Authors (including presenting author) :
KW Mak (1), SY Wong (1), CK Cheng (1), WY Wong (1), KY Cheng (1), MC Woo (1), YY Chan (1)
Affiliation :
(1) Department of Medicine and Rehabilitation
Introduction :
Death is inevitable and often unveils anxiety, causing despair, unspoken goodbyes and prolonged suffering for patients and their families. Futile aggressive interventions at the end-of-life jeopardize patient’s dignity and peace. A pilot End-of-Life (EOL) Care Program was launched to enhance end-of-life experiences, facilitate open discussions about death and foster a dignified transition for patients and their loved ones.
Objectives :
* Recognizing death as natural part of life.
* Promoting comfort and dignity.
* Enabling informed decision-making.
* Offering physical-psychological-social-spiritual support.
* Facilitating home or community care when appropriate.
Methodology :
The program was implemented in two geriatric beds of Tung Wah Eastern Hospital, supported by an interdisciplinary team comprising geriatrician, palliative care specialist, nurses, physiotherapists, occupational therapists, social workers, clinical psychologists, and chaplains. The program targets inpatients with life expectancy less than one month.
Referrals are initiated by clinicians based on established criteria. Suitable cases are transferred to designated wards for EOL care. Patients are co-cared by geriatrician and palliative care physician skilled in managing frail patients and distressing somatic symptoms. Biopsychosocial needs are monitored and documented by nursing staff using standardized forms. The team facilitates advance care planning discussion, provides symptom management, and offers support to families.
Stable patients may discharge with community resources and home support, such as JCECC and the CGAT EOL team. For patients passing away in the hospital, relatives are provided with condolence cards and funeral information, with follow-up calls and caregiver satisfaction questionnaire conducted in one month.
Result & Outcome :
From May to December 2024, referrals of 4 male and 8 female patients were received, among which 1 male and 3 female patients were recruited to the EOL care bed and passed away. The remaining were not recruited due to unavailability of beds or relatives’ refusal.
Caregiver satisfaction questionnaires were conducted with 2 female and 2 male relatives of the 4 deceased patients respectively. Notably, 1 patient had an advance care planning prior to recruitment, and none had advance directives in place.
Caregiver satisfaction scores range from 4.5 to 5.0 out of maximum of 5, highlighting caregivers’ recognition towards the compassionate care, symptom relief management, and effective communication under the program.
In conclusion, The EOL Care Program facilitates patients to pass away with dignity and peace, enabling meaningful farewells and transforming the end-of-life experience into compassion and closure.
