Changing End-of-Life Care in Hong Kong

People no longer have to die in hospitals in Hong Kong

About 10 years ago when a relative was nearing the end of her life, my uncle told me that she could not die at home in Hong Kong -- it would have to be reported to the coroner's court, complicating things, particularly in terms of paperwork and getting a death certificate.

Instead it was best that she passed in a hospital, which sounds like a horrible place to be, taking your last breaths surrounded by loved ones in a sterile room shared by other patients in a similar situation.

But things are slowly starting to change. Last year the Legislative Council passed amendments in the cases of where residents who died in care homes for the elderly and met certain criteria are no longer required to be reported to the coroner. 

There are suggestions on end-of-life care

Legislation was also passed in 2024 to legally empower patients to state their medical care wishes for their last days in advance directives.

Now a think tank says Hong Kong has come up with a financial reason why seniors should be allowed to die at home or in care facilities.

Our Hong Kong Foundation released a research report on end-of-life care and suggested the city could save more than HK$90,000 per patient in medical expenses if dying patients spent their last days outside a hospital setting.

"If we have a comprehensive end-of-life care system, it could help reduce the usage of hospital services," foundation vice-president Ryan Ip Man-ki said.

That could hep the healthcare system save HK$91,460 per individual in medical expenses, the foundation said, citing data from a Hong Kong Jockey Club program supporting end-of-life care in the community.

Death doulas help people have "good deaths"

As a result that would help reduce hospitalisation by 11.91 days, accident and emergency admissions by 0.95 times, and intensive care unit stays by 0.29 days.

While these statistics are admirable, what about bringing some humanity to someone's last days on earth?

In North America there are some people who are "death doulas", who help others or their loved ones to prepare for "a good death". 

They educate and empower people on how they would like to die -- would that be at home, who would they like to be there, what kind of music would be played, and so on. It would also include what kind of funeral or service they would like and if they would prefer cremation or burial. 

This is a relatively new concept, but it is something Hong Kong should also consider. We should be giving our end-of-life patients the dignity of choosing how they want to spend their last moments, not in a hospital setting (if possible).

While my relative had planned everything else, from what she wanted to wear in the casket to the music played in her funeral, I'm sure my relative would have appreciated the chance to die in the comfort of her own home.

Turquoise-Coloured Budget for Hong Kong

Chan walking into LegCo to deliver his budget speech

Hong Kong Financial Secretary Paul Chan Mo-po unveiled his budget today and it reflects the tough economic climate the city is in.

Chan reported the deficit is at HK$87.2 billion for financial year 2024-45, with the aim to get Hong Kong into the black by 2028-29. Meanwhile the city's reserves continue to dwindle, from HK$734.5 billion (US$94.5 billion) to HK$647.3 billion, and is expected to decrease further to HK$580.3 billion in 2025-26. 

In order to tighten the government's belt, he announced pay freezes for civil servants and cutting some 10,000 posts. That clearly reveals a very bloated operation.

Ip wearing sunglasses and leather top

Other ways to bring in more money is to charge HK$200 instead of the current HK$120 for departure tax, allow betting on basketball games through the Hong Kong Jockey Club, and to make seniors shell out more for public transportation.

The elderly have had a great time taking advantage of the HK$2 fare on most public transit, and the government has had to subsidise the rest of the fares. But now there will be a cap on 240 trips per month, and seniors will have to pay 20 percent more on those routes costing over HK$10. 

It's controversial because it's mean to take away what was a privilege for the elderly, though 240 trips is more than reasonable.  

Chan's address clocked in at one hour and 48 minutes, and some lawmakers lost interest and looked at their smartphones.

However, it was hard to tell with Regina Ip Lau Suk-yee, who wore dark sunglasses inside the Legislative Council chamber. Lau claimed she had an eye inflammation, but she looked grumpy; she did comply with the dress code of wearing something turquoise to match the colour of the budget's cover.

Olympic Medallist's Welcome Home

Cheung shows off gold medal with fellow fencer Cedric Ho

Gold medal fencer Cheung Ka-long returned home to a hero's welcome at Hong Kong International Airport today.

Media waited for him in the arrivals area along with some 100 fans. Some people even tried to get on flights that would arrive around the same time as Cheung in the hopes of meeting their Olympic idol.

The 27-year-old Cheung is the first man in 68 years to win back-to-back gold medals in foil, and has been handsomely rewarded with HK$9 million (US$1.2 million), of which HK$6 million from the Hong Kong Jockey Club and HK$3 million from Lam Tai Fai College for alumni.

He described winning the two medals as "one of the best moments in [his] life", and said the Hong Kong spirit was instilled in him during training.

"I think our spirit is [to] never give up, to try our best to get everything [and] to give everything on the piste," he said.

"I don't want to have any excuses and waste my efforts from training. I just keep going, keep fighting. This is how it is," he told the crowd.

Cheung's first order of business after arriving home?

Eating some local food.

