Palliative Care Non-Cancer (PCNC) Service for Advanced Pulmonary Diseases
Haven of Hope Hospital

Caring towards a less distressing departure

International medical research shows that patients with advanced chronic obstructive pulmonary disease (COPD) suffer more than cancer patients at terminal stage. Patients with advanced chronic lung diseases like COPD often face a harrowing end to their lives, suffering from pain, shortness of breath, and increasing weakness as pitiless conditions advance. Some even have to rely on oxygen concentrators for the rest of their lives. Haven of Hope Hospital (HHH) addresses patients’ physical, psychological, social, and spiritual needs, providing holistic care in hospital, specialist outpatient clinics and the community to help patients with advanced lung diseases see out their lives in as little distress as possible.

Team leader and Associate Consultant of Department of Medicine Dr Jeffrey Ng says the palliative care team and respiratory team has long identified the needs of COPD patients. So when the Hospital Authority started to develop palliative care for non-cancer (PCNC) patients in 2010, the multidisciplinary team in HHH began providing this service for patients with advanced lung diseases. The team involves palliative care specialists, advanced practice nurses, palliative home care nurses, respiratory nurse specialists, physiotherapists, and a medical social worker.

PCNC service features one-stop outpatient services. Healthcare professionals discuss advance care plans with patients during consultation. To complement drug treatment, physiotherapists use non-drug therapies for breathlessness and other symptoms management. The medical social worker addresses the psychosocial needs of patients and their families. Patients in the community are supported by home care nurses and a hotline service, while patients admitted to HHH receive consultative service from palliative care specialists, respiratory nurse specialists and medical social worker. Team members regularly report on the progress of patients so that everyone designs and adjusts the most appropriate treatment plan for the patient.

The team has so far handled more than 400 cases, with an average patient age of 76. About 80% of patients suffer from COPD with a majority requiring long term oxygen therapy at home and some need non-invasive ventilation. On the result of the team’s efforts, statistics speaks for itself. Between 2012 and 2014, the number of attendance, admission, and patients’ average length of stay all diminished remarkably. Accident and emergency (A&E) attendance among patients dropped 46%, admission through A&E by 52%, and the overall length of stay in acute hospitals and rehabilitation hospitals by 27%.