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Fragmented community efforts and low public engagement in current EoLC community services
are vital issues that the Government need to address in order to confer confidence in the public to
pass away within preferred familiar surroundings, no matter in RCHEs or at home. An
overarching policy framework tackling more than just legal barriers should be in place to
enable dying in community settings become an actual option.

3. Conclusion: EoLC service provision in community settings
We reiterate the sub-themes in this document below to encapsulate the core message of this
submission:
 High public acceptance on advance directives (1.1)

 Limited public understanding of advance directives (1.2)

 Establishment of ADs is resource-draining (2.1)

 An efficient pathway is a key motivating factor for making ADs (2.2)

 Embracing technology in the end-of-life care model design (2.3)

 Community resources are needed to actualise dying in place (2.4)

Whilst OHKF welcomes the current legislative proposal on promoting advance directives and
dying in place in Hong Kong, it is evident to us that a comprehensive policy and vision is yet to
be devised to allow the realisation of a ‘good death’ in Hong Kong. This is echoed in a
systematic review paper by the Chinese University of Hong Kong that covered 35 reports to
summarise key features in EoLC together with implementation barriers and facilitators.
“Supportive policy and environment”, which involves legal frameworks and policies that enable
the delivery of quality EoLC, is only one of eleven factors that the paper underlined across
macro-, meso- and micro- levels (Threapleton et al, 2017).

The urgency to develop an apt EoLC model is further heightened by the pressing trend of
population ageing highlighted by statistics indicating that Hong Kong’s elderly population will
increase to one million plus in the coming twenty years (Census and Statistics Department,
2017). Furthermore, our study indicated that today, already 11.2% of respondents needed to
provide daily care to the elderly, or to patients with chronic conditions within their own
household (OHKF, 2019a). This prevalence is set to increase with population ageing, further
illustrating a rising need for well-developed, accessible and comprehensive EoLC services in
Hong Kong.

Amongst the many aspects contributing to the betterment of EoLC in Hong Kong, we emphasise
the importance of public education and the development of a community-based EoLC service

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