The pursuit of a good death: a qualitative analysis of the effectiveness of advance care planning community engagement in Singapore

Abstract

The increasing healthcare and social demands of Singapore’s ageing population have spurred a national interest in Advance Care Planning (ACP) to provide quality end-of-life, concomitant with one’s wishes. However, since its inauguration in 2011, ACP uptake has been lacklustre, with only 27, 000 ACP conversations documented as of 2021. To enhance uptake numbers, this paper analyses outreach efforts under Living Matters and LiveWell. LeaveWell., a nationwide programme and campaign respectively, using the four Is framework and attributed this phenomenon to the limited outreach precipitated by the institutional structure of Singapore’s healthcare system; the normative perception about ACP and the wider healthcare sector; as well inadequate adaptation of two programmes to local needs. Concluding with insights from abroad, this paper recommended to re-envision community outreach as a community-based approach to better promote ACP to the public and encourage its uptake.