03/11/2025

MONDAY | NOV 3, 2025

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Malaysia faces palliative care crisis, warns NGO

Ensuring dignity in end-stage support KUALA LUMPUR: As Malaysia’s healthcare system continues to champion healthy living and disease prevention, a harder truth remains – many Malaysians enter their 40s already battling chronic illnesses. For patients with terminal illnesses, palliative care becomes their lifeline although the system, experts say, still lacks the support needed to provide it fully. According to Tham Su Ming, strategy and communications director at Hospis Malaysia, this is where the country’s focus must broaden. “We talk about prevention, which is important. However, we must also recognise that not everyone has equal access to healthcare, nutrition or the means to maintain a healthy lifestyle. “Many people are now living with advanced heart or kidney disease, or late stage cancer – they face these conditions due to circumstances beyond their control. “They, too, deserve care, comfort and dignity in how they live their remaining lives.” She added that a recent cancer registry report showed that 64% of cancers in Malaysia are detected at Stage 3 or 4, when chances of cure are low. She said while treatment may still help slow disease progression, patients often face immense physical, emotional and social burdens. “We have to be realistic. It may not be curable, but it doesn’t mean they should be left without support. “Palliative care is about helping them live as well as possible for as long as possible.” Tham stressed that palliative care focuses not just on the patient, but also on caregivers and family members. For younger patients, especially those who are breadwinners, the situation becomes even more complex. “We may not be able to solve financial issues, but we try to connect them with welfare organisations. That’s what holistic care means. “It’s not about giving up. It’s about ensuring dignity, comfort and coordinated support, because the well-being of patients and their families still matters.” Tham said Hospis Malaysia continues to collaborate with both local and international bodies to improve training but warned that retention will remain a challenge without broader systemic solutions such as better pay, improved career progression and national-level support.

Ű BY IKHWAN ZULKAFLEE newsdesk@thesundaily.com

o Limited facilities and shortage of trained professionals could leave thousands without critical services as population ages, says Hospis Malaysia

approach extends beyond that. “Pain is part of it, yes, but there’s so much more. It’s about anxiety, dignity, decision-making, family dynamics and often just having someone to talk to.” The aim, she stressed, is not about prolonging life at all costs, but to ensure that whatever time remains is meaningful, dignified and as comfortable as possible for both patients and their loved ones. With the demand for palliative care projected to double by 2030, Hospis Malaysia is urging greater public and private support to sustain and expand its services. “Palliative care is about people – the people are trained, compassionate, experienced caregivers. They are what make this kind of care possible.” – By Ikhwan Zulkaflee Tham said addressing this looming crisis requires coordinated efforts to expand services, invest in training and ensure that palliative care is recognised as a national healthcare priority – otherwise, hundreds of thousands of patients and families risk being left without essential support. highlighting the ripple effect of serious illness on spouses, children and extended families. The core problem, she stressed, is not just infrastructure but a critical shortage of trained personnel. “Healthcare is about people. Palliative care requires doctors, nurses and allied health professionals trained to manage not just pain but also complex physical, emotional and psychological symptoms.” While many associate palliative care solely with pain relief, Tham emphasised it is both “a science and an art”. “Pain and symptoms vary drastically between individuals. Providers need specialist training to deliver care that is effective and compassionate.” Hospis Malaysia is one of the few NGOs offering community-based palliative care in the Klang Valley, serving around 1,500 patients a year – a fraction of the national need. “We’re only filling a small part of a much larger gap. If we don’t scale up services, from community hospices to hospital-based care and train more professionals, we simply won’t be ready. It’s a crisis waiting to happen,” she warned. Tham said recruiting and retaining skilled personnel is the organisation’s biggest operational challenge. “In the last 30 years, we’ve faced many challenges, but the biggest is finding good people we can train to serve, especially nurses. “They come, they go. And when they’re good, they get poached by Singapore, the Middle East, the UK and Australia. We understand it, but it makes building a sustainable care model extremely difficult.”

KUALA LUMPUR: Only one in 10 Malaysians who need palliative care can access it – a shortfall that could leave 200,000 patients without support annually by 2030, says Hospis Malaysia. Tham Su Ming, the NGO’s strategy and communications director, said the country is critically unprepared for the rising demand driven by an ageing population and a surge in non-communicable diseases (NCD), warning that Malaysia is facing a ticking healthcare time bomb. She explained that the situation is worsened by the limited number of public facilities and the shortage of trained specialists, many of whom have left for better-paying jobs abroad.

cancer, heart failure, kidney failure and dementia. “If we don’t address this gap urgently, we’ll face a major healthcare crisis as demand doubles,” she warned, adding that the impact extends far beyond patients themselves. “When someone is very ill, the whole family is affected. So if we’re talking about 200,000 patients, the number of people emotionally and physically affected is likely to be much higher,” Tham said,

“The Health Ministry estimated in 2019 that about 100,000 Malaysians require palliative care each year – but that figure was based on mortality data that may date back to as early as 2014,” she told theSun at the Voices for Hospices 2025 Charity Gala Dinner at the Majestic Hotel recently. By 2030, 15% of Malaysia’s population will be over 60 and Tham said this demographic shift is expected to trigger a sharp rise in life-limiting illnesses such as

“You’re dealing with people at the most vulnerable stage of their lives. All nurses, even the experienced ones, must go through our in-house training, which takes an average of about six months.” – By Ikhwan Zulkaflee Free human-centred services for patients

The charity gala dinner, that highlighted the importance of dignity and compassion in end-of-life care, was attended by (from left ) Dr Ednin Hamzah (Hospis Malaysia CEO), YAM Tengku Datin Paduka Zatashah Sultan Sharafuddin Idris Shah and Datuk Kathleen Chew (Hospis chairman and YTL Corporation group legal advisor). – ADIB RAWI YAHYA/THESUN

KUALA LUMPUR: Every home visit by Hospis Malaysia’s palliative care team costs around RM500 but for patients and their families, it is priceless. Despite the cost, patients are never charged a single sen. The organisation’s strategy and communications director Tham Su Ming said what they receive goes far beyond a medical check-up. “We are offering a comprehensive, deeply human-centred approach to care. The way Hospis Malaysia practises palliative care is team-based. “We have doctors, nurses, rehab therapists, pharmacists – all playing different roles when they go in to see a patient,”Tham told theSun in an exclusive interview. Each patient’s journey begins with an in-depth assessment by a senior nurse or doctor, who identifies physical

covers staff salaries, training, travel, medical supplies and operational expenses. Yet, no patient is ever billed. “A private palliative care doctor’s visit can cost significantly more. But we absorb the cost through donations and fundraising, so no one is turned away because they can’t afford it.” The RM500, she added, reflects the collective effort behind each visit – from medical advice and symptom management to psychosocial support and caregiver education. “You can have a very clinical model of palliative care that says: ‘Tell me now, what’s important, because I only have one hour’. “We don’t operate like that. We give patients time to tell us when they’re ready.” While many assume palliative care is limited to pain relief, Hospis Malaysia’s

opened up.” The man finally revealed that he wished to live with his daughter in Kuala Lumpur once his condition worsened – but could not bring himself to ask. “As a traditional Chinese father, he felt he would be intruding into what he saw as his son-in-law’s home. There was also a cultural stigma around dying at home, which he feared might burden his family,”Tham explained. Eventually, the patient asked a Hospis nurse to speak with his daughter on his behalf – a delicate conversation that unfolded slowly, with care and compassion. “This story shows the emotional depth that palliative care often involves and why rushing it simply doesn’t work,” Tham said. Hospis Malaysia estimates that each home visit that costs about RM500,

symptoms or breathlessness, alongside emotional and psychological concerns. “These issues don’t always surface during the first visit. Building trust takes time. Sometimes it’s only after the fourth or fifth visit that a patient will open up.” Unlike the time-pressed consultations of busy hospitals, Hospis Malaysia’s model prioritises relationships over routine. Tham recalled the story of an elderly patient from Penang who frequently travelled to Kuala Lumpur to visit his children. Diagnosed with late-stage cancer, he appeared physically well but remained reluctant to discuss his future care plans. “Our team kept asking him gently, ‘What’s important to you?’It took almost six visits over three months before he such as pain