Watching a loved one degenerating is never easy and yet it is a part of life. You do not want to see them go, and yet, you want the process to be as smooth and painless as possible.
Isabella Alexandria Lim and family experienced the opposite of that and had to go through an ordeal during her grand mother’s last days.
On May 13, Isabella posted her recount on Facebook to share with her followers her harrowing experience at Changi General Hospital and express her disappointment.
What Allegedly Happened
19 Feb: Admitted due to fall
Grandma was admitted to CGH on 19th Feb due to a fall at home. At the hospital, she was assessed to have sustained a compression fracture. Therefore, she had to be admitted until she was fit to go home.
During this time, Grandma’s dementia took a turn for the worse which resulted in her crying all day. Sadly, the family was not able to bring grandma home as she contracted Urinary Tract Infection (UTI) during her stay and had to be cleared of UTI first.
4 April: Doctors declare her cleared of UTI
To the family’s relief, grandma was discharged and could finally go home. However, grandma continued to have trouble peeing and had blood in her urine.
7 April: Admitted in the hospital again
This caused the family to wonder if grandma was actually cleared of UTI, to begin with.
18 April: Transferred to Ward 68
Ward 68 is CGH’s dementia ward. This was meant to help to provide a more targetted dementia care for grandma.
Isabella observed that it was at this point that grandma’s condition continued to spiral. Grandma could not eat much and complained of stomach aches. She even vomited blood.
According to Isabella: “The doctors suspected she had ischemic bowel but because of a few reasons (e.g. old age and poor kidney function), a contrast dye scan to confirm the diagnosis and surgery was not an option for her. The doctors told us that she would most likely die because were no other treatment options except palliative care.”
25 April: sad news
The family was informed that grandma only had a few days or a week to live. Isabella struggled to understand how her grandma’s UTI had resulted in her on the brink of losing her life. She was heartbroken.
Isabella’s family decided that they wanted grandma to be as comfortable as she could be. The doctors attempted to feed her via the tube as grandma did not want to eat. However, her body rejected the food and grandma puked. Hence, the hospital stopped feeding her entirely.
‘Due to water retention in her hands and feet, they also stopped the IV fluids completely’.
26 April: Family told that grandma would most likely die that night
Delivered with this bad news, the family prepared for the worse. However, grandma managed to pull through 9 more days without food and water.
A dutiful granddaughter, Isabella, a marketing executive, took time off work to look after grandma.
26 April – 3 May: “Unprofessional, unsympathetic and insensitive towards grandma and family”
During this period, there were multiple occasions in which the quality of care afforded to grandma was subpar.
Firstly, family members were not updated with complete information
It can be very distressing to have a loved one in a critical condition in the hospital. As the family, many would prefer to be given as much information as possible. The awareness will help them cope with their emotions and know what to expect.
Sadly, the family members were not given sufficient updates.
Out of the blue, grandma became unresponsive. It was only when the family questioned the doctor that they were informed that grandma was administered morphine at 8 pm the night before.
This upset the family greatly as grandma could not have given consent due to her dementia and none of the family members was consulted first. To make matters worse, grandma never fully regained consciousness until she passed away.
Secondly, the staff took away the heater blanket without consulting family
Grandma was given a heater blanket to keep her body warm as her temperature was low. This was on for about a week. Then, the family realised that it disappeared one morning. When they asked the nurse, they were rudely replied with “put every day got cost, you know?”
While it is important to make sure that the family members are aware of the cost, additional care should not be taken away unless it is the family’s desire. During this painful time, the cost may be the last thing on one’s mind.
Thirdly, the on-call doctor allegedly washed his hands off her grandma
Seeing that grandma was resilient and hanging on, Isabella wanted to ask if there could be any other treatment options available for grandma.
As the primary doctor was not around, the on-call doctor came in.
Instead of assessing the case and thinking of possibilities, the on-call doctor’s first reaction was to detach herself from the case by saying “I just want to say that I don’t know ANYTHING about your grandmother.”
The doctor was the only one qualified in the room to make assessments on what more could be done, however, she did not seem to be considerate of the family’s concern for the grandma.
As if that was not bad enough, her heart rate went from 40bpm to 110bpm at one point. When she asked if the nurse could come over, she was replied with a loud sigh and she whispered something into her colleague’s ear.
15 minutes later…
The other nurse finally showed up. And when asked what the heart rate meant, the nurse replied that it depended on God.
The on-call doctor was brought in again to give a diagnosis. Instead of tending to their questions on the heart rate, the on-call doctor simply replied “err there’s so many of you here” and raised her hands up in the air.
Fourth, refusal of blood test
Seeing that grandma’s condition appeared to be stabilising, they requested for another round of blood tests but they were declined. When they eventually transferred hospital to NUH, they found out that grandma’s blood count did actually improve.
Last but not least, poorly run wards.
The nurses were rarely present at the nurse station. The family often had to wait, request for a change of diapers or change of position to avoid bed sores. The family eventually had to take it upon themselves to serve the grandma.
3 May: Transfer to NUH
As the family had enough of the poor treatment of grandma. They made the decision to transfer her to NUH.
Here, grandma was finally given the adequate care and attention that she deserved. She was checked at one to two-hour intervals and moved to avoid bed sores. They were given booklets on end-of-life care to know what to expect and to prepare themselves.
5 May: Grandma passed away
I am relieved to hear that at least her last 3 days on earth were better than what she had been receiving at CGH.
Changi General Hospital
CGH has since responded to her post. CGH was ‘saddened by the news of the patient’s passing and empathised with the family’s anguish, but insisted that “appropriate medical care was given during her stay at CGH”.’
They acknowledge the ‘communication gaps’ and hope to improve.
CGH has been coming under fire recently for its slips in care standards.
Earlier this year, a cancer patient won a lawsuit against CGH for a delayed diagnosis that prevented her from seeking the necessary treatment and possibly avoided death.
It is no secret that the medical sector is short on staff, however, as a regional medical hub, it is disappointing to hear of such a story in Singapore.
Palliative care in Singapore
Death is part of life. Like what Isabella said, it should be a process that can be done with dignity.
With an ageing population, it is more important than ever to talk about this once taboo topic.
Here’s a simplified summary of the South Korea martial law that even a 5-year-old would understand:
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