kevin sinclair's hong kong

PUBLISHED : Wednesday, 15 June, 2005, 12:00am
UPDATED : Wednesday, 15 June, 2005, 12:00am

Hong Kong is about to be educated on the quality of dying. The Society for the Promotion of Hospice Care believes it is vital for people to understand that specially trained health workers can help ease terminally ill patients as they face the end of their lives.

So they plan to recruit celebrities to help promote Hospice Awareness Month in October. 'We need more hospice beds,' says Faye Chan Man-yu, the society's programme development director. Publicity may encourage the government to provide more funds for specialist aid for the terminally ill.

Ms Chan points to statistics that show plainly the inadequate provisions of hospice care. Four years ago, there were 290 beds dedicated specifically to the dying; that has dropped to 253. With about 30,000 deaths in Hong Kong every year, this is clearly insufficient; about 12 per cent of people have access to hospice palliative care. This means dying not only with dignity, but also without pain. The society provides extensive training to health-care workers outside hospices.

'By training caregivers, we hope that regardless of the setting, the dying will be supported with quality end-of-life care,' she explains. Because of lack of space in hospitals, staff are trained to look after people who opt to die at home. This throws immense strain on staff and on relatives of the dying patient; families need a lot of education, help and support to care for someone they love who is facing death.

The model that the society points to is the Bradbury Hospice in Sha Tin. It is the only place in Hong Kong that caters exclusively to patients facing imminent death.

Bradbury, which opened in 1992 and provides 27 beds, will be under the spotlight next week at a symposium on how health-care professionals can help those without hope to die without pain. The conference is part of a programme sponsored by Hong Kong Freemasons.

The Reverend John Chinchen, who is president of the Freemason's District Board of Benevolence, claims that hospice care has been thrust into the background.

He says young doctors receive little training in helping to ease terminally ill patients during their last days of life.

Because the Hospital Authority has largely integrated hospice care into general wards, terminally ill patients are usually cared for by staff without specialised training.

Mr Chinchen, an Anglican chaplain who has had much experience over the past 30 years helping the dying and their families, contends that a solution would be to make Bradbury a teaching hospital administrated by the Chinese University's Faculty of Medicine at Prince of Wales Hospital.

This would mean young doctors routinely getting direct experience of how to help the dying. It is one subject that will be discussed on the sidelines of the Palliative Care Symposium to be held by the Faculty of Medicine at the University of Hong Kong next week.

Medical specialists and other experts will discuss how to provide care for patients in the last 48 hours of their lives.

A key part of this in modern medical practice is the use of drugs to relieve pain.

But there is also the issue of the toll that constant proximity to death has on staff; 'compassion fatigue' and burnout will be one topic discussed at the symposium.

Mr Chinchen has spent many hours sitting at deathbeds. He contends that there is little concept in Hong Kong of the value of spiritual needs.

'Even if a person has no religious belief they can be comforted by the presence of a chaplain,' he says.

The Freemasons raised $400,000 for the society, part of which has paid for the cost of the conference.

There is universal acceptance that skilled hospice care, especially for the last 48 hours of a person's life, is the civilised way for a society to provide a dignified exit for the terminally ill.

According to the Hospital Authority, the quality of care for the dying cannot be measured by the simple number of beds.

The authority's senior executive manager, Daisy Dai Siu-kwan, insists that most patients prefer to stay at home where their families and outreach nurses can care for them.

'Facilities aren't the only solution,' she says. 'Home care is good for patients. They want to be with their families within their own environment during the end stages of their life.

'The authority is actively expanding community services. Money is obviously limited and we try to do our best.'

Many argue that this is not enough.