Introduction: Neurodegenerative conditions, such as Alzheimer’s disease, Parkinson’s disease and motor neurone disease, are progressive and incurable conditions that ultimately lead to a state of total functional incapacitation and death. These conditions are “terminal” and, therefore, should be managed with a palliative care approach. This article highlights some of the issues in caring for patients with end-stage neurodegenerative conditions from a palliative perspective. Methods: This review is based on evidence from pre-existing medical literature on the above subject and the authors’ personal experiences and observations. Conclusion: Patients with end-stage neurodegenerative conditions have needs similar to that of advanced cancer patients. Therefore, the principles and practice of palliative care should be applied to such patients. This may also mean that palliative care training should be undertaken in nursing homes, where a large number of such patients are located.

Background: Majority of individuals, including both younger and older adults, had to adapt to digital means to cope with lockdown measures and pandemic-induced lifestyle changes during the COVID-19 pandemic. While internet accessibility was beneficial during the pandemic, existing literature suggests that excessive use could lead to the rise of problematic internet use in adolescents and younger adults. However, the effects on older adults remain unclear. Objective: This study aimed to examine differences in internet use during the lockdown phase of the COVID-19 pandemic and explore how age differences in mental health could be explained by time spent on the internet. Methods: A door-to-door survey of a nationally representative sample of 602 adults in Singapore was carried out using computer-assisted personal interviewing during the early phase of the COVID-19 pandemic (October to November 2020). Participants were categorized into younger (21-59 years old) and older (60 years or above) age groups. We assessed self-reported measures of depression, anxiety, and stress; psychosocial adaptability; ability to perform essential activities; social support; health status; digital media use patterns, and time spent on the internet. Procedures complied with existing safe distancing measures. Results: Older adults reported being less able to use digital platforms to meet needs and acquire information updates compared with younger adults during the lockdown period of the pandemic. Older adults spent significantly less time on the internet for both work and personal uses per day (mean 146.00 min, SD 9.18 min) compared with younger adults (mean 433.27 min, SD 14.32 min). Significant age differences in depression, anxiety, and stress were found, with younger adults showing poorer mental health. Mediation analysis showed that age differences in depression, anxiety, and stress were partially explained by time spent on the internet. These variables together explained 43%, 40%, and 40% of the variances in depression, anxiety, and stress scores, respectively. Conclusions: The findings showed that younger adults spent significantly more time on the internet compared with older adults during the lockdown phase of the pandemic. They were also ahead in their ability to use digital resources to meet needs and engage socially compared with older adults. Despite this, the mental health of younger adults was poor, and this was partially accounted for by the amount of time spent on the internet. Since past research suggests that excessive time spent on the internet could lead to disordered use, the benefits brought by digital technologies could have been attenuated during the lockdown phase of the pandemic. Considering this potential negative effect, it is imperative to educate both young and old adults in the appropriate use of information and communication technology.

Background: By 2050, 80% of the world’s older population will reside in developing countries. There is a need for culturally appropriate training programs to increase awareness of eldercare issues, promote knowledge of how to better allocate resources to geriatric services, and promulgate elder-friendly policies. A monthly distance geriatric education programme between a public hospital in Singapore and health institute in Uganda was implemented. This study explored the enablers and barriers to the delivery of culturally appropriate geriatric education programmes via a videoconferencing platform. Methods: We conducted 12 in-depth interviews with six teachers from Singapore and six learners from Uganda. The interviews were audio-recorded, transcribed and analyzed using an inductive thematic approach to analysis with the aid of the NVivo software. Results: Enablers included inter-personal real-time interactions between teachers and learners whereas misaligned perceptions of cross-cultural differences between Singaporean teachers and Ugandan learners were a barrier. Rapport building, teacher motivation and institutional support were perceived to contribute to the programme’s sustainability. Overall, Ugandan learners perceived that the training improved knowledge, skills, attitude and practice of geriatric care. Participants suggested that future initiatives consider aligning cross-cultural perceptions between partners, conducting a training needs analysis, exploring complementary modes of information dissemination, and allotting time for more interaction, thereby reinforcing mutual sharing. Adequate publicity and appropriate incentivisation may also better sustain the programme. Conclusions: Our findings suggest that cross-cultural training via a videoconferencing platform was feasible. Our results inform planners of future distance educational programmes of how to improve standards of cross-cultural competency and forge promising international partnerships.

Background: Transiting into the community setting often presents novel difficulties for nurses because the role demands skills that might not have been obtained through usual clinical experience or training. The Ageing-in-Place Community Care Team (AIP-CCT) Community Nurse Basic Training programme was developed to address this learning gap. This training programme prepares nurses to lead in a multi-disciplinary team in delivering patient-centred care to patients with progressive or life-limiting conditions in the community setting. This study evaluated the inaugural training programme provided to a group of nurses from an acute hospital in Singapore. Methods: Qualitative in-depth interviews were carried out with 13 participants from the training programme three-months after completion of the AIP-CCT Community Nurse Basic Training programme provided by an acute hospital to understand the programme’s impact on their knowledge, skills and clinical practice, as well as barriers and facilitators to learning. Results: Overall, perception towards the training course was mixed. Course content was found to be relevant, and participants reported that training led to improvement in their practice. However, experienced nurses felt that the content of some modules were lacking in depth. This could have explained why only junior nurses tended to hold favourable attitudes and felt that the training led to increase in their confidence level. Although medical content was assessed favourably, the course was not able to address some of the constraints faced by community nurses such as managing expectations and handling difficult patients in the home care setting. For some modules, face-to-face training was preferred and e-learning components can be improved to increase communication and interaction. Conclusion: This study provided insights into how a community nurse training programme could be developed to meet the needs of community nurses. The training was able to reinforce skills and knowledge, address knowledge gaps and provide new clinical care approaches and communication strategies. These incremental effects on experienced community nurses could be extrapolated to have greater benefits for inexperienced community nurses. Based on findings of the study, potential changes to the training programme were discussed to improve training outcomes.

Background: Clinical empathy is a crucial skill for healthcare professionals, enhancing patient outcomes, and satisfaction. However, existing scales, such as the Jefferson Scale of Empathy, focus primarily on cognitive empathy, overlooking the affective component. This gap highlights the need for a validated tool that measures both cognitive and affective empathy in healthcare professionals. This study developed and validated a multidimensional scale—the Multidimensional Clinical Empathy Scale—for assessing both cognitive and affective empathy in healthcare professionals and students. Methods: This three-phase study involved item generation, reduction, and validation, using literature reviews, qualitative studies, and survey methodologies. Exploratory factor analysis and confirmatory factor analysis were applied to test the scale’s validity. The Multidimensional Clinical Empathy Scale was constructed using a five-domain theoretical model: Empathetic Connections, Valuing Empathy, Empathetic Behaviours, Genuine Concern, and Perspective Taking. After content validation and exploratory factor analysis, the scale was reduced to 26 items with high internal consistency (Cronbach alpha of 0.94). Results: There were a total of 977 participants, comprising doctors, medical students, nurses, and nursing students from acute hospitals, community hospitals, medical schools, and nursing schools. The final 26-item Multidimensional Clinical Empathy Scale demonstrated strong psychometric properties, with factor loadings confirming the multidimensionality of clinical empathy. Confirmatory factor analysis confirmed the scale’s four-factor structure, and the scale was validated across diverse healthcare settings with robust reliability and Content Validity Index (0.90). Conclusions: The Multidimensional Clinical Empathy Scale provides a comprehensive, validated tool for measuring both cognitive and affective empathy in healthcare professionals and students. Its multidimensional structure offers potential for broader applications in clinical education and research.