At Assisi Hospice, we serve over 60% of our patients through our Home Care service, providing a critical option for patients who prefer to and can be cared for at home. Besides our doctors, nurses and social workers, our occupational therapists also make home visits to provide support for our patients and their families.
“Being in patients’ homes help us identify our patients’ and families’ challenges with their activities of daily living, strategise ways to overcome those challenges and ultimately, enhance patients’ abilities to participate in activities which are meaningful to them,” said Ms Celine Yong, Assisi Hospice’s Senior Occupational Therapist.
She shared the story of two patients to highlight the impact of bringing occupational therapy to their homes.
64 year-old Geyabalan S/O K Ramiah (fondly known as Mr Balan) was diagnosed with interstitial lung disease. He used to work as a storeman in Ikea but could not cope with moving heavy objects after his diagnosis as he felt breathless easily. He switched to working at the Ikea restaurant, but it soon became too physically demanding for him as his condition deteriorated. He worked as a Safe Entry staff and eventually lost his job when Safe Entry requirements were removed.
Mr Balan was the sole breadwinner of the family. His wife and caregiver Mrs Balan had Charcot foot, a serious complication that affects the bones, joints, and soft tissues of the foot, and could not stand for long periods or walk long distances. The couple did not have children and were dependent on Mr Balan not only financially, but for running errands for groceries and everyday needs.
When he came under the care of Assisi Hospice Home Care team in January 2022, he was depressed and suffered from insomnia due to the deterioration of his physical condition and the financial burden. He was also stuck at home as he felt breathless and could not walk for long distances. He had expressed his wish to retain his mobility in the community, to enable him to find work or at least continue to get necessities for the family.
After understanding his needs, our care team helped with his application for a motorised wheelchair. Celine, our occupational therapist, trained him to use the motorised wheelchair independently on public transport. The training was done over four sessions, where he first learned how to manoeuvre the motorised wheelchair at the void deck, and next ventured out on the bus and MRT. Journeying with Mr Balan did not just help him maintain his mobility, but lifted his spirits and built his confidence too.
Mr N had been diagnosed with chronic obstructive pulmonary disease. He was in hospital for a long time, but discharged himself against medical advice and went home.
He came under the care of Assisi Hospice Home Care team in March 2022. He had desperately wanted to walk again, but his muscles had wasted away with prolonged bedrest from hospitalisation and he could barely sit up without being extremely breathless and tired. Celine, our occupational therapist, worked with him at his home to improve his stamina and ability to sit. Gradually, he managed to take a few steps with a rollator, but was still very limited by fatigue and breathlessness. They worked together to re-evaluate Mr N’s goal. When Celine realised that Mr N had not been able to get out of the house for over a year due to his prolonged hospitalisation, they aimed for that instead.
Celine said, “It took a while for this to happen because Mr N was very anxious and fearful of becoming breathless while he was out. Some weeks, he didn’t want to move from his bed, literally paralysed with fear, so I just sat with him. I told him that no matter how he was feeling that day, I would show up for him and we would move and go out when he was ready.”
Eventually, Mr N was ready. The first place that they went to was the hairdresser because he had not had a haircut for over a year. They would also sit out at his void deck and enjoy the green space – he loved being in nature and would sleep under the trees.
