Three-Part Guidance Documents for Palliative Care of Patients including those with Life-Threatening Illness

The Philippine Society of Hospice and Palliative Medicine (PSHPM) and Hospice Philippines, through the support of The Ruth Foundation and the Philippine Society of Public Health Physicians (PSPHP), is providing guidance documents for communities, RHUs and hospitals especially outside cities. These recommendations are useful in the COVID situation as health facilities and hospitals are in the ECQ and GCQ scenarios. These guidelines are designed for physicians and health professionals in the community, district and provincial hospitals. The annexes contain useful algorithms and matrices that may be adapted by hospitals and communities.

The Guidance Documents

Part 1: Care for Palliative and Bedridden Patients in Communities on Enhanced Community Quarantine

This guide is written for community health workers including Municipal Health Officers, RHU physicians, public health nurses, other RHU staff and community health workers so they can strengthen local resources and provide advice to family members/ caregivers with palliative patients.

Part 2: Guidance for Palliative, Hospice and Bereavement Care for COVID-19 and other Patients facing Life-Threatening Illness in Hospitals

This guidance document is especially prepared for physicians, nurses and officials in level 1 and level 2 private or public hospitals. These are re-commendatory guidelines coming from experts in palliative and hospice care using the best evidence and practice in the current public health emergency.

Part 3: Triage Decisions, Shared Decision Making and Advanced Care Planning for COVID-19: A Guidance Document for Levels 2 & 3 Health Care Facilities

This document aims to guide the process for Shared Decision Making and Advance Directives. It is for health professionals including doctors, nurses and hospital management especially those with COVID-19 and other patients facing life-threatening illness. It is most relevant in L2 and L3 hospitals where COVID patients may be referred. These include Provincial and Regional Government Hospitals as well as private hospitals of the same level.

Click this button for access to additional guidance documents

The will open a link that contains other useful technical documents such as:
1. The link to the ESMO COVID Palliative Care Pathways
2. E-Book on Palliative Care Guidelines for COVID-19 Pandemic, Task Force in
Palliative Care, Kerala, India
3. Ethics Guidelines on COVID-19: Crisis-Level Hospital Care, Ethics Study Group,
University of the Philippines Manila

What Are Some Of Your Best Or Memorable Moments With Your Mom?

In celebration of Mother’s Day this 2020, we asked this question to our staff:

Here are their fun and heart warming answers:

A fun memory.. Off to church in matching outfits. Christmas based on the design. Age appropriate style (Mom did the designs). - Isobel, Volunteer Care Coordinator

This one is taken in Singapore, it was our first international trip na two lang kami kaya super memorable ito. Yung pangarap ko na mabigyan sya ng vacation abroad natupad ko nung matapos ko ang contract ko sa Saudi. She is a great woman, that I will always look up to. She taught me how to be strong in all circumstances and put all my trust in the Lord. She was also a fighter. She never became a burden to all of us even if she was already enduring pain from cancer. She is the best person I've ever known in my entire life. Until her last breath, she made sure me and my sister's future were well secured. Given a chance to get to have my own child, I will make sure to pass on all the beautiful things she has taught me. I will forever miss her and be proud that she is my mother. - Mitch Nermal, Nurse/Patient Care Coordinator

I just realized that my Mama likes going to the mall. When my Papa used to work in a government port agency, he was always away because he had to be in different ports in the country. My Mama always brought us to the mall (any mall in Manila). She likes buying my sister and I the same style of clothes and shoes but in different colors (and my Ate didn't seem to agree with that), even up to this point that we were both in our 30s. This picture was taken during the opening of Robinson’s Galleria :) Of course, she bought us terno clothes and shoes again :) Our Papa only knew we were going somewhere in Alabang but ended up in Galleria instead :) Look at my mama’s smile of victory. LOL. She loves being with my brother, too (she calls him, Bunso). This year is the first Mother’s Day, he won't be around. And we can't go to the mall either because of the lockdown. But we will do our best to make this day (and everyday) a memorable Mother’s Day for her :) Mama, you’re the best! Thank you for your unconditional love! We love you so much! - Dr. Ara Ofina, Palliative Medicine Doctor

