Authors (including presenting author) :
To TY (1), Iu TL (1), Chow TH (1), Tong HW (2), Woo J (2), Lee SW (1)
Affiliation :
(1)Department of Medicine and Geriatrics, Tai Po Hospital
(2)CUHK Jockey Club Institute of Aging (JCECC)
Introduction :
Hong Kong is facing a growing population with irreversible chronic illnesses and therefore an increasing demand on end-of-life (EOL) care. Unfortunately, the issue regarding how to die with dignity and comfort is often overlooked. Our aim is to promote and educate our infirmary patients and families the importance of advance care planning.
Objectives :
1.To educate infirmary patients and family members on how to face death and the importance of good EOL care
2.To promote Advance Directives (AD) and Advance Care Planning (ACP) as mean to ensure their autonomy in EOL care
3.To allow open conversation and sharing of experiences on EOL care
Methodology :
We started to promote EOL care concepts in infirmary wards since mid 2019. Patients and relatives who were interested were welcomed to approach the medical team for more information. We collaborated with the JCECC to host seminars every three months. There were case sharing and scenario-based questions to make the discussion more interactive. The essence of good EOL was emphasized. Follow-up interviews were arranged for each of the patients and families, to explain the nature of their diseases and to address their concerns. Their expectations on the management during the last phase of life were formulated. The AD or ACP forms were signed if any decisions were made.
Result & Outcome :
Patients and relatives were attentive and eager to express their wishes and opinions on EOL care. The seminar served as a good communication platform for healthcare providers, patients and relatives. Patients were able to start an open conversation with their families regarding their preferences on EOL care and their autonomy was respected. Relatives shared their struggle on decision making especially when there was disagreement among family members or contradiction to the Chinese traditional philosophy. The seminar also allowed personal reflections and team discussions on the significance of 'Good death'.
We received good feedbacks from the participants. The majority had better preparation on facing death and felt that their emotions and worries could be channelled. 70% of patients and relatives who attended our EOL talk had signed either the ACP or AD voluntarily.
