In its advanced stages, most patients need extensive care which includes palliative care in permanent or out-patient hospice nursing ("Cancer: Prognosis", n.d.).
The Coordinating Committee (Hospice) of Hospital Authority (HA) Hong Kong SAR Government defines hospice or palliative care as "the care of the patients and their families with active progressive advanced disease and a limited prognosis for whom the focus of care is the quality of life" (Liu, 2005, p.183). Palliative care started in Hong Kong in 1982. At the beginning, it was a "consultative team" in a general hospital. In 1986, a second palliative care team was established who worked primarily with those who had incurable lung malignancy. Diagnosis of the disease was not necessary in order to get a referral. The team gave pain and symptom management as well as practical, emotional and spiritual support to the patient and their family. Due to lack of public knowledge, patients had unrealistic expectations thinking that palliative care can cure the disease and prolong ones life. It was not until 1985 when a demarcation between cure and palliative care was made with the help of the Society for the Promotion of Hospice Care. Their goals were aimed at public education, fund raising, and the establishment of an independent hospice in Hong Kong which will serve as a discernible symbol for the public (Sham, 2003, p.65). It was through their efforts that the Hong Kong community came to know and understand the scope of palliative care. In an article by Hon Joseph Lee in his interview with Dr. York Chow on hospice care services, it was written:
At present, there are 10 palliative care centers and six oncology centers [in Hong Kong] under HA [Hospital Authority] to provide palliative/hospice care, which includes in-patient service, out-patient service, hospice/palliative day care service, home care service and bereavement counseling (December, 2008).
Patients who admit themselves in hospice are almost always dying. Different cultures have different perceptions of death. In Hong Kong, "death is seen as a curse" (Chow and C. Chan, 2005, p.2). It is believed that the very thought of death will bring bad luck and the very mention of death will invite evil spirits in or speed up the process. The Chinese concept of death is deep-rooted and is influenced by the Folk and Taoist beliefs that "the dead have to be judged in hell and punished according to the sins that they have committed in life" (C. Chan, 1999, p.213). Chan (1999) cited examples that illustrate the Folk and Taoist teachings on children:
Children are told if they steal when alive, when they die their hands will be cut off as a punishment. If people do not treat their family well, they will be eaten by hungry dogs. If someone kills, he or she will be burnt in eternal fire (p.213).
Because of this grotesque and mind boggling picture, they do not talk about death nor do they prepare for it. This leaves them ill-equipped and often times carrying heavy emotional baggage to their grave.
Chinese people in Hong Kong have a traditional attitude that contributes to the disinclination to intervene when a person is dying. It is believed t