Singapore

Beer, cigarettes and durians for the terminally-ill

Medical institutions rethinking what constitutes quality of life for patients

Nurses find Mr Klassen Alaric Philip, 80, to be a quiet man. The only time he shows some personality is when he refuses to take his medication.

Otherwise, the bachelor with schizophrenia and lung cancer is mostly in a confused and depressed state of mind.

Last Tuesday, he perked up when he spotted beer in the Treats Trolley that volunteers push around Assisi Hospice.

The trolley contains snacks or drinks for patients and their caregivers to indulge in.

He was offered either Sapporo or Heineken. Mr Klassen took his time to make up his mind before deciding on Heineken.

In under five minutes, he gulped down three cups of beer.

The yellow liquid went down so fast that he coughed slightly.

"Slow down, when was the last time you drank beer?" volunteer Pauline Teo, 70, asked him jokingly.

He told her it was in the 1950s on a plane in Vietnam when he was a soldier with the US Army.

Then he began reminiscing about his days in the army, rare for a man who usually does not even make eye contact.

Last Tuesday was the first time that Assisi introduced alcohol to its trolley, following several requests from patients.

Assisi Hospice chief executive Choo Shiu Ling said: "Patients' wish for specific type of treats such as cigarettes and alcoholic drinks will be granted as long as they are not excessive in nature or detrimental to their current condition. We grant requests that can be unconventional but meaningful for patients."

Medical institutions worldwide, including in Singapore, are rethinking what quality of life means for dying patients.

Honouring the personhood and wishes of these terminally-ill patients can take precedence over rules or convention.

Last month, a Danish hospital broke protocol to grant a 75-year-old his last wishes.

Nurses at Aarhus University Hospital defied no-smoking regulations and wheeled him out to a balcony for a smoke and a glass of cold white wine while watching the sunset with his family. He died a few days later.

Besides Assisi, Dover Park Hospice has also been flexible about offering patients alcohol.

Dover said the last time a patient requested alcohol, volunteers from its "Happy Hour" team obtained some hard liquor for the patient to drink with his son, as that was what they used to do together weekly.

"It is not so much about bending the rules, but rather listening to the needs of patients," said a Dover spokesman.

St Andrew's Community Hospital, which started operating a palliative ward two years ago, allows relatives to take patients to an open area to smoke if they are not on oxygenators.

Patients can also eat "previously forbidden food" like durian and char kway teow. They can have their own pets brought into the ward for a visit, too.

Its spokesman said: "Rules and guidelines are meant to protect and not to restrict a patient's freedom. When it no longer serves its purposes, to insist on a restriction reflects an absence of empathy."

Assisi residents, too, can smoke in the garden. Once, a patient even took a few puffs in his room as he could not be wheeled out. He died hours later.

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