to build across the three organisations.

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[1] The APHN Council consists of 7 members to be appointed by sectors on a rotation to be determined alphabetically according to the name of the sectors (Constitution 12.2a), 7 elected members, and 6 Co-opted member.

The article first appeared in the APHN newsletter Issue 33. Read here.
All information is correct at time of publishing.

By: Joyce Chee, APHN Executive

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Singapore Statement

August 31, 2017 by Leave a comment

The Singapore Statement was issued at the 12th Asia Pacific Hospice Conference held in Singapore from 26th – 29th July.

Photo Credit: HPM Global

Singapore Statement

We participants of the 12th International Conference of the Asia Pacific Hospice Palliative Care Network on 28 July 2017 in Singapore,

  • finding that there is a huge burden of unrelieved suffering associated with life limiting illnesses in the region,
  • viewing with concern that less than 10% of those in need have access to pain relief and palliative care globally, and
  • aware of the World Health Assembly resolution of 2014[1] which calls on all member countries’ health systems to integrate evidence-based, cost effective and equitable palliative care services in the continuum of care, community and home based care and universal coverage schemes,

request member states in the region to ensure:

  • adequate funding and effective implementation of national palliative care strategies to implement palliative care in the region,
  • the inclusion of palliative care in non-communicable diseases control programs and in HIV and TB control programs,
  • inclusion of palliative care education in basic education for all health professionals, and
  • improving access to palliative care for children and young people.

[1] Reference: World Health Organisation. World Health Assembly WHA 67.19 Agenda Item 15.5. Strengthening of palliative care as a component of comprehensive care throughout the life course. Available at http://apps.who.int/gb/ebwha/pdf_files/WHA67/A67_R19-en.pdf

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‘Happy Death Day’ – palliative care and death awareness exhibition held in Thailand

August 23, 2017 by Leave a comment

This article was originally from eHospice.

Some 3,300 participants, with another 30,000 people watching the exhibition online, attended the ‘Happy Death Day’ palliative care and death awareness exhibition. The exhibition consisted of various zones, consisted of a talk on how to prepare for death and a ‘Last Talk’ session where people diagnosed with terminal illnesses share their experiences, feelings, hopes and dreams. The second day saw participants reflecting on their lives while lying in a coffin at the exhibition and interacting with speakers, patients, carers and the healthcare team at the ‘Death Cafe’, a casual setting to promote conversations on palliative care or death-related issues.

Read the full article here.

 

An exhibition is an interactive way to promote awareness of hospice and palliative care during World Hospice and Palliative Care Day 2017. Email us at aphn@aphn.org to let us know what activities you will be having to celebrate and support hospice and palliative care.

Filed under ehospice, Events, Home, In the region

APHN statement on our stand against the deliberate ending of life

August 2, 2017 by Leave a comment

The Asia Pacific Hospice and Palliative Care Network promotes access to good-quality hospice and palliative care for all in the Asia Pacific region. We value every moment of life and do not support any action that has the intention of shortening a person’s life. Restoring dignity and enhancing quality of life is the basis of palliative care.

We do not support the deliberate ending of life and we view with concern moves in certain jurisdictions in the region to legalise physician-administered euthanasia and physician-assisted suicide.  Licensing doctors to administer or supply lethal drugs to seriously-ill patients has no place in the practice of health care.  Such moves devalue the dying and undermine society’s responsibility to protect its most vulnerable members.

Australia and New Zealand are acknowledged leaders in fostering palliative care development in the Asia Pacific region. In much of this region, pioneers are struggling to establish good end-of-life services in the face of little political and financial support. Eighty percent of the world’s dying has little or no access to morphine for pain relief.

The United Kingdom, Australia and New Zealand have been ranked as the top three countries worldwide in the 2015 Economist Quality of Death Index. The eyes of the world are on these nations and on how they discharge their responsibilities to dying people.

