Being in the forefront among the top hospice and palliative care countries, Taiwan receives not only affirmation but also pressure to continue the progress. After all, there is still much to do and a long way to go. While taking the responsibility to carry out hospice care, it is important not to forget to encourage the team members since it is due to their endeavor and perseverance that the Hospice Foundation in Taiwan has continued to grow strong over the years.
For decades, Taiwan has spared no effort in promoting hospice care, particularly in these four aspects. The first is to promote life education to the public. With the efforts made by governmental and non-governmental organizations, professional academic institutions, and religious groups, a significant increase in acceptance of the hospice concept can be seen, when compared to the early days when hospice was just an idea recently introduced to Taiwan. Secondly, the participation of professional academies and institutes in hospice also infuses sufficient energy on-site. Thirdly, the laws and policies are the driving force that has promoted Taiwan’s hospice care so that providing hospice care can be protected and have its legal basis, which currently, Taiwan is taking the lead in the world. Finally, our colleagues consistently improve the quality and capability of care.
The above four aspects make us stand out among 81 countries included in the Quality of Death and Dying Index 2021. We are proud that Taiwan received a very high overall rating in the Index.
Embrace the Frontline Healthcare Workers Rather than Discourage
In order to train qualified workers, we have held many training courses, with an average of 300 participants completing the training annually. However, the dilemma of insufficient staffing in the medical field still exists. We ask ourselves, Where are all the trainees that are needed in this field? It forces us to realize that hospice care is a job that may be well-received by the public, but nevertheless, is unpopular among healthcare workers because of the sheer amount of stress involved.
Unlike the typically accepted medical treatment that aims to save lives and extend people’s lifespan, hospice care workers have the invisible yet enormous pressure when caring for the dying patients and assisting them to a good death.
Therefore, instead of forcing the healthcare professionals to move forward, I usually insist that we give applause and encouragement to those who are willing to devote themselves to hospice care. After all, how can we develop and establish hospice care if these frontline workers are already discouraged themselves, and may not even wish to stay in the field? They are undoubtedly a most valuable foundation for hospice care to carry on.
By Using Soft Power, Taiwan’s Hospice Care Can Stride Forward
On the other hand, while accepting the affirmation of Taiwan’s hospice success, we should neither belittle ourselves nor become complacent. There are still many areas in hospice care which need improvement; we can certainly do even better, and we need to do better.
Some twenty years ago, a quote by Morrie Schwartz made a deep impression on me. He said, “Learn how to live and you’ll know how to die; learn how to die, and you’ll know how to live.” I did not quite understand what the sentence wanted to convey at that time; however, after numerous years of contact working with multiple patients and their families in hospice care, I have gradually come to realize the depth of its meaning. In the past, when a patient was dying, we wanted to help him die well, but it would actually be more appropriate to say that we should help him live well. After all, how can we die well without first having lived well? And in order to live well, there is nothing else more important than to help a person obtain a peaceful body, mind, society (i.e., relationships), and spirit.
Therefore, we should continue to promote and publicize life care education; we should expect the influences of government, non-government, and religious groups to be combined; and, we should hope to receive more attention from the professional medical associations.
The nature of hospice care is to provide warm support, caring, and companionship, which do not conflict with the typical medical treatment. Undoubtedly, the practice of hospice care is a collective consensus, particularly when holistic care is well advocated nowadays. Even if we can discard the word hospice, we cannot lose the spirit of hospice. All medical associations should give more attention to hospice care and include the topic in their core curriculum. It is gratifying to know that the Taiwan Society of Nephrology and Taiwan Society of Critical Medicine have already added hospice care courses into their curriculum.
In order to improve the quality of Hospice Care, the government also convened experts to write the White Paper on Hospice and Palliative Care in Taiwan (commissioned by the Taiwan National Health Research Institute) so that we can follow the direction and achieve the set goals step by step.
Taiwan’s warm and friendly culture, as well as its soft powers such as the kind-hearted customs, are undoubtedly key advantages for promoting hospice care. We look forward to closely linking the love and warmth, and utilizing the power of social harmony to build upon a better hospice environment in Taiwan.