End of Life Care
Hong Kong is facing a rapidly aging population. Unfortunately increased longevity does not translate to increased well-being at old age and good “quality of death”. Elderly persons, their families, health and social care professionals are increasing concerned with the inadequate, disjointed and lack of choice in care and treatment to allow our elders to die with dignity and comfort at the end of life.
End of life care straddles conventional policy domains of health and social care to complex narcotics laws in restricting the use of opioids, regulations on certification of deaths and the handling of dead body, legal status of advanced directives, professional training of care personnel, to the economics and financing mode of end of life care. To ensure the availability and quality of end of life care, there should be a holistic, coherent policy solution.
High level policy recognition to align the legal and service parameters of medical and social care is crucial. WHO and the Worldwide Palliative care Alliance (WPCA) have advocated for a whole systems approach to developing end of life care strategies.
Cross professional collaboration and assurance of service standards; moving from a hospital-inclined model of care to community-based care support; inadequate funding and manpower resources are all challenges in designing and managing an integrated end of life care system. Engagement of users, practitioners, service providers and policy makers in rational policy deliberation through impartial, systematic and evidence-based policy research are essential in the policy and program design process.
Last but not the least, combating perceptions of death and cultural taboos are critical hurdles in improving support to people in the last days of life and care after death. Promotion of life and death education, involvement and empowerment of service users and carers in the policy process are important parts of public engagement to ensure appropriateness and acceptability of policies and programs.
- Advocate for an End of Life Care Strategy for “Dying with dignity and comfort” in Hong Kong –Input in Agenda Setting, analyzing and studying policy choices and recommendations for policy implementation
- Develop an Joint-up Multidisciplinary Care system, that is cost effective and of choice to people facing death, through the engagement of professionals, practitioners and concern groups
- Alignment of Public Expectations and Preparations on Dying Well, Dialogue and Information Campaign to generate public awareness and acceptability
- Dialogue with Policy Makers and Advocacy for Policy Change and incorporation of Coherent Policy Directives and Resources for providing high quality, holistic and co-ordinated care for people at the end of life.
- Professor Cecilia Chan, Department of Social Work and Social Administration, HKU
- Dr. Amy Chow, Department of Social Work and Social Administration, HKU
- Professor Christine Fang, Faculty of Social Sciences, HKU
- Dr. Vivian Lou, Department of Social Work and Social Administration, HKU
- Dr. Sui-Ting Kong, Faculty of Social Sciences, HKU