SMU study shows Singaporeans are more comfortable discussing end-of-life matters

Majority surveyed want palliative care to be made more available

Singapore, 5 October 2019 (Saturday) - A nationwide study which was recently carried out by Singapore Management University (SMU) showed that Singaporeans are now more comfortable discussing end-of-life matters and issues concerning their own death.  The survey found 53.3% of Singaporeans compared to 36% five years ago indicating that they are comfortable discussing this topic, with only 6.6% of respondents indicating that they object to seeking palliative care.  A majority - 82% of respondents surveyed in contrast to 71% five years ago - further expressed that it is important that palliative care be made readily available in Singapore.  This motivation is associated with enhanced attitudes towards end-of-life planning, better understanding of palliative care, increase in knowledge as well as greater receptiveness of palliative care.

The research, which was aimed to better understand end-of-life communication and sentiments towards palliative care in Singapore, was led by Principal Investigator, Dr Yeo Su Lin, Assistant Professor of Communication Management (Practice) at the SMU Lee Kong Chian School of Business.  The co-investigators were: Dr May Oo Lwin, Professor, Wee Kim Wee School of Communication and Information, Nanyang Technological University; Dr Peh Tan Ying, Consultant, Division of Supportive and Palliative Care, National Cancer Centre Singapore; and Dr Raymond Ng Han Lip, Consultant, Palliative Medicine, Tan Tock Seng Hospital.  This study was done in collaboration with the Singapore Hospice Council.

The study surveyed 1226 Singaporeans and permanent residents aged 21 years and above across different age groups and ethnicity over four months from April to August 2019.

Assistant Professor Yeo said, “Our study showed that it is the younger segments of Singaporeans between the ages of 21 and 50 (62%) who are more aware and are better informed of the purpose of palliative care in relieving symptoms and improving quality of life for patients.  Further analyses revealed that digital media have likely helped to open up end-of-life conversations for this group who also tends to be active digital users.  Respondents within this age group who had looked for information on palliative care in the past indicated that medical or health websites, social media and online news were their choice media platforms that they go to when they want to discuss or learn more about this specialised medical care.  Their media consumption patterns are likely to have resulted in heightened awareness and greater appreciation of palliative care.

This is encouraging as conversations on end-of-life care with a larger online social support group would allow them to make better informed choices for their aged family members in the near term and for themselves in the future.  However, while our study showed that they are more aware and also more comfortable talking about their own end-of-life matters, they are less comfortable discussing death with someone who has a life-threatening illness.  This is understandable as people tend to want to be more sensitive to others’ feelings.”

The research also found that 77% of Singaporeans want to be cared for at home when they approach the end of their lives.  Furthermore, respondents indicated that their fears of dying were: 1) being a burden to family members and loved ones; 2) perceived medical costs; and 3) wellbeing of family members after death.  As for Singaporeans’ life priorities at the end of life, they were: 1) ensuring illness or death will not be a financial burden to family members; 2) leaving with the feeling that life is complete with no regrets; 3) to be surrounded by loved ones; and 4) to have control over pain relief and other symptom control.

Assistant Professor Yeo added, “Finding that 77% of Singaporeans wanting to be cared for at home at the end of life is not surprising as past studies have also found similar results.  However, there is a limitation to this research in that it did not seek the views of caregivers.  We only have empirical evidence that showed one side of the equation. Whether patients get to have their wishes fulfilled is highly dependent on their caregivers.  Caregivers’ preferences are often influenced by multiple factors which may include coping and availability of resources as well as strength of relationships between patients and caregivers.  It is a complex interplay of factors which the SMU team will continue to work with the SHC in a follow-up study.”

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