TO REDEFINE END-OF-LIFE CAREGIVING
SINGAPORE – Lien Foundation has partnered HCA Hospice Care (HCA) to launch a first-of-its-kind Day
Hospice, Oasis@Outram, which redefines end-of-life caregiving to focus on the personal growth of not just patients but also the community around them. Established with a gift of S$2.47 million by the Foundation, HCA’s third Day Hospice will officially launch in January 2022.
It leverages design thinking to shift the conventional caregiving model to a progressive one that aims to foster positive connections between patients and the wider community surrounding them such as family members, caregivers and volunteers. With unique and unprecedented hospice facilities such as an open bar, a ‘spalon’ for manicures, massages and haircuts, and community-led programmes, HCA and Lien
Foundation hope to reframe the end-of-life stage in Singapore and internationally as a period of positivity, personal growth, and community support. Oasis@Outram is located within Outram Community Hospital (OCH), enabling patients of OCH to access and enrol in the hospice. This is in support of our national healthcare strategy, which looks to transform care through its integration across providers, moving care beyond the hospital to the community. Oasis@Outram’s caregiving framework is anchored by the three ‘D’s – Dignity, Diversity, and Development. Respecting the dignity of patients is of utmost importance, with all aspects of care acknowledging qualities that make patients unique individuals. For example, patients have the autonomy to choose from a diverse range of activities and programmes at any given time when they are at Oasis@Outram. The caregiving framework also aims to facilitate the development and growth of patients, encouraging them to reflect and find meaning despite facing the end of life. The three ‘D’s philosophy is supported by the environment design of the hospice, which was done by the 2015 President’s Design Award recipient, Lekker Architects.
Beyond functionality and safety, the aesthetically-pleasing design allows patients to derive pleasure from their surroundings and supports a model of care that values patients’ dignity. From the spatial configuration and environment set-up that respects the patients’ personal choice to move through and use the hospice’s space as they wish, to the use of colours and materials that evoke a sense of nostalgia and warmth, Oasis@Outram’s design challenges the conventional hospice concept of utility, emphasising the importance of heartware, in addition to hardware, in a caregiving facility.
The hospice has also developed key service rituals that are integrated into every aspect of the patient's experience from start to finish in collaboration with The Care Lab, an international design studio that looks to reimagine care through design. Led by the 2018 President’s Design Award recipient Lekshmy Parameswaran and László Herczeg, the team specially designed a service journey for Oasis@Outram that facilitates the patients’ development and growth, encouraging them to reflect and find meaning despite facing the end of life.
Examples of key service rituals include the Day Wall, which displays the various activities happening throughout the day which patients have the freedom to partake in, ranging from horticultural sessions to a manicure at the spa, or even a bubble bath at the jacuzzi for children. In contrast to mandatory activities at other day hospices, patients have the option to opt-out of activities if they wish, to spend time with friends and loved ones at Oasis@Outram’s open café and bar area. To create fun experiences for patients through unexpected moments, the hospice introduced the Wonder Cart, a roving cart of excitement and entertainment that is used to celebrate birthdays and liven up everyday activities at the day hospice.
”Concepts like joy, beauty and dignity are not mutually exclusive to the provision of care; they are important aspects of life that everyone should be able to enjoy even at the end of life.”
The hospice’s team of trained caregivers, volunteers, and healthcare professionals facilitate service rituals that help patients to grow and develop, and support them emotionally through facilitating difficult and important end-of-life conversations. The Wheel of Life is an icebreaker conversational toolkit for patients to reflect on how satisfied they are in different aspects of their life currently, and then map out personal goals they want to work towards improving. To facilitate an open discussion about the end of a patient’s life, the Bite Size Future Kit involves an afternoon tea session where a snack or candy will be paired with a card that contains a question relating to end-of-life choices for the patient such as “Are you afraid of being a burden to your family and others?” and “Where do you want to die?”. Patients and their loved ones will then be prompted to discuss difficult but important topics with a trained staff member. The use of such toolkits allow patients to unpack and communicate their needs and desires in a simple and playful way, and helps to foster greater trust between patients, their family members and caregivers.
In addition to its service rituals, Oasis@Outram also hopes to reframe end-of-life care experiences by involving volunteers to run the different facilities and activities. Families and caregivers are encouraged to participate in various activities alongside the patients. This fosters a greater sense of community at the hospice and also allows nonpatients to shift their perception of end-of-life care and death to a more positive outlook that cherishes relationships.
Mr Gabriel Lim, Programme Director of Lien Foundation said, “Oasis@Outram is conceived as a place that celebrates life in the face of death.” Remarking on the design of the centre, he added, "In spaces run by charities, functionality is often prioritised over design. But well-designed spaces can sometimes bring healing and dignity when human companions can’t, especially for social-emotional challenges. We hope Oasis@Outram inspires the design of similar facilities in future."
Ms Angeline Wee, Chief Executive Officer of HCA elaborated, “As Singapore's largest home hospice care provider, HCA has always strived to provide quality comfort and support to patients with life-limiting illnesses. The new Day Hospice at Oasis@ Outram exemplifies our commitment to blaze new trails in the field of palliative care and to add life to the days of our patients. We want our patients to be able to do what they want, when they want and feel the dignity that they so deserve.”
Ms Lekshmy Parameswaran, Co-Founder of The Care Lab said, “Our overall intention with Oasis is to design a service that offers beneficiaries the opportunity to learn and grow even in this final stage of life; to come to terms with their situation, reflect on their lives and focus on doing the things that matter to them and bring them joy. We hope they are able to find closure with family and friends, celebrate the experiences they’ve lived through and ultimately leave the world in peace. Beyond Singapore, we also hope the story of Oasis inspires other systems and care teams internationally, ultimately driving a positive impact to more families around the world.” Ms Ong Ker-Shing, Director of Lekker Architects said, ”Concepts like joy, beauty and dignity are not mutually exclusive to the provision of care; they are important aspects of life that everyone should be able to enjoy even at the end of life.”