Senior Care Coordinator
Khoo Teck Puat Hospital
Whilst making my rounds in the hospital ward, an elderly patient Mr Yap CM called out to me. Mr Yap had been admitted for hematuria a few days back and the Urology team had pronounced him fit for discharge later that day.
Mr Yap expressed concern over his impending departure from the hospital as he lived alone. His main care-giver, a cousin from Malaysia, would only be arriving in a few days’ time. He had hoped to remain in the hospital’s care till his cousin’s arrival in Singapore.
I brought Mr Yap’s case to the attention of his medical team and highlighted the issues he faced if he were to be discharged before the arrival of the main care-giver. Upon consideration, the team agreed to postpone his discharge to the weekend.
Mr Yap was visibly relieved when I shared the update with him. Thereafter, he went on to share his worries over the daily provision of his meals after his cousin returns to Malaysia. For personal reasons, he declined referral to the Meals-On- Wheels programme.
As such, a home visit to Mr Yap’s residence was in order; an endeavour I undertook in the next few days. I noted Mr Yap would face a myriad of challenges when it came to catering for his own meals in future. His apartment was in a mature housing estate and did not have lift landings on every floor. He would have to make his way down a few flights of stairs and cross a busy road to the nearest coffee shop in order to buy his own meals.
I had the opportunity to meet and speak with Mr Yap’s neighbours during my visit. They asked about his health and well-being and volunteered their assistance in purchasing his daily meals. They also promised to look in on him in the evenings, thereby providing the help Mr Yap would need upon his discharge.
I was very much heartened by the “kampong spirit” exhibited by Mr Yap’s neighbours. I am glad I was given the opportunity to intervene and put in place a few measures before Mr Yap’s discharge and rally the support he would need during his recovery period.
Key Learning Points:
- Case managers can make a difference in a patient’s life when we work with them to explore and come up with solutions.
- Case management is not routine work and sometimes requires us to think out of the box.
- Walking a mile is our patients’ shoes helps us understand and better attend to their needs.