"I went to Paris some time ago, so I miss Hong Kong food, and any Asian food I can have is great," he said.

Black and White Photography at M+

Two Women (Gloucester Road) by Yau Leung

At Hong Kong's M+, there was a special exhibition featuring black and white photographs sponsored by the Hong Kong Jockey Club. Entitled Noir & Blanc: A Story of Photography, it seems like a good excuse to features pictures from famed photographer Fan Ho, known as the "Cartier-Bresson of the East". 

Ho's photos show cool composition

He was born in Shanghai in 1931 and at the age of 14 was given his first camera, a Kodak Brownie from his father. Within a year he won his first photography competition in 1949 and when he was 18 years old he bought a twin lens Rolleiflex.

A few years later Ho and his parents moved to Hong Kong, where he created numerous stunning images of the city. They include Smoky World, 1959, where he has a low angle shot looking up at people walking through Central Market. It looks very dramatic with a smoky atmosphere as people walk up and down the stairs, and there are gradient tones from white to black.

One his his most famous pictures is Approaching Shadow in 1954, where Ho composes a striking image of a lone woman stands against a wall looking down. In this photograph he manipulated the image by adding a diagonal shadow in the darkroom, apparently alluding to the fading of youth.

Another lovely photograph called Reflection, 1951, features the patterned grilles on windows and in one of them is a shadow of a person.

Liu captures everyday Chinese life

There are other photographers like Yau Leung's Two Women (Gloucester Road) taken in 1961. Two women shown from the back wearing form-fitting qipaos and heels as they walk under the covered walkways of shophouses in Wan Chai. 

For a bit of brevity, contemporary photographer Liu Heung-shing's China After Mao - Skating in Dalian, 1981, shows a man wearing drab work clothes but donning a pair of roller skates and skating past Mao Zedong, who stands valiantly in the wind.

It's a great contrast between the two, Mao serious and looking undeterred, while the man holds a bird-like pose, his left leg in the air, his arms out wide, showing that Western capitalism has made life more fun in China. 

The exhibition even has a self-portrait of landscape photographer Ansel Adams. Called Self-Portrait, Monument Valley, United States, taken in 1958, he is a silhouette, standing on a mountain with his camera on a tripod as there are lightning bolts in the sky over the mountains. 

Adams' wild self-portrait

What a lovely treat to see these photographs, particularly those of Fan Ho!

Noir & Blanc: A Story of Photography

On until July 1, 2024

M+

HK Quarantine-Free by November?

If no need for quarantine, then these containers are for who?

Wow is there really light at the end of the Covid-19 tunnel?

New Secretary for Health Lo Chung-mau is suggesting that quarantine measures could be lifted by November -- just in time for a government-sponsored bankers summit in a bid to keep and lure finance types to Hong Kong.

During that time there is also supposed to be the wildly popular and alcohol-soaked Rugby Sevens tournament... but no details as of yet.

Others are mortified that November is way to far off...

Lo says quarantine-free arrival with conditions

Nevertheless, Lo told the South China Morning Post that as Hong Kong is under the "one country, two systems" principle, the territory does not and has not followed the mainland's Covid-19 protocols and policies.

He said while there is the possibility of quarantine-free arrivals into Hong Kong, there will be conditions attached, but they were not outlined. Presumably it could involve a battery of tests or reporting daily to health workers?

Meanwhile Chief Executive John Lee Ka-chiu has established his advisory panel on the pandemic. There are some familiar faces like David Hui Shu-cheong, Gabriel Leung, and Yuen Kwok-yung, while new ones are Ivan Hung Fan-ngai, Wallace Lau Chak-sing, and Lau Yu-lung.

Former Hong Kong leader Carrie Lam Cheng Yuet-ngor had four advisors, and now Lee has six. As we saw over two and a half years, each expert had their own opinion and that was already bad enough with four, and now there are two more?

Leung stays on despite going to HKJC

Interesting that Gabriel Leung stays on, as he has a new job at the Hong Kong Jockey Club.

It will be interesting to see if Lee keeps a tight leash on these advisors or if they will all tow the same line or not speak at all?

And in other health news -- don't eat too much dim sum! There's a lot of salt in those bamboo steamer baskets!

The Centre for Food Safety tested 120 dim sum samples from 50 restaurants and found the sodium content of shrimp siu mai, spring rolls with shrimp, and steamed minced beef balls were relatively high.

Christine Wong, the centre's controller, said for example, an adult could effectively consume around one-third of the daily sodium intake by just having shrimp siu mai and a shrimp spring roll dish.

She advises people to eat less dim sum and for restaurants to provide sauces on the side and in smaller portions.

Shrimp siu mai has a lot of sodium in it

With inflation skyrocketing, surely there are fewer people eating out there days, and then the Covid-19 social-distancing restrictions too.

And this news is just what restaurants need -- fewer people patronising the food and beverage industry when they are still trying to recover from the pandemic...