This year, Hospice Foundation of Taiwan has the privilege to invite Professor Yoshiyuki Kizawa from Japan, Professor Young Seon Hong from Korea and Dr Chun-kai Fang from Taiwan to share their point of views in the JKT Research Project Taipei.
Prof. Hong recently retired and is now the honorary professor of the Catholic University of Korea. Hospice began in South Korea at the Calvary Hospice by Sisters of the Little Company of Mary in 1965.
In 1998 Korean Society for Hospice and Palliative Care (KSHPC) was established, its membership includes physicians, nurses, social workers, pastors and volunteers.
With the inauguration of KSHPC in 1998, KSHPC has started with Case Conference, CMR program for physicians and nurses, and also published the textbook for hospice and palliative medicine.
During 2002-2004, KSHPC opened Busan and Daejon chapters, and also the Hospice Palliative Model Project for Terminal Cancer.
During 2004-2008, two more chapters of KSHPC were opened at Taegu and Chungbuk, the organisation hosted the 6th Asia Pacific Hospice Conference, and held the Presidency of 2007 APHN council.
The national 10 Year Cancer Control Plan was also published in 2006, as well as the Standards for role of hospice and palliative care and for the hospice facility.
Since 2012, two more chapters in Kwangju and Chungbuk was established. This year, Korean government announced the Law on the Hospice and Palliative Care and the Determination of Life Sustaining treatment for Terminally Ill Patients and Reimbursement of National Medical Insurance system for hospice palliative care.
Overall, Prof. Hong pointed out five aspects that worth paying attention to:
- Comprehensive national palliative care policies are vital for extending access to palliative care, especially like NHI reimbursement, Hospice law, and Provincial distribution of PCU.
- Government and all interested parties in medical, academic and social sectors prepare and collaborate together to make effective enforcement Ordinance and Regulations of the Hospice law with the process of emerging consensus.
- Hospice palliative care services currently target terminal cancer patients and their families only. Patients with serious, life-threatening illness will still need to be included under NHI’s palliative care scope.
- Standardisation of training and operation of advanced training programmes for all types of professionals who participate in the hospice palliative interdisciplinary team are required.
- The general public is still unfamiliar with hospice palliative care services, more public campaigns are required to raise awareness.
For the leadership, KSHPC is looking for a leader with VISION ASIA quality, which means Vision: hospice spirit; Ability to attract donation; Social relationship; International relationship; and Academic interest.
Prof. Hong concluded that the development and growth of hospice in South Korea has been largely dependent upon the vision and the ability of the institution leaders.
Korean hospice is at a very important period of its history, the enactment of hospice law, which is containing determination of life-sustaining treatment for terminally ill patient. So the role of leadership and management is even more important in palliative care in Korea.
Dr Chun-Kai Fang is currently the head director of Hospice and Palliative Care Center in Mackay Memorial Hospital, Board of Hospice Foundation of Taiwan and Council Member of Asia Pacific Hospice Network.
He points out that though with honour Taiwan has significantly improved the ranking in the 2015 Quality of Death report to No. 6, there are still many things needed to be done to establish a sustained palliative care development strategy.
Dr Fang stressed the core force of quality palliative care as staff. Only when you have enough and healthy staff, can they provide palliative care service from their hearts.
Based on Dr Fang’s SWOT analysis of current Taiwanese palliative care, the strength of Taiwan is well developed academic societies, national policies and National Health Insurance system, and also the common knowledge people have with palliative care; however, Taiwan has a serious weakness of not having enough financial support.
Take Mackay Memorial Hospital for example: since 2015 Mackay has expanded the 4 Full Care to 6 Full Care, including Whole Community and Whole Mind along with Whole Person, Whole Family, Whole Team and Whole Process. You can notice the quality Dr Fang is after is no longer from hardware, but the softer side of patient’s heart.
Whole Mind means full heart and soul, psychological services, and psycho-oncology services; as for Whole Community, it means when patients are discharged from the hospital, the care will be continuous offered by the community/society.
As also being the Chairman of Asia Pacific Psycho-Oncology Exchange Foundation, Dr Fang shares with us the application of Distress Thermometer (DT) and Family Relationships Index (FRI).
Both of DT and FRI are currently adopted by the family service systems. FRI is developed by the SaTSG of Medical Research Department based on grief theories and services of social workers and psychologists, and it is evident proved.
In conclusion, no matter it is in Japan, Korea or Taiwan, clinical palliative professionals and academic experts are all contributing, hoping to make every life worthy and being respected.
Besides these private sector efforts, public sectors like Korean and Taiwanese governments have also published the latest legislation on palliative care this year.
Korean government announced the Hospice and Palliative Care and the Determination of Life Sustaining treatment for Terminally Ill Patients and Taiwanese government announced the Patient Self-Determination Act. T
his is surely a vibrant and cheerful update and a big step forward. This is the third year of speaker exchange between Japan, Korea and Taiwan. We are looking forward to seeing more sparks and more exchange and cross-nation collaboration continue on.
The article was first published in the HFT newsletter.