Receiving Hospice Care, the Elderly Pass Away With Dignity

Caregiver is holding the hand of a hospice patient.
Caregiver is holding the hand of a hospice patient. (photo:
By Thomas ZhangSeptember 8th, 2023

"Thank you for helping my mother fulfill her last wish." A few days after an elderly woman passed away due to cancer, her family members sent a message of gratitude to the caregivers at the Ci’en (Mercy and Grace) Elderly Care Center in Huadu District, Guangzhou, Guangdong, who had taken care of their mother during her final days.

In traditional Chinese culture, "death" has always been a heavy topic that people tend to avoid, especially when dealing with elderly individuals in their later years. Avoiding discussions about what happens after death seems to be an unspoken social etiquette in daily communications. However, as society evolves, helping these elderly individuals in the final stages of their lives bear the pain threshold and peacefully complete their life journey with dignity has become an increasingly important topic of concern for both the general public and the Christian community

Yao Wenfu, director of the center, and Sun Xiaomei, vice director, discussed hospice care with staff members of the Gospel Times, an online Chinese Christian newspaper. While gaining an understanding of its essence, they also revisited the truth and the beginning of God's creation, seeking to rediscover and reconstruct a renewed awareness of the dignity of life.

In June 2022, the center launched a comprehensive hospice care project called "Anxie Yizhan (Resting Station)." They established 20 end-of-life care beds and formed a professional team consisting of medical, social work, legal, and religious experts.

Director Yao explained, "The word 'Anxie' (rest) originates from the Bible, and we hope that each elderly person's life can rest in the love and grace of the Lord and ultimately find their home in heaven. 'Yizhan' (station) implies that the cessation of the physical body is just a stopover in each person's life journey, not a complete ending."

"Through our project, we aim to help elderly individuals in the terminal stage of life, along with their families and even more people, rebuild their understanding of the value and meaning of life. By doing so, we can eliminate the fear of death and allow each person to depart from this world with dignity and peace," Yao emphasized. The approach to achieving this goal is through spiritual care, an indispensable aspect of end-of-life care services. Yao continued, "If the person is a Christian, I will talk to them about the eternal home in heaven, letting them know that there is a Heavenly Father waiting for them to return home to enjoy eternal blessings." He further explained, "But for individuals with different religious backgrounds or those without faith, I will listen to their expectations regarding the afterlife."

"Our core goal is for individuals to leave this world not in fear and pain but with composure and dignity. This is the essence of our service."

Compared with the elderly care industry that started in the early days of the founding of the People‘s Republic of China (PRC) in 1949, hospice care has only been in the eyes of the Chinese public for 20 or 30 years, but its necessity and urgency have become increasingly apparent in people's daily lives.

According to Director Yao's recollection, in recent years, the center has admitted many elderly individuals in the terminal stage of life. Most of them were already in the late stages of illness upon admission. Their physical condition was too weak to be further extended through medical interventions such as chemotherapy, but they still retained some faint signs of life. However, whether from the perspective of hospitals or families, the situation of these elderly individuals in the final stages of life is heartbreaking.

"Generally speaking, regular hospitals, considering factors such as medical resource costs, the patient's physical condition, and the family's expenses, rarely follow through to the last moment of life for non-emergency terminal patients. In most cases, they would recommend conservative treatments to spare the elderly from further suffering and advise the family to take them home to spend their last moments," Director Yao explained. "However, once the elderly individuals return home, their families often lack the necessary caregiving skills, consistent time, and professional medical equipment to provide effective care. As a result, many terminal patients can only depart from this world in pain and torment while carrying feelings of guilt toward their families."

"For elderly individuals in the terminal stage, families often prepare for their departure but do not prepare for how to help them pass their final stage of life with dignity," Director Yao said. He witnessed many terminal elders and their families suffering from anxiety, sadness, and regret due to a lack of a proper understanding of life and death. In his view, this was because of the absence of end-of-life care services.

