A descriptive study of the demography, symptomology, management and outcome of the first 300 patients admitted to an independent hospice in Singapore.
The aims of this study were: 1) to describe the demography, symptomology, investigations conducted, non-pharmacological interventions and outcome of patients admitted to an inpatient hospice and 2) to identify the nursing and medical needs of terminally ill patients. Case-notes of the first 300 patients admitted to Dover Park Hospice were studied retrospectively. There were 159 men and 141 women making up 325 admissions. The racial distribution was: Chinese 95.0%, Malays 3.0%, Indians 1.3% and Others 0.6%. Two-thirds of the men (64.2%) had spouses while 44.7% of the women were widowed. The mean age was 64.7 years. The 3 most common cancers were lung (21.7%), colorectal (14.6%) and hepatobiliary (12.5%). A proportion of patients (39.5%) were not known to have any metastases. Most patients were referred from hospitals and the home-care based Hospice Care Association. The commonest reason for admission was for "terminal care" (57.2%). At admission, only 38% of the patients were aware of their diagnoses and prognosis while 30% did not know either. The average length of stay was 25 days with 7.7% of patients having more than one admission. The most common symptoms were pain, anorexia, breathlessness, insomnia, constipation and dry skin. Non-pharmacological interventions ranged from manual evacuation of the rectum to transfers to tertiary hospitals for surgery and other more invasive interventions. Many patients also attended day-care activities (23.1%). Outcome of the 325 admissions were as follows: went home 20%, died in the hospice 73.2%, went home to die 4.9% and others 1.8%.
Low
J A
JA
Department of Geriatric Medicine, Alexandra Hospital, Singapore.
Pang
W S
WS
Lee
A
A
Shaw
R J
RJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006738:Hospices / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D010343:Patient Admission; D010361:Patients / Q000145:classification / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012846:Singapore