Changi General Hospital (CGH) has promised to “learn from” the incident involving an elderly dementia patient who was recently admitted into their care, after the patient’s granddaughter blasted the hospital in a viral post on social media.
Criticising the hospital for extending “unprofessional, unsympathetic and insensitive” care towards her dying grandmother, Facebook user said that her grandmother was admitted to CGH on 19 Feb after she fell and suffered a compression fracture. During her stay at CGH, Lim’s grandmother contracted a Urinary Tract Infection (UTI) and was discharged on 4 Apr.
At home, however, Lim’s grandmother kept crying and still had blood in her urine and experienced trouble urinating. Three days later, she was admitted at CGH once again.
More than 10 days later, on 18 Apr, Lim’s grandmother was finally transferred to the dementia ward where she could receive better care for her dementia condition. Unfortunately, Lim alleges that the situation went downhill thereafter instead of improving.
Revealing that “doctors told us that she would most likely die because there were no other treatment options except palliative care” and that “she would only have a few days or a week to live,” once her grandmother’s appetite declined and she vomited blood and suffered from stomach aches, Lim lamented: “Until now I can’t comprehend how her condition declined so quickly from a fall to UTI to this.” She recounted:
“I was heartbroken. Nonetheless, we wanted her to be as comfortable as she could be. The doctors started her on a feeding tube because she didn’t want to eat but she vomited the food out the first time she was fed so they stopped the feeding completely. Due to water retention in her hands and feet, they also stopped the IV fluids completely.
“On 26th April, the nurse on duty told my entire family to stay overnight as my grandma’s vitals were going down and that she would most likely die that night. My grandma however pulled through for 9 more days without food and water. I stopped going to work so that I could be there to take care of her.”
Recounting specific incidents of allegedly poor care during the time she stayed at CGH daily from 9am to 2pm, between 26 Apr to 3 May, Lim said that her family eventually managed to transfer her grandmother to the National University Hospital (NUH), where her grandmother passed away peacefully.
Urging CGH to re-evaluate their staff training methods and teach them how to better deal with families who are going through a difficult time, Lim revealed that despite the allegedly poor service at CGH, her family has to bear a five-figure bill from the hospital. Criticising CGH. She wrote:
“To be honest, it really felt like the staff at CGH had given up completely on my grandma when they decided to put her under palliative care. Just because she was on palliative care, does it mean that a hospital doesn’t treat her bedsores? Does it mean that they can give her as little care as possible? No. You treat a dying person with the same dignity and respect as you would treat a regular patient.
“CGH, I urge you to re-evaluate your training towards your staff for end-of-life protocols! Learn how to deal with families who are going through a difficult time. Don’t make insensitive remarks like “it depends on God”.
“Most importantly, treat your dying patients with the same respect and care you would give to a regular patient in the hospital. It was heartbreaking to see my grandma in the state that she was during the last days of her life. In fact, I wish we had admitted her to NUH from the start. Now, we have to pay a 5 figure medical bill to CGH for what? Disappointing service.”
CGH has since responded to Lim’s complaint. In a response published on its Facebook page, the hospital said that it is “saddened by the news of the patient’s passing and empathise with the family’s anguish.”
Revealing that the the CGH Medical Board conducted a thorough review of the case after receiving feedback from the patient’s family, CGH said that the Board concluded that appropriate medical care was given to the patient.
The hospital, however, acknowledged that “there were communication gaps which could have been prevented” and that they “could have done better in engaging the different family members and helping them understand the diagnostic and therapeutic interventions by the care team.”
Asserting that the patient’s family was advised on the treatment options and chose conservative treatments focused on alleviating symptoms that caused discomfort instead of invasive procedures, given the patient’s pre-existing conditions and advanced age, CGH indicated that it closely monitored the patient and cared for her adequately while respecting the family’s wishes to minimise disrupting the patient’s rest.
As an example, the hospital recounted: “The patient was assessed to be at risk of developing pressure sores. We promptly took preventive measures which included close monitoring of her skin condition, placing her on a pressure-relieving air mattress and turning her at regular intervals to prevent pressure sores from developing while respecting the request from family members to minimise disrupting her rest.”
In her post, Lim had alleged that the doctors at CGH allegedly denied her family’s requests to move her grandmother to NUH. She said that the CGH doctors stated “doctors in the other hospital would say the same thing” or “she would probably die on the way in the ambulance.”
On 3 May, the family had had enough and transferred Lim’s grandmother to NUH against the CGH doctors’ advice. Lim wrote:
“We had a talk with the primary care doctors and they reiterated that my grandma was on palliative care and they were giving her the best they could. Were they? Were they trying to maximise the quality of life of my grandma during her last days or were they just waiting for her to die???
“We decided to transfer her against the doctors’ advice. We figured that if she was going to pass away regardless of the transfer or not, we would rather place her somewhere where she could receive dedicated care. We were asked to sign a release form stating that CGH will not be liable should anything happen and they kept emphasizing on the fact that my grandma would most likely pass in the ambulance.”
Lim further alleged that the primary care doctor at CGH refused to speak to NUH and that CGH nurses allegedly refused to book an ambulance for the family to get to NUH.
Addressing these allegations, CGH said: “During a subsequent family meeting, the family asked about the process to seek a second opinion at another hospital. The high risks associated with a hospital transfer due to the patient’s condition, was highlighted.
“The family decided to proceed with the transfer and the care team facilitated with a doctor’s letter to NUH Emergency Department to enable continuity of care.”
Apologising for the “anxiety caused to the family,” CGH said that “it would be more appropriate for us to meet with the family to address their concerns, and provide full details of the case,” due to patient confidentiality.
The hospital assured: “We will do our best to learn from this incident and improve our care delivery processes.”
Read CGH’s statement in full HERE.