The National Neuroscience Institute (NNI), Singapore General Hospital (SGH), and Temasek Foundation have piloted a new model of care to provide community-based support and intervention for seniors with moderate to advanced Parkinson’s Disease (PD) and their caregivers.
As the disease progresses, persons with Parkinson’s become more dependent on their caregivers, and the burden and stress on the latter increases. The Temasek Foundation Parkinson’s Disease Community Care Programme is tailored to help people with Parkinson’s in the moderate and advanced stage of the illness cope better. The programme includes phone or video consultation and home visits by SGH community nurses. Patients and caregivers can also go to the nearest Community Nurse Post for assessment, training and other assistance.
“Our patients and their caregivers need support on how to manage the symptoms of PD, which can severely affect their quality of life and put caregivers at high risk of burn-out. This community care programme allows the clinical team to monitor the patients’ conditions more closely and provide timely advice and support in between their hospital appointments. We aim to improve patients’ well-being, reduce the need for unscheduled hospital admissions and ease the load on caregivers,” said Associate Professor Prakash Kumar Manharlal, Senior Consultant, Department of Neurology, NNI and lead of the programme.
People with Parkinson’s suffer from symptoms such as slow movements, stiffness and uncontrolled shaking of limbs. These symptoms can be eased with medication but the disease is not curable. As the disease progresses, some people with Parkinson’s may have to take up to 15 pills throughout the day to manage their symptoms, making medication regimes increasingly difficult and confusing to manage. Therefore, helping them and their caregivers understand and manage their complex medication regimes is a key part of the community nurses’ role.
“After the programme was introduced, we have observed that caregivers are now more confident in taking care of their loved ones with Parkinson’s. It also allows patients and their caregivers to raise any medical issues like worsening of symptoms and social issues affecting care, to the community nurses so they can be addressed in a timely manner,” shared Senior Staff Nurse (Community Nurse), Goh Rui Hao, SGH.
About 40 community nurses were trained to perform advanced clinical assessments of the patient’s physical and psycho-emotional health, as well as to reinforce recommended exercises prescribed by therapists to help patients maintain their mobility. The nurses are also equipped to identify movement and non-movement PD symptoms, and look out for changes to patients’ communication abilities.
The Temasek Foundation Parkinson’s Disease Community Care Programme is expected to benefit up to 200 seniors with advanced PD, and 200 caregivers.
Mr Lim Hock Chuan, Head of Programmes at Temasek Foundation, said: “We want to enable seniors to age in place as well as age actively and gracefully. This includes persons living with Parkinson’s. With timely intervention and holistic care for patients provided by trained medical personnel and caregivers in a community care setting, the need for hospitalisation can be reduced. Ultimately, we can help improve their quality of life and enable them to enjoy their golden years with their loved ones.”
Since the pilot started in October 2020, over 180 patients and caregivers have enrolled in the two-year programme, which is available to SGH patients within the five southeast zones served by SingHealth Regional Health System, namely, Tiong Bahru, Telok Blangah, Katong, Chinatown and Bukit Merah. SGH patients with moderate to advanced stages of PD and their caregivers may apply for this service through their doctors.
Among them is 87-year-old Mdm Loke Yuet Moey, who was diagnosed with PD in 2016. Mdm Loke has difficulty walking short distances and the loss of independence has made it hard for her to adjust to life with PD. Now a trained SGH Community Nurse visits Mdm Loke regularly at home and her case is discussed by the multi-disciplinary PD team at SGH. The closer monitoring allows problems to be picked up earlier so timely advice and support can be given in between her hospital appointments. The team has also provided caregiver training to Mdm Loke’s daughter, Mdm Tang, to help her manage her mother’s condition. “I’m very thankful for the support to help my mother maintain her quality of life, and for me to be a better and more confident caregiver,” said Mdm Tang.
For more information on the Temasek Foundation Parkinson’s Disease Community Care Programme and how it has helped patients like Mdm Loke: