Page 6 - TERMINAL DISCHARGE GUIDELINE FIRST EDITION 2023

Chapter 1
Foreword

Foreword from National Head of Service Palliative Medicine
Ministry of Health, Malaysia

Caring for the terminally ill is never an easy task and while clinicians often

find themselves in challenging situations to maintain comfort and dignity
for patients, family members face even more challenging times as they
strive to fulfil their dying loved one’s final wishes. Among these wishes,

majority of patients who are aware that they are facing the end of life often
request to spend their final days or hours at home as this is the place they
feel most at peace and familiar with. Family members also find the home

to be a more personal and private space where they can be free to support
their dying loved one. While many patients want a home death, families
are often reluctant to have the patient at home as they fear the person will
be in pain and very uncomfortable. They also fear that they would not have

the appropriate know-how to care for the person at home. This is where
the healthcare-system needs to be more supportive towards families of
patients at the end of life.

To have a peaceful and comfortable death at home is truly a blessing and
while this was more common prior to the 1970s, as the field of modern

medicine evolved with more technology and advanced interventions in
critical care / acute medicine, the number of patients with terminal
illnesses began to shift towards deaths in hospitals where acute medical

interventions are applied all the way till death. With the development of
palliative medicine, better clinical decisions at the end of life are now being
made and families are given a better understanding of prognosis and the

benefits or futilities of interventions. Families are now better equipped to

HOSPITAL KUALA LUMPUR 6
TERMINAL DISCHARGE GUIDELINE 2023