In Singapore, past efforts to develop the capacity and capability in palliative care among health care workers have largely excluded nursing aides, the non-regulated segment of the health care rank and file. More recently, nursing homes in Singapore are eager to use the palliative care approach in the care of the frail elderly. These are largely attended to by nursing aides, supervised by qualified nurses. In January 2010, a part-time 48-h Palliative Care course for Nursing Aides was conducted over 19 sessions. It was designed to prepare selected nursing aides of a nursing home in anticipation of an expanded new residential facility being planned.
A face-to-face individual interview was conducted with the participants 6 months post-course. Open-ended questions based on the learning objectives asked for actual examples that illustrated the application of the new knowledge. Participants gave very heartening narratives that showed understanding of palliative care concepts. For example, one said, the course has ‘opened my heart’; another said she felt she was gave hope to her residents who were depressed and afraid; yet another shared that she was able to show care and lead patient to peaceful death; importance of family involvement and comfort during the last days.
Their supervisor reported observations which indicated positive behavioural changes for example, more observant of patients' symptoms, more interested in learning to cope with complex problems, more gentle with the very frail.
The training was worthwhile when the nursing aides expressed deep appreciation for the learning opportunity which has enabled them to give better care to the residents using the palliative care approach.
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