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The Final Goodbye

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The recently established Palliative Huddle at Bright Vision Hospital, where a multidisciplinary palliative team gets together three times a week to discuss the patients’ previous 24 hours, was instrumental in bringing about an end-of-life couple’s last meeting.

Theirs were two hearts separated by an unfortunate twist in life. The wife in Bright Vision Hospital (BVH) was diagnosed with advanced dementia and cancer, and her husband was receiving treatment for cancer at another hospital. The care team knew that the husband will be admitted to BVH for palliative care and thought that it would be a good idea to reunite the couple. Associate Consultant Dr Loo Yu Xian was the doctor-incharge of the couple’s care.


As a generalist in a community hospital with an interest in end-of-life care, Dr Loo has been caring for palliative patients for the past three years. “We knew her husband was getting referred to us but we did not know the exact day and time. As a team, we kept a look out for this as we knew it would be of utmost importance to reunite them,” he shared. But as time went by, the patient’s condition deteriorated and her husband’s admission was delayed. Things did not look too good with each  passing moment and the team resolved to work together to bring about this reunion.


Using the Palliative Huddle as a platform, the multidisciplinary team updated each other on the situation and made plans to coordinate the reunion by working with other colleagues in the hospital.


They knew that teamwork would be an integral component, and thanks to the combined effort from everyone, the couple eventually met. The team ensured that the admission process went  well, each member of the team contributing their strengths and expertise to the situation.


The wife passed away that very night, but both of them got the chance to say their final goodbyes. The husband was also able to make arrangements for his wife’s funeral.


The team was happy for the couple to have their final meeting, as they could sense the value it had for both of them.


“None of us could have done this alone because of the critical timing. Having the Huddle allowed us to come together and coordinate team-based efforts,” explained Dr Loo.


HOW THE PALLIATIVE HUDDLE WAS BORN

The idea of a Palliative Huddle stemmed from the team’s overseas study trip to St Christopher’s hospice in the UK. While it was not something new, the Huddle was a step-up from what was the norm in BVH.


The challenge was to catch everyone at a common timing, not always easy as the medical, nursing, social work and rehabilitation teams were on different schedules.


“It was not easy to gather everyone. We currently meet three times a week, but our aspiration is to move towards having a daily Huddle.,” said Dr Loo. 


This Huddle ensures that the team would not go more than two days without being updated on how patients are doing. In doing so, the team experience benefits that arose for both patients and staff.


Depending on patients’ needs, with the Huddle in play, the team is able to send the right person to handle the situation. This allows the team to be more efficient in care delivery while also reducing the blindspots to issues that matter most to patients and  families. The Huddle can also be a support platform for members to check on each other, offer support and to spark discussions on how care can be better delivered.


“Patients benefit from the Huddle as the team is empowered to deliver person-centred care. This requires additional effort from every member of the multidisciplinary team, but at many times the reward proves worthwhile, just as it did in this case of reuniting a couple before the final departure."