Pain management more "valuable" than extending life span: survey

SINGAPORE: A survey on end—of—life care has found that Singaporeans prefer to manage their pain than to extend their life span.

The survey findings were presented by the Lien Centre for Palliative Care at a conference on Wednesday.

A first—of—its—kind study has shed some light on the end—of—life care preferences among Singaporeans.

The survey included scenarios where respondents could trade off some factors against others.

Researchers then pegged a monetary value to various factors by seeing how people would change their course of treatment if the cost differed.

As a result, on average, management of severe pain was valued at S$24,000 a year, while quality healthcare was valued at S$21,600 a year.

An additional year of life was only worth an average of S$9,100 to older Singaporeans, if they were critically ill.

This was much lower than the S$50,000 benchmark used by some countries like the UK when deciding whether to subsidise or introduce life—extending treatments.

The survey also showed that not much value was placed on a caregiver’s time.

Assistant Professor at the Lien Centre for Palliative Care, Chetna Malhotra, said: "Individuals are willing to pay much lower to avoid caregiver burden which was about S$450 a month — almost equal to what they would pay to a domestic helper. Maybe because they think they can easily substitute a foreign domestic worker for a family member or a friend, or they think that providing care for family members is one of the expectations of a child."

But the results of the study may not mirror reality, since the survey was done with people who may not be undergoing end—of—life care.

For one, hospices said they are surprised at the caregiver burden cost, because their patients are usually concerned about being a burden to their family caregivers.

Those surveyed are also more willing to pay for home deaths as compared to dying in an institution.

Dr Akhileswaran, chairman of the Singapore Hospice Council, said: "When we see that healthy people are willing to pay to spend their final days at home, and also willing to pay for a pain—free life at home at the end of life, it gives a positive indication to our national strategy and that’s something we can say we are probably working in the right direction."

A similar study is being conducted among patients with advanced cancer.

— CNA/cc