More patients in Singapore to receive hospital-level care at home and in nursing homes
A collaboration between NHG Health and social service agency Thye Hua Kwan Moral Charities allows patients to recover in the comfort of their homes, while continuing to receive treatment.
Mr Jiang Tong Kai being assisted by his wife Madam Bey Chin Kiat. Mr Jiang is receiving treatment at home under the Mobile Inpatient Care @ Home programme.
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SINGAPORE: Mr Jiang Tong Kai is back in the familiar surroundings of his home after being admitted to Khoo Teck Puat Hospital (KTPH) for lower limb swelling from fluid retention, constipation and poorly controlled diabetes mellitus.
Although the 82-year-old remains an inpatient, he is now receiving hospital-level care at home instead of in a hospital ward.
Hospital staff briefed his wife Madam Bey Chin Kiat on how to care for him at home. She will be supported by healthcare professionals through home visits, while charity workers will provide daily support.
“At our advanced age, it’s not convenient to travel to and fro. I’m so happy that they can come to our house instead,” said Mdm Bey, who added she used to spend long days in the hospital with her husband.
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The arrangement is made possible under the Mobile Inpatient Care @ Home (MIC@Home) programme, which allows suitable patients to receive treatment at home.
Following a pilot in 2022, the Ministry of Health expanded the care model in 2024. It is now available at all government restructured hospitals, except the Institute of Mental Health.
The initiative is expected to benefit a growing number of patients by enabling them to receive care in the comfort of their own homes, while freeing up hospital beds for those with more complex medical needs.
So far, about 152 patients across KTPH, Tan Tock Seng Hospital and Woodlands Hospital have benefited from the programme. Another 150 patients are expected to receive care under the initiative by the end of the year.
Initially, patients who required help with daily activities needed a caregiver at home to support their recovery. For elderly patients living with ageing spouses or limited family support, that proved challenging.
To bridge that gap, public healthcare provider NHG Health partnered social service agency Thye Hua Kwan Moral Charities (THKMC) in July 2024 to provide additional support in patients’ homes.
The charity’s 60-strong team of care staff visits patients daily for five days after they return home, monitoring vital signs, assisting with medication and wound care, and helping with other caregiving needs.
“We (look) at the diagnosis and what special care that the patients need, and highlight (that) to the care staff assisting the patients at home,” said THKMC staff nurse Norlela Abu Bakar.
Hospital doctors, nurses and allied health professionals will continue to oversee care via home visits and teleconsultations.
“With a familiar home environment with loved ones around them, (patients) can be happier and can make a better recovery,” said Dr Boh Toon Li, senior consultant at KTPH and lead geriatrician for the MIC@Home programme.
Currently the programme is free of charge, but THKMC is exploring a paid version of the service and expanding the service to other health clusters.
SPECIALIST CARE IN NURSING HOMES
As part of the broader effort moving healthcare beyond hospital walls, another initiative is to bring specialist geriatric care directly into nursing homes.
“Seniors already account for about 40 per cent of (all) acute hospital admissions, and many of these are avoidable,” said Dr Sharen Lim, consultant in geriatric medicine at Woodlands Hospital.
Furthermore, Dr Lim said that nursing home residents are admitted at a higher rate than the elderly population in the community, making it increasingly important to strengthen care within these homes.
To reduce hospitalisation among frail elderly residents in nursing homes, Woodlands Hospital piloted a programme at Ren Ci @ Woodlands nursing home, where a team comprising a geriatrician, an advanced practice nurse and a community nurse worked alongside nursing home staff.
The team reviewed residents’ health, adjusted care plans and supported nursing home staff at the facility.
After the one-year pilot involving 300 residents, unplanned hospital admissions and emergency department visits fell by about a third. More than 60 per cent of residents also did not need hospital admissions during the period.
Reducing unnecessary hospital transfers can make a significant difference for residents, said assistant nurse clinician Anushiya Rajendran from Ren Ci @ Woodlands.
“Hospital visits can be very tiring for the residents,” she said, adding that fewer trips to the hospital have also given seniors more time to spend on meaningful activities.
She said that having direct access to specialist support has boosted the nursing home staff’s confidence in managing residents with complex medical needs.
Woodlands Hospital hopes to expand the THRIVE (Transforming Health and Resilience In Vulnerable Elders) programme to more nursing homes beyond Ren Ci @ Woodlands, while building a more sustainable model of care.
Source: CNA/oc(dn)
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