Palliative Home Care

Many terminally ill cancer patients on palliative care wish to spend the last days of their lives with their families at home, but families are often ill-equipped to provide the level of care required. Realising this need, NCSMSB has been providing palliative home care services for cancer patients since its inception, initially with the help of volunteers, and now with trained and qualified staff.

The Palliative Home Care Team is guided by our Executive Committee member, Dr Tiong Tung Hui, who is trained in palliative medicine.

The Palliative Home Care Team works very closely with Two Tree Lodge Hospice Kuching and Kuching Life Care, to provide more comprehensive palliative care services, with good logistic support.

NCSMSB is only able to accept referrals if the patient lives within a 20km radius from the office. As people move away from the city, we expect a greater demand for our services from the outlying areas.  The service radius may be extended if more resources are made available in the future.

Due to the increasing number of cases and with limited resources, priority for home care is given to those at the end stage of their illness, to provide medical support to the patients and support for their families.

Our home care palliative service is provided free of charge.

The number of home care cases referred to our team has increased significantly between 2017 to 2021 (Figure 1), and the upward trend is continuing. The majority of these cases were direct referrals from Sarawak General Hospital Kuching. Patients with colon, lung, liver and breast cancer made up more than half of the cases referred.

Loan of Medical Equipment

As many patients on palliative care also require various equipment to make them more comfortable, NCSMSB loans out medical devices such as hospital beds, ripple mattresses, commode chairs, wheel chairs, oxygen concentrators etc to our patients. These equipment are either bought by the Society through small grants by the Ministry of Health, or are donated by the patients’ family and the general public.

Between 2017 - 2021, 333 patients borrowed 531 pieces of equipment from NCSMSB (Figure 2 and Figure 3)

The loan of these medical equipment to patients and the general public is free of charge.

Public Education/Awareness

NCSMSB conducts education and awareness programmes on various aspects of cancer. Scientific seminars for doctors and allied health professionals are held at least once a year. Participants are awarded certificates upon full attendance at these seminars to qualify them for their Continuous Professional Development Points ( CPD Points ) to renew their professional registration.

Public Talks and Forums are also organized regularly. These are mainly targeted at the general public. Cancer survivors and families of cancer patients are strongly encouraged to attend. Topics range from the clinical aspects of cancer to more general issues such as diet, exercise, pain management, as well as other issues faced by patients, their carers etc. Information sharing is very much encouraged to further knowledge and understanding of the disease. NCSMSB always tries to select issues that would interest the above audience and to source for speakers that are experts in these fields.

However, NCSMSB had to stop its education and awareness programmes ever since the Covid-19 pandemic. A WhatsApp group chat has been set up to share information and updates on cancer. A Facebook group under the National Cancer Society Sarawak Branch has also been set up to inform the general public of cancer updates and programmes.

Participants at the scientific seminars are charged a nominal fee to cover the cost of organizing these seminars, but the other programmes such as public forums and talks are free of charge.

Training

In the absence of proper palliative academic courses in local and national nursing schools, and the emergence of palliative care as a sub-speciality in recent years, NCSMSB has taken the initiative to train its staff and volunteers in palliative care through workshops and seminars.

Our nurses attend weekly group discussions on palliative care and patient case studies conducted by Dr Winnie Ling, an oncologist with Two Three Lodge Kuching, and Madam Helena Kearsley, a retired UK-trained Palliative Care Nurse Consultant.

They also attend regular discussions with doctors from the Palliative Care Ward, Sarawak General Hospital, on how to best manage their palliative care patients.

University of Malaysia Sarawak (UNIMAS) has selected NCSMSB to be one of their chosen NGOs for their final year nursing students’ attachment. This is to allow these students to gain more insight into hospice care before their graduation. This programme had to be stopped temporarily in 2020 due to the Covid-19 situation in the State.