Joanne Chia
GeriCare@North, Alexandra Health System, Singapore
Title: Advance care planning in nursing homes in Singapore
Biography
Biography: Joanne Chia
Abstract
Nursing home residents are admitted to hospitals for treatments that are often distressing and futile. Lack of discussions on end-of-life care and preferred setting of death can lead to unnecessary hospitalizations. This causes more confusion to the elderly, with the elderly dying in hospitals or returning in worse condition than before they were admitted. GeriCare@North program is a partnership between an acute hospital and 8 nursing homes in Singapore working together to enhance the quality of life for nursing home residents by upskilling the nurses in geriatric and palliative care. As part of palliative care, we started training nursing home staff in advance care planning (ACP) in 2014. To date, GeriCare@North has trained staff in 8 nursing homes to carry out ACP discussions with their nursing home residents. The nursing homes are now leading their own ACP discussions. From September 2014 to December 2015, there were 50 deaths with completed ACP. 82 percent of these residents with ACP were able to pass away in the settings of their wishes. While ACP is still in its infancy in Singapore and has yet to gain a firm foothold, initial results show that ACP has an impact on the place of death. With growing awareness and acceptance, ACP can give nursing home residents control over how they would like to be cared for right to the very end.