For those of us trying to improve end-of-life care, licensing doctors to provide or administer lethal drugs to patients poses serious risks of sabotaging efforts around the globe to convince governments that pain relief and good end-of-life care are basic human rights.

The Asia Pacific Hospice and Palliative Care Network appeals to you therefore to recognise your responsibilities on the world stage when considering any proposed legislation before you.

 

Yours faithfully

 

Associate Professor Cynthia Goh
Chair, Asia Pacific Hospice Palliative Care Network

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Thank you everyone for your support. The comments section is closed. You may read the archived comments below.

Comments from the community:

“Thank you for highlighting the risk that legalising assisted dying risks sabotaging efforts to improve pain management, palliative care and end of life care in countries where there is a poor commitment to human rights.”

“The vast majority of patients can die comfortably with good palliative care. Resources are better utilised enhancing good palliative care, rather than developing morally and ethically grey services (Euthanasia and Physician Assisted Suicide) that may only benefit a very small minority. Society should evolve to compassionately care for dying patients, and not evolve towards using euthanasia as a convenient but cold alternative.”

“It is a matter of urgency to stop this move to legalize Euthanasia, whatever else it may be called, PAS or MAID etc.”

“As a specialist physician in Palliative Care for 34 years I have assisted more than 30,000 people at the end of their lives. I have never killed anyone and find the idea abhorrent.”

“Human rights is the right to live till the end”

“We need palliative care not euthanasia”

“I support the APHN statement against Physician assisted suicide and Euthanasia”

“Respecting life is to allow the person to live to the end with holistic support”

“They say assisted dying doesn’t hurt palliative care. Sign up to show you disagree.”

“I fully support the APHN stance on resisting any law change on assisted dying”

“No to Euthanasia and Physician Assisted Suicide! We are committed to the defense of human life from womb to tomb. There is a time to live and a time to die. Let us not artificially prolong nor shorten life or the dying process. It’s all about respect, stewardship, and accountability.”

“To take care of Elders and Sick people is Asian tradition. We should generate multidimensional & creative ways to reduce the sufferings at the end-of-life, not PAS/Euthanasia.”

“End of life care/ care of terminally ill is NOT physician assisted suicide.”

“There can be no guaranteed legal protection for those that are vulnerable against coercion if euthanasia is legalised. The focus needs to be on equitable and good palliative care for all.”

“I wholeheartedly support the invaluable skill and support that is given to patients from our own Palliative Care team. I would also welcome more frontline education given to medical staff to enable more “to get on board with timely and compassionate” patient referrals to the Palliative team. I would also support more funding to enable more frontline staff to be trained and encouraged to “grow” Palliative services in our mainstream hospitals. Thank you”

“Better understanding of palliative care by both health professionals and the community is needed to overcome the myths of euthanasia and the slippery slope of legal quagmire if euthanasia was to be legalised in Victoria.”

“The Chinese word for euthanasia is 安乐死, which literally means “happy death”. However, “happy death” is not the same as “Happy. Death”

“Doctors never kill. Even at the last moment of life has its own values.”

“Palliative care provides comfort for patient till the end of their life, it does not provide comfort to end their life.”

“We need to find better ways to care for human beings that are suffering instead of silencing the sufferer through actions of euthanasia or to provide the means for assisted dying to occur. Fund better care options for the chronically ill and dying – not legislate against the living that are already vulnerable and need care”

Filed under Home, In the region, International

Palliative Care Workshop on Suffering and Hope

July 13, 2017 by Leave a comment

Workshop On Suffering & Hope: 4 – 6 August 2017

 It is inevitable that despite the best of advanced medical interventions, most patients succumb to their life-limiting illness. The burden of suffering may cause despair to patients and their families.

This three (3) day workshop, in collaboration with the Asia Pacific Hospice Palliative Care Network, addresses how to deal with issues of suffering as many may not know how to give hope when all curative treatment becomes futile. It is most suitable for doctors, senior clinicians, nurses, psychologists, counsellors and especially those involved in making crucial decisions when the transitions from cure, to prolonging survival and palliation becomes the aim of holistic patient-centred care.

