Accompany the Elderly till the End with End-of-Life Care
Life and death is inevitable, but it is possible to choose a “good death” and make after-death arrangements with people around. At the Society’s two residential homes, namely the The Hong Kong Jockey Club Shenzhen Society for Rehabilitation Yee Hong Heights (YHH) and The Tsang Shiu Tim Home for the Elderly (TST), we provide End-of-Life care service, which aim to help them make after-death arrangement before they pass away so there would be no regret for them. Social Worker Ms LU Yan and nurse Ms KWOK Shek-ngo are part of the teams providing End-of-Life care service. Through their work, they learn about “good death”.
With the advancement of medical technology, the life expectancy has been increasing over time. But as people grow older, they suffer from more illnesses and different levels of deterioration before passing away. As people with chronic illnesses already suffer from distressing pain, invasive medical treatments may make it worse. The purpose of End-of-Life care service is to help the elderly alleviate their pain and discomfort so they could have a higher quality of later life, hanging with their family and friends before passing away peacefully. They would not have to travel back and forth to hospital and be left in torment as a result of their illness and treatment.
Helping Others is the Greatest Motivation
Ms LU, social worker, joined YHH after graduating from university. Her duties include providing residents and their families with information and emotional support in End-of-Life care service. “I still remember the feeling of depression when I first got involved in End-of-Life care service because I always faced death and knew that the residents I was taking care of would pass away soon. But then I understood that my work helped others face up to dying with dignity and less remorse, and such good deeds would be my ‘good fortunes’. The fulfillment from my work has become my driving force to continue to strive for my work.”
As a social worker in elderly care, Ms LU is well aware of the difficulties of promoting this service. It is noticeable that each of the resident has their own attitudes towards death, so she would try to make sense of their mindset and physical conditions in her daily routine and invite suitable residents to join life education group, where they would share and review their life and its meaning. The group would enable the residents to think deeply of End-of-Life care, advance directive and making after-death arrangements. We encourage them to tell us about their wishes and what they want for their after-death arrangement as they receive End-of-Life care.
“Before joining the life education classes group, many residents wanted to go with the flow when it comes to making after-death arrangements. They realised that the arrangements can be made based on their wishes afterwards. As their family may feel regretful and remorseful without knowing their wishes, after-death arrangements can be beneficial to both elderly residents and their family,” said Ms LU.
Bidding Farewell to Family through Online Farewell Party
One of the recent cases that left a deep impression on Ms LU was Grandma Zhu “Grandma Zhu was very friendly and had a lot of friends in our home. Her health gradually deteriorated in mid-2021 and even painkillers could not relieve her pain. In light of this, we decided to organise an online farewell party for Grandma Zhu in June and invited staff of YHH, including doctors, nurses, carers, social workers and the superintendent, along with some of her best friends at YHH, her family, friends and pastor who were not able to travel to the Mainland due to the pandemic. In the farewell party, we looked back the fragments of the happy moments they we had spent together. Grandma Zhu also gave away her handmade souvenir {Ping-on beads} and expressed her love [I love you all and I know that you love me too. I am ready to go to heaven. I feel neither lonely nor painful as if I was boarding a plane to fly. So don’t be sad for me, but live a happy life.] Grandma Zhu eventually passed away last October. We organised an online memorial for her family, residents who were close friends with Grandma Zhu, along with staff and volunteers of YHH. It was difficult to let her go, but knowing that she passed away without pain nor regret, but rather with a grateful heart, our hearts were filled,” said Ms LU.
Demand for End-of-Life Care Service on the Rise
Before joining the Tsang Shiu Tim Home for the Elderly, nurse Ms KWOK Shek-ngo used to work in a public hospital in the End-of-Life care unit. Ms KWOK mentioned that such service was only provided to end-stage cancer patients, but it has been extended to people with renal failure, chronic illnesses or with life-limiting diseases due to the social change now. She reminisced about her time working in hospital, where many of the patients were already in their final stage of life with deteriorating conditions, and her duty was to take good care of them. TST allows her to spend more time with the residents and develops a strong bond with them, she realised that she had to know more about their needs during their stay.
“For instance, a daily shower may not be arranged in some understaffed public hospitals, we can only wipe the patients with wet towel. But at TST, we are able to arrange daily shower and even hair-drying services for residents. In fact, these small caring acts are quite important to the elderly residents,” said Ms KWOK.
Ms KWOK stated that it is vital to help the residents and their families to get prepared mentally and practically for the changes arising from the passing of the resident in the End-of-Life care service. The family may feel off-guard when the residents pass away. Keeping the residents company before their passing may help their family feel less regretful and remorseful.
“I remember Grandpa Kong, who passed away at 90 at TST. In his final days, we arranged a separate room for him so that his two daughters can come visit and feed him with his favourite food every day. We also organised a mini birthday party last September, inviting all his children and grandchildren. We filmed a video during the party and Grandpa Kong was over the moon. A month after the party, Grandpa Kong passed away but I am glad that his children and grandchildren were by his side in his later days.”
The sadness is inevitable when one witnesses the passing of the elderly. It took time for Ms LU and Ms KWOK to recover. Receiving positive feedback is an important drive for them to strive ahead. For instance, the daughter of Grandma Zhu sent her feedback to the YHH staff, “Thanks to the YHH team. Grandma Zhu passed away peacefully. At 95, she left the world with joy, satisfaction, happiness and a grateful heart. What a beautiful thing to return to heaven. She was not lonely because there were two kind-hearted angels that arranged everything for her to say goodbye. It was simple but meant a lot to her and the family.”
