Palliative care for dementia patients

It's common for a terminally ill cancer patient to receive palliative care at a hospice.

But doctors and families also want such care for advanced dementia patients. 

Lynda Hong reports.

For the past six years, Stella Lee has been caring for her mother.

Stella explains some of the challenges that come with home care for her mother, an advanced dementia patient.

"This feeding tube needs to be changed every 2 months. So the nurse will come and change. But in an emergency, if she pulls out the tube, I have to do it myself. At the hospital, I was given hands-on doing it. And I've done it a few times. Of course, I'm a bit frightened, but no choice, I've got to stuff it in."

Advanced dementia affects the brain that controls motor capability, causing incontinence and difficulty in swallowing.

These patients are usually bed-ridden, increasing the chances of painful bedsores which can lead to fatal infections.

Geriatric Consultant from Alexandra Hospital, Dr Philip Yap, agrees that home care is best for advanced dementia patients.

"Usually in a foreign environment like a hospital or even a hospice they may not be comfortable and they may sometimes act out with difficult behaviour like shouting, etc. So I think there is a need to develop better home medical care for people with dementia. At the moment, this is provided mainly by our geriatric home based teams. We need more of these teams to deliver such care. "

Dr Yap points out that dementia patients admitted into acute hospitals may be subjected to invasive procedures but what they actually need is palliative care.

"Acute hospital care, which is sometimes aggressive and invasive, may not be the best form of care for persons with advanced dementia. So there is generally lack of palliative care in our hospitals for someone with dementia."

But Dr Yap expects more palliative care to be extended to advanced dementia patients in 10 years, when the number of dementia patients in Singapore is estimated to increase to over 50,000.

That's twice the current figure of 20,000, where it's estimated that one out of five has advanced dementia.