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Under the epidemic, the hospital has suspended visits. It is difficult to see the last patient.

2022-06-05T23:10:18.454Z


After the outbreak of the fifth wave of the epidemic, public hospitals and nursing homes stopped family visits, and many patients were unable to see their families for the last time when they were dying. Liang Wanfu, a specialist in geriatrics, the director of health care for the elderly at Hong Kong Sanatorium and Hospital, said:


After the outbreak of the fifth wave of the epidemic, public hospitals and nursing homes stopped family visits, and many patients were unable to see their families for the last time when they were dying.

Liang Wanfu, a geriatric specialist, the director of health care for the elderly at the Sanatorium and Hospital, said that patients and their families do not want to "hang their lives" any more, and would rather sign "no CPR documents" and "advance medical directives" and no longer receive life-sustaining treatment , chose to spend the last time of his life at home, he pointed out that the number of people who died at home was twice as many as before the epidemic.


▼On March 9, Queen Elizabeth Hospital transferred non-COVID-19 patients in the hospital▼


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About 20 people signed "advance medical directive" before vaccination

Liang Wanfu said that at present, anyone who is 18 years old or above and who is mentally capable, even a person who is completely healthy, can make an "advance medical directive".

When a person is terminally ill or in a vegetative state, the person concerned can refuse life-sustaining treatment, but must be accompanied by two witnesses, one of whom is a doctor.

He also pointed out that in the past, there were 10 to 20 middle-aged people who were worried about losing consciousness after the injection before the injection of the new crown vaccine, so they hoped to sign the "advance medical directive" first.

Liang Wanfu pointed out that patients who choose to die at home may be "so severe that they can't eat enough, and (the family) feeds as much as they can."

(Provided by Sanatorium and Hospital).

The patient or family member asks the doctor to sign the discharge certificate

Liang Wanfu pointed out that during the fifth wave of the epidemic, public hospitals and nursing homes have stopped and restricted family visits.

The family members of the patients felt that the number of meetings with the family members was greatly reduced when their lives were dying. In addition, the patients thought that frequent visits to the hospital were very hard and did not want to be admitted.

Therefore, some patients or their family members asked doctors to sign the discharge certificate, hoping to send the patient home in a short time, and the number of inquiries about death at home was twice as high as before the epidemic.

He said that the family members hope to accompany the patient 24 hours a day and walk through the last time of the patient's life together, and do not want the patient to continue to suffer from the pain of treatment in the hospital.

He pointed out that patients who choose to die at home may be "so severe that they can't eat enough, and (the family) feeds as much as they want."

▼On February 21st, the Temporary Care Center of Kwun Tong Choi Wing Road Gymnasium will accept those who are waiting for admission▼


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Not suitable for patients who need supporting hardware and medical expenses

Liang Wanfu pointed out that different preparations are required for death at home. First, the doctor must determine that the patient's condition is terminal or irreversible, the patient and family must reach a consensus, and then the patient must sign the "No CPR Act" and "Advance Medical Directive" , the doctor and medical team will come to follow up the patient's condition every two weeks.

However, the hospital also needs to ensure that the patient's home environment has enough space to place medical equipment, such as hospital beds, oxygen and sputum suction equipment, etc. The family must also be able to afford medical expenses, because medical expenses alone cost 10,000 to 20,000 yuan. It costs about 3,000 to 5,000 yuan for transportation to move the body to the funeral home, and the family also has to pay other fees.

In addition, if the patient suffers from bleeding disorders or severe asthma, the home environment is not suitable for such patients to die at home.

Due to various factors to be considered, public hospitals cannot provide 100% at-home services.

In 2019, the government conducted a public consultation on "Advanced Care: Legislative Proposals on Advance Directives and Death at Home", which suggested clarifying and revising the duties of a doctor's witness when making an "advance directive", "no CPR" The documents are in statutory forms, and the elderly dean can sign a death certificate in the event of a natural death, and no longer need to be heard by the Coroner's Court. Liang Wanfu hopes that the relevant provisions will be passed by the Legislative Council in 2023.

At present, no more than 1% of patients choose to die at home. It is hoped that after the legislation in the future, the recognition will be strengthened so that more people can choose.

Allied health care at Ruttonjee Hospital coordinates remote visits to help terminally ill patients say goodbye: every sentence is unforgettable. Residents of residential care homes in Hong Kong will resume limited visits on May 13. All residents of residential care homes in Hong Kong will be tested for the epidemic in stages. Official visit visitors must test negative by themselves. 26 hospitals resume special visit arrangements. Each patient can be arranged to visit the hospital once or twice a week. A "mobile shelter" is built to isolate the confirmed elderly to prevent cross-infection and to be used as a visiting space.

Source: hk1

All news articles on 2022-06-05

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