Authors (including presenting author) :
Ho SF(1), Chu KF(1), Tong KO(1), LEUNG PY(1), Chu CC(1), Fung SC(1), Wai NT(1), Tsang KF(1), Chan CY(1), Chan CH(2), Wong MC(1), Lo SH(1), Wong CS(1)
Affiliation :
(1) Department of Clinical Oncology, Tuen Mun Hospital, New Territories West Cluster
(2) Nursing Services Division, New Territories West Cluster
Introduction :
Death and dying affect each and every one of us. Although it is natural, it can be challenging for all of us. Most of deaths in Hong Kong occurred in hospitals. Issues relating to privacy and dignity were consistently raised by patients and relatives. There was a need to bring transformational changes to deliver greater comfort, privacy and dignity to our patients.
Objectives :
To improve the quality of death of patients facing difficulties associated with terminal cancer
To improve hospital experience of patients and relatives
To make death more bearable
Methodology :
Patients approaching the end of life were assessed every morning. A sunset room was provided to give the patients and his or her family to have more privacy and precious moment. The environment was warm and homelike allowing greater interaction between the patient, relatives and friends. The room was connected to outdoors with large windows overlooking nature to increase sensory input. A sofa and 24-hour visiting time were available to encourage relatives to have a long stay. Warming blankets and other grooming kit were accessible to relatives. Lighting and TV can also be adjusted by the relatives.
Personal preferences were respected allowing religious and spiritual support and activities. Resources and tools for cultural, religious or faith tradition perspectives were available. Patients may choose to wear their own clothing to leave this world. Professional air purifier was also available to improve quality of air. Natural and soft lighting helped to create a calm and soothing atmosphere. The rooms and corridor were equipped with art-work and decorative wall promoting a greater sense of well-being.
Relatives were encouraged to have more precious moments with the patient such as saying thank you, asking or giving forgiveness in this private and quiet space. Facilities were provided to show and print out family photography. Their last conversation would not be disturbed by others.
Result & Outcome :
For a patient approaching the end of life, the environment should provide some recognizable connection with the home, spirituality and nature. Recent international studies indicated that the ideal was to provide a single room in order to improve quality of end of life care. The setting and environment should be appropriately supportive. The sunset rooms in the Tuen Mun Hospital served over 700 families each year. Both patients and relatives had positive hospital experience and expressed appreciation to this heartfelt arrangement.
