“Can I not be admitted to the hospital?” asked Madam Tsang Yip-hung to the nurse. In her 80s, Madam Tsang went to the hospital every week to undergo intubation and treatment. With puncture marks all over her arms, she could but endure the pain by herself. As soon as she learnt about The Salvation Army Palliative Care in Residential Care Homes for the Elderly Project (or PC Project), she seemed to have found a chance to break this painful cycle, and decided to join the project right away.

Madam Tsang completed lower secondary school decades ago. In those days, she was regarded as an intellectual, modern and independent lady. When she has aged, she still knew her own mind and refused to live with her son and daughter-in-law. She did enjoy living alone and led a relaxing life, meeting friends for dramas or singing Cantonese opera during her leisure time.

Frequent Visits to the Hospital

However, not every day is a sunny day. Owing to high blood pressure and sugar level, Madam Tsang has suffered from strokes for four times. As a result, the left side of her body was paralysed. Subsequently, she was admitted to The Salvation Army Po Lam Residence for Senior Citizens for care. “Very often we received calls from the  Residence, sometimes in the middle of the night, telling us her blood sugar was off the chart and must be admitted to the hospital at once,” said her daughter-in-law. Intravenous therapy, blood drawing and drip are almost the must-dos for every admission. She was hospitalised for one week, discharged for two days, and then urgently rushed to the hospital again. Every time when her family was notified, they left behind all their work and hurried to the hospital. The same scenario repeated again and again, making the entire family physically and mentally exhausted.

In 2015, Madam Tsang and her family learnt that The Salvation Army’s PC Project could provide comprehensive palliative and hospice care. Together they listened to the detailed explanation by the social worker of the Residence and realised that elders with terminal illnesses may forgo futile treatment and opt for pain relief medication. They can receive spiritual and mental care, and pass away naturally with dignity in a familiar and comfortable setting. “Great! It’s good not to go to hospital again,” Madam Tsang said at once. After considering for a week, she decided to join the project and her family respected her choice.

Physical and Mental Care

From then on, the project physician has continued to monitor Madam Tsang’s physical condition and prescribe some medicine for her, whereas nurses regularly measured her blood sugar level. Staff of the residence closely attended to her and kept in close touch with her family. The Salvation Army social workers together with volunteers paid her regular visits and held gathering parties for the family to reminisce the good old days. Sometimes they would bring Madam Tsang out for a walk despite her mobility challenge.

Visiting the flower markets was the most anticipated annual activity for Madam Tsang. To help get her smiles back, the social worker and residence’s staff took her for a walk in a nearby flower market during the Chinese New Year in 2017. Despite being tired, she was so excited and kept asking to try various snacks. As she turned around, she could not get her eyes off the blossoming orchids and said, “Let’s buy this one!” Holding the little pot of orchids and a few bright red couplets in her hands, Madam Tsang returned to the residence beaming with smiles. She put the flowers at the bedside, reminding her of such a beautiful day.

Spiritual Comfort

Madam Tsang also kept thinking about Lieutenant Billy Lam, Corps Officer (Pastor) of Tseung Kwan O Corps (Church) of The Salvation Army. Over the past two years, the continued visits and talks have built a strong relationship between Madam Tsang and Lieutenant Lam. When she was in pain, Lieutenant Lam would persuade her, “Try  praying. Jesus will help you.” Madam Tsang would calm down and find peace through prayers.

Life and death are not in our hands, but Madam Tsang wants to properly make her last plans: to complete the final journey of her life comfortably and naturally. Her family respects her wish and says, “Let’s meet again in heaven.” 

Hear the Elders Out

One of the reasons for Madam Chan Kit-bing, an elderly resident of The Salvation Army Po Lam Residence for Senior Citizens, to join The Salvation Army Palliative Care in Residential Care Homes for the Elderly Project is that “there’re more familiar faces here (in the residence). I don’t want to go to the hospital.” Many elders think the same and want to pass away peacefully in a familiar setting.

According to social worker Chan Ho-kong, the elderly are generally more open to discuss the issue of life and death; on the contrary the family would treat it as a taboo. The Salvation Army encourages family members to make end-of-life planning with the elders while they still have cognitive abilities, and respect the elders’ wishes.

The Salvation Army Palliative Care in Residential Care Homes for the Elderly Project

Since its implementation in 2010, the project sponsored by ”la Caixa” Foundation and The Bank of East Asia Charitable Foundation Limited has been providing professional palliative care and comprehensive mental, social and spiritual care for elderly patients with terminal illness. Some participating residences have set up special rooms where family members can stay with the elders throughout their final journey of life. The project provides counselling service for participants and their family, and offers training to medical and nursing professionals and residence staff. Through organising seminars and workshops, the project also promotes life and death education to the elderly, family and residence staff.