Please find here, the workshop program and registration form for those who are interested to attend. Registration submission can be made either online at our website: www.hospismalaysia.org or, emailed to: education@hospismalaysia.org or faxed to: 603 9133 3941. For further enquiries, please contact Wai Mun or Ira at telephone: 03 9133 3936 extension 267.

Filed under Home, In the region, Training & Education

How to uphold patient dignity at the end of life

February 19, 2017 by Leave a comment

This article is from Palliative Matters.

According to Dr Harvey Max Chochinov, international expert in dignity and palliative care, dignity is not just a concept associated with managing bodily functions but also a dying person’s perception of how they are seen by others. For people who are dying, they feel a loss of dignity when focus on their illness or disease leaves them with the sense they have been defined generically as a patient and all they have.

The research also shows significantly higher rates of depression, anxiety and feelings of hopelessness in people experiencing a loss of dignity and healthcare workers have a responsibility in understanding the impact of their interactions with patients.

Read the full article here.

 

 

 

 

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Rosalie Shaw Travelling Scholarship for Asia Pacific Hospice Conference 2017

December 13, 2016 by Leave a comment

Rosalie Shaw Travelling Scholarship

Dear APHN members

Greetings to you all!

APHN is pleased to invite applications for the APHN Rosalie Shaw Travelling Scholarship for the Asia Pacific Hospice Conference in 2017. This scholarship was created in honour of our former Executive Director, Dr Rosalie Shaw, to enable APHN members from resource limited countries to attend the Asia Pacific Conference. The successful applicant will receive support of up to SGD 2,200 to fund the conference registration, travel and accommodation.

Eligibility Criteria

  • Must be a current individual member of APHN
  • Nomination supported by 2 other APHN members
  • Display leadership qualities and works in a palliative care service
  • Contribution to palliative care development in your country of work or residence
  • Must submit an abstract for the APHC
  • Must submit a report on the benefits of attendance within 3 months after attending APHC
  • Has not received any grants from APHN for the past 5 years

Preference will be given to members who have not received sponsorship of any kind for attending regional and international palliative care conferences.

Applications must be submitted online here by the application deadline 31 January 2017.

The successful applicant will be notified by email. The disbursement of monies by the APHN Secretariat will be on a reimbursement basis on receipt of original receipts and/or invoices.

Filed under Home, In the region

People with Alzheimer’s need more palliative care support

December 1, 2016 by Leave a comment

From Palliative Care Australia Press Release

Dementia and Alzheimer’s disease are the second leading causes of death in Australia, but patients often miss out on palliative care as they aren’t recognised as having a terminal condition.

Dementia is different from other terminal conditions because of the long, unpredictable course of the disease, difficult issues around capacity for decision making, difficulties in communication and lack of community understanding of the disease as a life limiting illness which requires palliative care.

Because of complications such as these, people with dementia may be unaware of, or denied access to, palliative care services.

Read the full release here.

Filed under Home, In the region

Presentations available for download from 5th International African Palliative Care Conference

November 29, 2016 by Leave a comment

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Download the presentations from the 5th International African Palliative Care Conference, hosted in Kampala, Uganda from 16-19 August today! It is FREE!

The conference programme is available here, with access to corresponding presenter Powerpoints and video presentations, outlined below:

From ehospice

 

Filed under Events, Home, In the region, Resources

Communication – Paediatric Longitudinal Assessment of Needs (PLAN)

November 11, 2016 by Leave a comment

content%202%20-%20jul%20forum1From Lien Collaborative for Palliative Care Newsletter

The Paediatric Longitudinal Assessment of Needs (PLAN) framework, designed and used by the team to facilitate interdisciplinary communication during meetings, was presented at the monthly SHC-LCPC multidisciplinary forum. Mr Desmond Tan, a medical social worker, and Ms Li Kejia Lily, a registered nurse, both are part of the multidisciplinary team at home based Star PALS (Paediatric Advanced Life Support) programme at HCA.