As a senior advanced social worker who has led multiple social elderly care service projects, Yao believed that although there has been a certain level of breadth and depth in social welfare and projects for the elderly in China today, there is still a significant gap and deficiency in the field of hospice care.

"At the beginning of the world, every person was created in the image of God. No matter which stage of life a person is in, the image of God is always in each person who is precious in God's eyes," Director Yao explained.

Therefore, at the elderly care center, whether an elderly person has lived there for ten years or just one day, regardless of the pain and scars they may have from their illnesses, the caregivers clean their bodies to let the elderly individuals leave this world with a dignified body.

"Respecting the dignity of life"—this is the core philosophy that runs through the entire end-of-life care project and the process of serving elderly individuals as whole beings. In Director Yao's heart, he firmly believed that this dignity of life came from God and should not be subject to arbitrary judgment or disrespect by anyone.

"In this project, our practice of end-of-life care is primarily through dialogues and conversations, forming a curriculum of life education," Director Yao explained. The elderly individual with advanced-stage colon cancer mentioned at the beginning of the article, in the final ten days of her life, underwent a profound transformation through this life education curriculum. She had been transferred to the center after hospitals refused further treatment.

"The first thing she said was whether we could give her an injection for euthanasia, so she wouldn't have to suffer from the illness anymore," Yao recalled. Although nearly a year has passed since the elderly woman's passing, the memory remains vivid in his mind. He said, "While I can understand and empathize with the elderly person's suffering, both morally and legally, we couldn’t fulfill such a request."

To care for this elderly individual, the caregivers at the center took shifts around the clock, not only to manage her pain but also to prevent any suicidal thoughts. Additionally, Sun Xiaomei maintained communication with the elderly woman, whose hearing had almost completely deteriorated, using paper and pen to help her rediscover the value of life and the meaning of death.

Through their efforts, the elderly woman gradually abandoned her thoughts of ending her life. She expressed her desire to return to her hometown in Inner Mongolia. After reaching an agreement with her family, the center arranged transportation and accompanied her on a journey of over a thousand kilometers, fulfilling her final wish. A few days after returning to the center, the elderly woman completed her journey on Earth.

"Through life education, we aim to help terminally ill elderly individuals establish a rational view of life and death. This is the fundamental purpose of our spiritual care. However, our care is not limited to the elderly," Director Yao emphasized. In fact, while this elderly individual with colon cancer received care and guidance at the center, life education courses for her family members were also conducted concurrently.

After explanations, the family of this elderly individual finally awakened to the fact that her request for euthanasia was a manifestation of her extreme fear of death. Subsequently, the two directors and the caregivers held discussions with her family members, helping them navigate their grief and feelings of guilt toward the elderly woman and providing guidance on funeral arrangements. Eventually, her relatives understood the elderly woman's wishes, emerged from their self-blame, and accepted the reality of her passing with peace in their hearts.

Yao explained that at the center, end-of-life care was not limited to serving the elderly individuals alone but also included their families. The services provided encompass diverse aspects, including pre-death life education, palliative care, fulfilling the final wishes of the elderly, setting up wills, arranging post-mortem matters, organizing funerals, and providing psychological counseling for caregivers.

Although they still face some societal misunderstandings and practical pressures, such as the lack of funding and facilities, Yao and Sun believe that this project is necessary and worth persisting with.

When asked about the reasons, Sun, who had previously traveled to Hong Kong for exchanges and learned about elderly care and end-of-life care services, shared her perspective based on her first-hand experiences.

In her view, in terms of service content, end-of-life care services in Hong Kong were more detailed and specialized in both ideology and practice. Furthermore, when it came to participants, it involved not only the elderly but also their family members, social workers, and different sectors of society that contributed to and supported efforts to improve the quality of life for the elderly in their terminal stages.

Regarding the current situation of end-of-life care services in China, Yao frankly admitted, "This has brought us a direction for improvement, which is to enable all levels of society to establish a correct and comprehensive consensus on the value of life, allowing each person to view death with a more peaceful mindset."

- Translated by Abigail Wu

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