Evolution of a hospice home care service in Singapore.

The hospice movement in Singapore was started in 1985 when St Joseph's Home opened its doors to terminally ill patients by setting aside 16 beds for hospice care. A newspaper article about this work brought together a group of volunteers who started a hospice home care service under the auspices of the Singapore Cancer Society in 1987. This service was originally entirely staffed by volunteers until a charitable foundation made possible the employment of a nurse coordinator in 1988. Nearly two years later, in December 1989, the Hospice Care Association, a new charitable organization specifically devoted to the promotion and provision of hospice care, was formed. With charitable funding from the community, the new organization built on the experience of the volunteer-run hospice home care service and developed it into one in which professionals provide most of the care, supported by volunteers. Full-time staff were responsible for the day-to-day running of the service, providing for reliability and setting and maintaining of standards, while the role of volunteers changed to that of supporting, supplementing and enhancing the quality of the care given to patients. This paper chronicles the evolution of this service and describes its present functioning.