The survey, commissioned by the Lien Foundation, also found that cost is seen as a major barrier to accessing these services, with 64% of Singaporeans viewing hospice and palliative care as expensive.
The wide-ranging survey asked a representative sample of 1,000 Singaporeans about their attitude and preferences around death and dying, as well as their levels of awareness and receptivity towards hospice palliative care.
The survey showed that three quarters of Singaporeans (76%) are open to receiving hospice palliative care for themselves and 80% are open to getting hospice palliative care for their loved ones. 71% agreed it is important that hospice palliative care services be made readily available.
The majority of Singaporeans (81%) placed having control over pain relief and other symptom control as one their top priorities at the end of life. However, this was priority was second to wanting to ensure their death would not be a financial burden to family members – the number one priority, cited by 87% of respondents.
Cost of care
More than two in five of those respondents who would not consider hospice palliative care cited high costs as the reason, and more than half of all surveyed (64%) think hospice palliative care is expensive.
80% of all respondents think that hospice palliative care should be covered by medical insurance.
Dr Jeremy Lim, Partner and Head of Asia Pacific Life Sciences from Oliver Wyman, said: “There is a strong case to provide free hospice palliative care in the community. This would minimize patients seeking help in acute hospitals where running costs are high and further adding to bed pressures. It would also meet the wishes of Singaporeans, the majority who wish to die at home where they can be with loved ones in familiar and comfortable settings.”
Place of death
According the survey, 77% of Singaporeans wish to die at home – although government statistics show that only 27% of deaths in Singapore take place at home.
For those who want to die at home, 76% of all respondents would still choose to do so even if there were insufficient support from family, friends or medical professionals. This was especially pronounced for those aged over 60 years old (94%).
Lien Foundation’s CEO, Mr Lee Poh Wah commented: “We will have a greater chance of being able to die at home if our healthcare system is strongly geared towards hospice palliative care and it provides more professional and social support to meet patients’ preferences. A core proposition of hospice palliative care is to empower the dying with suitable care to let them spend their last days where they wish to be. Our health policy needs to contain the institutionalization of death, and increase the proportion of home deaths.”
Awareness and conversations
The survey showed that only half of Singaporeans are aware of hospice palliative care. When asked to define what hospice palliative care is, about a third of respondents could do so correctly.
However, most Singaporeans were open to considering such services upon knowing what hospice palliative care is about.
Singaporeans also have a growing desire for ‘die-logues’ or conversations about death and dying. Even though only half of the respondents have talked about death or dying with loved ones, seven in ten of them (71%) saw the need for national conversations on death and dying. 82% felt the general public needs to know more about hospice palliative care.
Mr Lee said: “The results give positive impetus to the implementation of the National Strategy for Palliative Care announced two years ago. Our society needs more open discussions to make end of life care a real priority. This, along with more accountability from our healthcare system, is needed to speed up the pace of change to improve the quality of death for Singaporeans.”
You can download the full report on the Lien Foundation Survey on Death Attitudes from the Lien Foundation website.