通过以人为本的临终关怀实现真挚旅程

July 2025 Table of Contents Executive SummaryExecutive Summary22IntroductionIntroduction2020 Cultivate a Proactive MindsetCultivate a Proactive Mindset1.Strengthen Advance Care Planning Development261.Strengthen Advance Care Planning Development262. Enhance Life and Death Education362. Enhance Life and Death Education36 3. Establish a Medical-Social Collaboration Platform503. Establish a Medical-Social Collaboration Platform504. Promote the Use of Gerontechnology664. Promote the Use of Gerontechnology665. Facilitate Dying in Place765. Facilitate Dying in Place76 ConclusionConclusion9494Dying in Place: A Guide to a Supported and Peaceful JourneyDying in Place: A Guide to a Supported and Peaceful Journey9696AppendixAppendix9898 Executive Summary What is End-of-Life Care and why is it important? End-of-Life Care (EoLC) remains a critical yet overlooked aspect of Hong Kong’s healthcare system. The need for comprehensive and compassionatecare during people’s final stages of life is crucial to maintaining patient dignity and quality of life. However, existing healthcare policies havepredominantly focused on medical treatments, leaving significant gaps in support for patients and their families during this critical phase. Percentage of population aged 65+ isexpected to increasefrom 23.6% in2025 to 33.1% by 2045. Among all age groups, the mostdrastic change in percentage is amongthe group aged 85+, increasingfrom3.3% to 8.6%. The urgency of improving EoLC is underscored by Hong Kong’s rapidly ageing population. By 2045, 33.1% of Hong Kong’s population will be aged 65+,up from 23.6% in 2025, withthe 85+ demographic increasing from 3.3% to 8.6%within the same period (Census and Statistics Department, 2020,2022). This demographic shift demands holistic care policies that address the need for comprehensive and compassionate care during the final stages ofterminally ill patients, fostering a dignified death. To improve healthcare and eldercare policies, EoLC should play a greater role in the discourse. EoLC encompasses medical, psychological, social,and spiritual support during the last 6 to 12 months of life. Recent legislative advancements demonstrate growing recognition of EoLC’s importance.Notably, amendments to the Coroners Ordinance (Cap. 504) now permit “dying in place” (DIP) in Residential Care Homes for the Elderly (RCHEs) withoutmandatory coroner reporting, under specified conditions (i.e., terminal illness diagnosis, physician attendance within 14 days before death, and deathcertification stating a natural cause of death), reducing hospital admission and enhancing dignity and comfort at the end of life (Hong Kong e-Legislation,2024a). Additionally, the Advance Decision on Life-sustaining Treatment Ordinance (Cap. 651) enacted in 2024 empowers individuals to put their end-of-life medical choices in writing via Advance Medical Directives (AMD), protecting healthcare professionals and rescuers (Hong Kong e-Legislation, 2024b). Despite these positive developments, gaps remain beyond medical care. Effective EoLC policies benefit not only patients and families but also alleviatepressure on hospitals, especially since medical service demand surges in patients’ final months (Hospital Authority, 2017). Shifting care from hospitalsto community settings aligns with the preference of 90% of Hong Kong citizens to remain in familiar environments in the final stages of life while offeringpotential cost savings estimated at over HK$ 91,000 per patient for healthcare system(Hospital Authority, 2024; Jockey Club End-of-LifeCommunity Care Project, 2025; Our Hong Kong Foundation, 2019). About the research Since 2019, the Our Hong Kong Foundation (OHKF) has been dedicated to researching and advocating for advancements in EoLC, having previouslypublished “Fostering Medical-Social Collaboration in Achieving Quality End-of-life Care” survey andAdding Life to Years: Comprehensive End-of-Life Care for Alladvocacy report in 2019 and 2024 respectively. Our survey conducted in 2019 highlighted a low level of public awareness and limitedexperience with EoLC services, emphasising the urgent need for enhanced public education and advocacy (Our Hong Kong Foundation, 2019). Buildingon these premises, our 2024 report focused on the establishment of a territory-wide Advance Care Planning (ACP) framework, the development of acomprehensive EoLC service strategy, as well as the enhancement of life and death education and professional training to better meet the needs ofpatients and carers (Our Hong Kong Foundation, 2024). Leveraging these prior findings, this report identifies key challenges and proposes detailed and actionable recommendations structured around twothemes—cultivating a proactive mindset and providing seamless care. Recommendations include strengthening ACP development, enhancing life anddeath education, establishing a medical-social collaboration platform, promoting the use of gerontechnology, and facilitating dying