There were five dimensions the team needed to assess.

  1. Physical and nursing care where diet and symptoms needed to be managed.
  2.  Practical and financial aspects such as the equipment loans and financial assistance.
  3. Spirituality for existential issues.
  4. Family and social aspects such as getting community and bereavement support.
  5. Handling grief, including negative emotions

Read the full article here.

Filed under Home, In the region, Paediatric, Training & Education

Barry Ashpole’s Media Watch (#484)

November 2, 2016 by Leave a comment

Barry Ashpole Media Watch

The latest issue of Media Watch, compiled and annotated by Barry R. Ashpole (Ontario, Canada) can now be downloaded here. More reports can be found at IPCRC.NET

Articles from Asia Pacific Region:

Fresh call for improved palliative care in residential aged care

AUSTRALIA | Australian Ageing Agenda – 21 October 2016 – New data released this week showed that among 231,500 residents with completed Aged Care Funding Instrument (ACFI) appraisals in 2014-15, 9,144 residents, had indicated the need for palliative care. Odette Waanders, CEO of Palliative Care Victoria, found the gap between the need for palliative care among the residents and the recognition and response for it is of extreme concern. Qualitative research would be valuable to identify factors for the variability in facilities and for improvement in standards, said Ms Waanders. However, Professor Deborah Parker, director of the New South Wales Centre for Evidence Based Health Care, said it was important to distinguish that ACFI is a resource allocation instrument, not taken to represent the number of residents who require aged care facilities. https://goo.gl/hFcV6C

 Ministry considers program to share end-of-life wishes of elderly with ER doctors, paramedics

 JAPAN | The Japan Times (Tokyo) – 17 October 2016 – There is an increase in elderly terminally ill patients, and doctors have to try to revive them following collapse despite the patients’ wishes, they are unsure. The Health, Labor and Welfare Ministry will back a system that allows nurses, paramedics and doctors who provide home care for elderly patients to share information and makes a record of their end-of-life wishes. “Some fire department officials perform CPR regardless of the patients’ will. We need a guideline,” said Seishiro Marukawa, who heads the panel deciding on the guidelines. He also added that it’s best to respect the will of the patient and rely on their personal doctor rather than ER doctors and paramedics. “Many family members ask us to do everything we can,” Ryota Konishi who heads the emergency room at a hospital in Kawasaki said. “But if they have been bedridden for a long time and have no prospect for recovery, we aren’t sure if life support is the best option.”

 

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Palliative care: The other opioid issue

October 31, 2016 by Leave a comment

From Nature

The ‘war on drugs’ has left many in developing nations with no access to strong painkillers. More than 5 billion people worldwide cannot get the medical opioids that they need. That is a staggering amount of unnecessary agony. – WE CAN DO SOMETHING ABOUT THIS!

Jim Cleary, an oncologist and palliative-care specialist at the University of Wisconsin–Madison – “Patients with pain have been unwitting victims of the war on drugs,” he says. The US-led war on drugs that followed resulted in widespread reluctance to prescribe and supply opioids for fear that patients would become addicted or overdose, or that drug cartels would divert opioids to the black market. Cleary says that countries such as the United States have an “unbalanced” opioid situation, and that abuse in these countries has distorted policies elsewhere, restricting legitimate access.

“It’s about the government and society at large accepting that while we have a responsibility to prevent abuse and diversion of opiates, we also have a responsibility to people in pain,” says former anaesthesiologist M. R. Rajagopal, who is a founder of palliative-care charity Pallium India in Thiruvananthapuram. Read more about the issue here.

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Please also check out “Life Asked Death” developing palliative care in Asia, a film on the Lien Collaborative Project by Lien Foundation and the APHN to find out what we are doing in other parts of Asia to relieve pain and suffering.

Filed under Home, In the region

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