Introduction of Palliative and End of Life Care

In Hong Kong, Advance Care Planning (ACP) is translated and promoted as a communication process in late-stage care where individuals pre-plan and decide on the care and arrangement they wish to receive when they lose mental capacity in the future, aiming to reduce suffering during the end-of-life period. Through this communication, family members or caregivers, healthcare professionals, and facilitators understand the individual's medical and caregiving preferences and assist oneself in executing the plan. This kind of communication also allows individuals to re-explore what is most important to them and seize the opportunity to fulfill their wishes.

Currently, there is no standardized  territory-wide future care planning applicable to all adults in Hong Kong. The Hospital Authority has its own set of Advance Care Planning guideline and documents primarily targeting seriously ill patients and those with deteriorating conditions, aiming to discuss decisions regarding life-sustaining treatment and care with patients, their families, and healthcare professionals.

However, in countries with more advance palliative care policies, some scholars and healthcare professionals have started to decouple ACP discussions from end-of-life care discussions in order to reduce public resistance to participating in life discussion and make the relevant discussions more aligned with the needs of different life stages. Therefore, the discussions emphasize what is most important to oneself when they are in good health, what becomes more important when one's health deteriorates, and what kind of individuals and social capital that can assist when one requires care, in order to maintain the quality of life for oneself and caregivers [1].

Therefore, we continue to use the acronym ACP, yet, where "A" not only represents "Advance", but also emphasizes "Autonomous," meaning autonomous management of one's health and life. "CP" not only refers to "Care Planning" but also emphasizes "Care and Life Planning," as life planning involves discussing not only medical and caregiving aspects but also other matters important to one's life. The Autonomous Care and Life Planning should cover at least the following 7 categories:

1.    Personal
2.    Health
3.    Care
4.    Legal
5.    Clinical
6.    Finance
7.    Self Help Network

We primarily classify service information according to these 7 categories, and place Advance Care Planning services in a separate column. We hope this service categorization can assist individuals in managing their lives on their own, and initiating discussions on life planning with their families, healthcare professionals, and other important stakeholders.

[1]: Abel, J., Kellehear, A., Sanders, C. M., Taubert, M., Kingston, H. (2020). Advance Care Planning Re-imagined: a Needed Shift for COVID TIMES and Beyond. Palliative Care and Social Practice, V14, 1-8.