Organizational capacities for ‘residential care homes for the elderly’ to provide culturally appropriate end-of-life care for Chinese elders and their families

Abstract

Developing culturally appropriate end-of-life care for Chinese elderly and families is not an endemic challenge for Hong Kong, but that of the Western countries with a noticeable trend of rising Chinese population. The particular development of Hong Kong healthcare system, which is currently the major provider of end-of-life care, makes Hong Kong a fruitful case for understanding the confluence of the West and the East cultures in end-of-life care practices. This study therefore aims at building our best practice to enhance the capacity of residential care homes in providing culturally appropriate end-of-life care. We conducted two phases of research, a questionnaire survey and a qualitative study, which respectively aims at (1) understanding the EoL care service demand and provision in RCHEs, including death facts and perceived barriers and challenges in providing quality end-of-life care in care homes, and (2) identifying the necessary organizational capacities for the 'relational personhood' to be sustained in the process of ageing and dying in residential care homes. Findings shed light on how to empower residential care homes with necessary environmental, structural and cultural-resource-related capacity for providing quality end-of-life care for Chinese elders and their families.

Quality of Palliative and End-Of-Life Care in Hong Kong: Perspectives of Healthcare Providers

“…In general, healthcare professionals may not have experience in EOL care, causing delay in referrals and moral stress in the discussion. This is consistent with other findings which also reported that despite having medical knowledge, healthcare providers may lack the skills and knowledge to provide palliative care services [ 8 , 13 , 15 , 23 , 24 ]. It echoes with the findings of a study in Hong Kong about the association between staff training in nursing homes and their willingness, competence, and self-care [ 7 ].…”

Person-Centered Dementia Care in China: A Bilingual Literature Review

“…Traditional Chinese culture, particularly Confucianism, recognizes treating others with dignity as a core concept in thought and moral practice. It fully acknowledges one’s humanity, particularly those with cognitive challenges or functional limitations (Kong et al, 2017). It recognizes human dignity as realized through relationships and interactions between self and others, which echoes the values of PCC and the senses framework (Nolan et al, 2004).…”

“…Chinese culture can serve as a premise or facilitator for operationalizing PCC in China, such as the concept of showing respect and treating others with dignity. However, some values and notions in Chinese culture can be barriers to applying PCC, such as the understanding of personhood, maintaining relational or family harmony at the expense of communicating or expressing oneself (Kong et al, 2017). Persons with dementia require a holistic, collaborative, and ongoing understanding from their care partners of their needs and preferred self to maintain meaningful social relationships and achieve a sense of belonging and continuity (McCormack & McCance., 2006).…”

Children With Intellectual Disability and Hospice Utilization: The Moderating Effect of Residential Care

“…14,18 One possible explanation for this results is that residential care facilities lack timely communication and coordination between their staff and the hospice care clinicians. 25 In addition, policies and procedures in residential care facilities may hinder or impede coordination of care with other providers such as hospice. 25 Alternatively, residential care facilities may lack the advanced clinical expertise to accurately assess end-of-life trajectories in children with intellectual disability.…”