Moms usually leave their jewelries to their children more especially to their daughters as inheritance. My Mom did not. Either she already had disposed of them or she did not find it necessary. At the time of her death I was granted by God the privilege to be with her as she had lived the last 13 years of her life in the US.She, however, left me something more valuable and that is the legacy of prayer. Mom had always been close to God in her own special way. She would have a regular prayer time when all the domestic chores are done. She would sit by the window and pray. That is why I want to always remember her. She was very active in church and everyone calls her Mommy. Mom was my first teacher. She would patiently teach me how to read my books in advance. She always made me feel special, though all my siblings also felt special because of Mom. I must have broken her heart when in times that I was not compliant. But that is a different story. She has faced many challenges but surpassed them all. Now as I look back, I guess her source of strength aside from her family was her relationship with God.After her death, she was awarded a posthumous award by her parish, which I was honored to accept on her behalf.I will remain grateful to God for creating me to be my Mom's daughter. - Tita Cottie, Counselor/Chaplain

My mom would usually give me candy to sit still for photos. Her bag seemed like Mary Poppin's bag with unlimited items in it...Snacks. Check. A screwdriver. Check. Alcohol, tissue, toothpicks, name it. She probably has it. - Mikee, Communications & Training Associate

“To the world, you are a mother.
To our family, you are the world.”

My mom is one of the best nurses I will ever know, who worked full time when I was a little girl. Despite that, she always prepared the best meals, especially her slow cooked beef for Sunday family lunches! Now that I’m a mom, I find myself trying to cook those Sunday lunches like she did, but will never be able to equal. It was also mom, who first told me the story of the Good Shepherd, and since that day, I have known Him as my own. - Dra. Mae Corvera, Executive Director/Palliative Medicine Doctor

The best medicine from my mama - her presence, her warm touch and a bottle of cold Royal Tru-Orange that she bought from the sari-sari store. Speaking of presence, looking back, it's really my mom who has always been present in every special and trivial moments of my life – first vaccine, first communion, first day in school, first (and all) graduation, first ER visit, circumcision, PTA meeting, field demonstration/performances and a whole lot more. Indeed, her presence is one the best presents I received in my life. - Ricky So, Graphic Designer

During my last birthday (to think I turned to an age that's last on the calendar), I cried like a baby. I thought something unfortunate happened to my mom, praning lang. Kasi naman, she has never missed a midnight-call or -text to greet me on my birthday ---that midnight until late afternoon of my birthday, I did not receive any. Kinabahan ako ng todo. The time na nakausap ko na siya, para akong batang nagtatampo. Haha! Given that we are far away from each other and as someone who does not really like getting birthday greetings, I value hers the most and really look forward to it. I think it's also because I value her becoming MY mom on that same day. She's my best friend and confidante. Parehas kaming madaldal and with her, I don't feel judged. She's a lot stronger than I am at tinitingala ko siya sa aspeto na iyon. Sana I can be even half of how she is. - Mamel, Training and Marketing Associate

She loved hearing kwento ng mga kalokohan naming magkakaibigan, whether friends ko sa lugar namin sa Bulacan, sa school and sa University nung nag-college na ako. She knew all my friends, that's why she was also a "nanay" to them. Her laughs were real and the joy in her eyes were priceless. Minsan nga napapaluha pa siya sa kakatawa sa mga kwento ko and I missed that for the past 24 years. I missed all the kwentuhan, mga masasarap na luto na namana ko (ehem), pag aalaga nia sa akin 'pag my sakit ako, mga goodbye and hello kisses everytime aalis ng bahay at uuwe. I missed the compliments coming from her na alam mong walang halong bola.. #genuinemotherlylove. Happy Mother's Day in heaven Nanay Betty, thank you for everything... I will love you until forever. - Virgie Roldan, Executive & Administrative Assistant

The most memorable experiences with my mom are all the instances when I got sick or had asthma attacks. Also, in high school and when I needed to go to school. Early in the morning, she always got up first to make breakfast for me, kami lang dalawa ang gising sa bahay.... These were the times I felt her love the most. She was always the one to take care of me. And now that she is in her octogenarian years, I always ask God to give me the opportunity to take care of her. I treasure every moment we have together. - Dra. Nanette, Medical Director of Patient Care

When I was in college, umuwi ako sa bahay isang hapon. May nakita akong kanin na may halong kung anu-ano...kinain ko...aba masarap. Dumating ang nanay ko, sabi, "bakit mo kinain iyan eh yung mga tira-tira yan na ipapakain ko sa baboy natin." Sabi ko, "masarap.'kala ko niluto niyo." Sabi ng nanay ko, "haay, mabubuhay talaga kahit saan itong anak ko. Kumakain kahit kaning baboy..." True naman na mabubuhay ako kahit saan at anong situation. - Lira Tañamor, Social Worker

Happy Mother’s Day!