Facebook user Isabella Alexandria Lim has expressed her disappointment with Changi General Hospital (CGH) on social media, criticising the hospital for extending “unprofessional, unsympathetic and insensitive” care towards her dying grandmother.
Lim’s grandmother, who suffers from dementia, 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 hereafter instead of improving.
Revealing that “doctors told us that she would most likely die because 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.”
Revealing that she saw “how some of the nurses and doctors were unprofessional, unsympathetic and insensitive towards my grandma and family,” during the time she stayed at CGH daily from 9am to 2pm, between 26 Apr to 3 May, Lim recounted the following incidents she encountered:
“1. Family members not updated with complete information
The first few days after the doctor’s prognosis, my grandma was still fully conscious and could speak. However, she became super unresponsive one day. We asked the doctors why and they told us that they administered morphine to her at 8pm the previous night. Now, why weren’t we made aware? Please bear in mind that my grandma has dementia, cannot speak/understand much English and would not have been able to understand what morphine was or how it could have helped her, therefore would not have been able to consent to morphine. Moreover, once my grandma was on morphine, she never fully regained consciousness until she passed away. I really wish we were at least informed about the morphine administration instead of keeping quiet UNTIL we asked why she was unresponsive.“2. Unsympathetic, insensitive and unprofessional staff
Because my grandma’s body temperature was really low, the doctor recommended a heater blanket to keep her warm. This heater blanket was on for about a week until one morning, we realised it was missing so we asked the nurse where it went. She said that the doctor ordered it to be removed and that my dad was already informed. Guess what? Nobody informed him. My aunt then asked them to put it back on and the nurse told her “Put everyday got cost you know??”, and mind you, this was the first time we were informed about the charges. Regardless of cost, we requested for it again.“On one night, I wanted to ask the doctor whether it was possible to pursue other treatment options for my grandma since she was fighting and hanging on. Unfortunately, my grandma’s primary care doctor wasn’t on duty so an on-call doctor showed up. The first thing she said when she saw me was “I just want to say that I don’t know ANYTHING about your grandmother” while raising both her hands in the air as if I asked her to surrender?? Errr. I understand that as an on-call doctor she may not know much about the patients BUT she could have at least read my grandma’s case file first OR ask me how her condition was instead of making me feel like I was forcing her to answer something against her will. Unprofessional and rude!
“On the same night, my grandma’s heart rate went from 40bpm to 110bpm. I went to the nurse and asked her if she could come over. Guess what? She looked at me in the eye, SIGHED and asked me to wait, turned to her colleague, mumbled something into her colleague’s ears and continued sitting down. Look, I understand if you’re busy, you could have let me know that you’d come by when you’re free, but come on, a LOUD SIGH was really uncalled for. In fact, it made me really angry. Anyways, the colleague that she was whispering to showed up after 15 mins and we asked her about my grandma’s heart rate. Her reply? It “depends on God”. Depends on God??? Are you kidding me. It was then we asked her to call the doctor and the on-call doctor mentioned above showed up. Again when she came into her room, and when we asked her about the heart rate, she raised both her hands up in the air (again) and said “errrr there’s so many of you here” as if we were intimidating her. Most of us weren’t even talking to her, we were just listening and trying to understand. And the way she spoke to us was rude as well.
“4. Refusal of blood test
Despite doctors and nurses saying that my grandma was going to pass in a few hours/1 or 2 days since 26th April, my grandma’s condition seemed to be stabilising so we requested for another round of blood tests to see if there was maybe an improvement or anything that we could have done for her. We spoke to the doctors about this and were denied the blood tests because according to them, “the results will be the same, so no point doing another blood test”. Hmm ok. On 3rd May, the day we transferred my grandma to NUH, they finally agreed to the blood test and we actually found an improvement in her lactate count and WBC count, however, by then her kidneys had already started to shut down. If the blood test had been done earlier when we requested for it, would it have been different? Maybe. Maybe not. But we wouldn’t know because they refused to do it.“5. Poorly run wards
The nurses were not present at the nurse station or the ward most of the time. We always had to wait, had to request for change of diapers, change of position to avoid bedsores etc. there was almost no initiative taken by nurses and most of the time, our family members did everything. We even helped open the doors to the ward (ward 68 is locked and requires a button to open the door) because there was no one available at the reception desk to do so and the doorbell would RING for ages until someone opened the door.
The “lack of care, the insensitive remarks and just overall disappointing service,” led Lim’s family to consider a transfer to the National University Hospital (NUH) several times but the doctors at CGH allegedly denied these requests “stating that “doctors in the other hospital would say the same thing” or “she would probably die on the way in the ambulance” so there was no point.”
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.”
The primary care doctor at CGH also allegedly refused to speak to NUH and CGH nurses allegedly refused to book an ambulance for the family to get to NUH. Lim also alleged that NUH helped treat the severe bed sores her grandmother had suffered while she was in the care of CGH.
Praising the level of care her grandmother received at NUH, Lim wrote: “The service at NUH from the moment we reached the hospital was a complete change from CGH. My grandma was immediately placed under end-of-life care and we were given booklets and guides on how to cope with end of life.”
Expressing her gratitude to NUH for their frequent checks on her grandmother and the staff’s general attitude of care, Lim continued: “The doctors and nurses at NUH are better equipped to deal with families going through a difficult time. They were kind, sensitive and respectful to my grandma (and us) and it felt like they were giving her 100% care even though she was going to pass. They also moved us to a private room.
“The last 3 days of my grandma’s life at NUH was made so much better. She was comfortable and she was treated with respect and dignity, like any other normal patient in the hospital would be.”
Revealing that her grandmother passed away peacefully on 5 May in NUH surrounded by her family, Lim thanked NUH and its staff “for making the last 3 days of her life a much more comfortable one.”
Urging CGH 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,” Lim revealed that despite the allegedly poor service at CGH, her family has to bear a five-figure bill from the hospital. Criticising CGH, Lim 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.”
Lim’s account is not the first public complaint against CGH. Complaints against CGH poured in online, after the hospital was found guilty of negligence by the Court of Appeals, in March.
Singapore’s apex court ruled that CGH was guilty of negligence last week, in a case where a delayed cancer diagnosis had caused a patient’s cancer to progress to terminal stage.
After the court ruled in the cancer patient’s favour, another CGH patient who was suffering from chest pain due to severely blocked arteries revealed online that CGH did not provide adequate care for him and that he was only properly treated at another hospital.
Since this story, several Singaporeans have shared their own experiences with poor care at CGH, on social media. Read their stories here:
-/TISG
https://theindependent.sg.sg/complaints-against-changi-general-hospital-mounting/
https://theindependent.sg.sg/another-patient-accuses-changi-general-hospital-of-inadequate-care/
https://theindependent.sg.sg/changi-general-hospital-found-guilty-of-medical-negligence-in-stage-iv-cancer-patient/
https://theindependent.sg.sg/cancer-patient-who-sued-cgh-for-medical-negligence-for-12-years-and-won-passes-away/
https://theindependent.sg.sg/heartbroken-netizens-urge-cgh-to-promptly-pay-the-parents-of-late-cancer-patient-who-claimed-medical-negligence-and-won/