Advance Care Planning – Start Small, Start Now

By 2064, over 35% of Hong Kong’s population will require some form of advance care planning. Yet, many of us are not prepared for it, let alone thought about it. 

The ageing population in Hong Kong is swelling, thanks to a general increase in life expectancy. According to the “Hong Kong Population Projections 2015-2064”, the number of elderly aged 65 or older will reach 2.58 million by 2064, making up almost 36%  of the population in the city. By 2066, the average life expectancy will reach 87.1 years for men and 93.1 for women. 

While a longer life expectancy can be a cause for celebration, it also raises some fundamental concerns around money and health. Two-thirds of those aged over 65 will need some kind of care, whether it is home care, assisted living, nursing care, or a combination of all three. To finance the anticipated longevity requires careful planning in all aspects.

Among the laundry list of priorities, a long-term care plan often comes as an afterthought. Why? Because many have failed to entertain the possibility that their health could deteriorate, and that  end-of-life could arrive sooner than expected — often the result of an illness, a sudden stroke, or even an accident. When this happens, family members are often left having to make decisions on behalf of the patient, with little or no time to reflect on what their loved one might have wanted.

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The absence of a genuine end-of-life discussion could have a lasting impact. A study published in 2008 found that a lack of collective decision making (on issues related to the location of care, use of life-sustaining treatments, and availability of comfort measures, etc.) can reduce the patient’s quality of life but also enhance caregiver anxiety and depression.

“Instead of delaying the conversation until it’s too late, family carers should approach end-of-life issues when your loved ones are healthy and able,” suggests Mickey Kwok Keung Li, who’s been working as a professional caregiver since 2013. 

Mickey breaks it down into 3 core discussion points when planning for long-term care:

1) Explore care options

  • What are the available and preferred methods of care out there?  Would the patient prefer to be looked after at home, in hospital, or at a nursing home?
  • Where does the patient want to spend the last few hours of his or her life? If so, is this option feasible?

2) Define roles and responsibilities for family members

  • Would the patient prefer to be tended to by a care coordinator,  nurses, or family members?
  • What is the best way to allocate manpower? Are your family members able to deliver  care?
  • If your loved one decides to live  independently at home rather than move in with you or into a nursing home. How can you help the patient meet his or her goals?

3) Anticipate costs 

  • Who will be settling the finances? Does the patient have the means, or is it a joint effort among family members? 
  • What are the alternatives?
  • Is an insurance plan for long term care a way out?

By covering the basics, family members can develop an initial plan and establish a foundation to build upon later. It is important to note that your loved one’s needs may be subject to change, and it is impossible to plan for every detail or eventuality. To manage the uncertainty and disruption to your daily life as a potential caregiver, we advise family members to frequently check in on the patient’s situation and make adjustments accordingly.