1. Future directions for in-patient care in palliative care service
Cynthia Goh, M.D. (Singapore)
Paper for the Asia & Pacific Region Hospice Network Forum
21-23 Feb 1997 Tokyo Japan
FUTURE DIRECTIONS FOR IN-PATIENT CARE IN
PALLIATiVE CARE SERVICE
Dr Cynthia Goh MB,BS; PhD; FRCP(EDIN)
Medical Director
Assisi Home & Hospice
The development of the Hospice Concept
The concept of hospice or palliative care comes from a variety of people from all walks of life. Not only were doctors, nurses, other paramedical staff, social workers and pastoral care workers involved in the development of this concept of care,but central to it is the perception of the needs of the dying patient himself Cicely Saunders, who is widely accepted as the founder and leading proponent of the modern hospice movement, developed her original ideas for a hospice with a terminally ill patient named David Tasma, who was her inspiration and partner. He was able to share with her his needs as the dying person, and together, they developed this idea of a place which provided the most up-to-date medical care, and yet was also a home, where a person was treated and valued as an individual, as in his own home. Later, other patients whom Cicely Saunders looked after added their ideas. Cicely Saunders gathered around her a group of professionals and lay people called the Foundation
Group, who further developed the idea of the in-patient hospice. After many years of deliberation, discussion and planning, this culminated in the opening of St Christopher's Hospice in London in 1967.
What is hospice palliative care?
Hospice care is a concept of care which tries to provide for the needs of the whole person. Not only does the dying patient have physical needs, which includes adequate food and water, medicines to control pain and other distressing symptoms, such as vomiting, difficulty in breathing or a nasty wound, he also has feelings of loneliness, sadness over leaving his family, and worries about what will happen in the future. There may be financial worries, over medical expenses, the education of the children, or the future income of the family. There may be worries about practical
