策劃及捐助

合作院校

社區照顧讓晚期患者心安、家寧

香港每年約有六萬人離世，其中超過八成死因屬非急性疾病。當面對不治之症時，患者與家屬不僅承受身體的煎熬，更面臨心靈創傷、家庭壓力與情緒困境的連鎖衝擊。儘管醫療體系致力於疾病治療，但對晚期病患而言，如何在有限的生命時光中保持生活質素，成為更迫切的課題。加上，晚期病患者在社區比在醫院的時間較長。為此，香港賽馬會慈善信託基金於2016年策劃和捐助「賽馬會安寧頌計劃」，以跨專業實證為本的社區晚期照護模式，讓病患在熟悉的環境中獲得專業支援，真正實現「心安、家寧」的願景。

2024年服務新里程

經過多年努力，計劃在病患長者照顧上成功實踐及建立了有效的醫社合作模式；加上計劃的社區公眾教育及政府對晚期照顧的關注，大眾對晚期照顧的認識和接受度提升。香港賽馬會慈善信託基金看到殘疾人士面對晚期病患，會有不同或額外的挑戰，於2024年策劃並撥款資助一項為期五年名為「賽馬會安寧頌：融和篇」（JCECC: Unison）的計劃，旨在以現時對長者創建的社區晚期照顧安寧照顧服務模式，調節切合這群體的獨特需要，再開發出合理調整的新服務模式，讓他們及其照顧者同樣地得到優質的社區晚期照顧。

「生之喜悅、逝之安寧 — 共建有選擇的未來」賽馬會安寧頌計劃一直以來見證這份信念的實踐。我們持續深化社區照護網絡，透過「醫社合作」創新模式，讓每個生命都能在溫暖的支持中，寫下屬於自己的圓滿篇章。

晚期病患者及其照顧者的需要

晚期病患者及其照顧者在疾病歷程中，會面對各種不同層面的挑戰。這些困難因人而異，程度與性質各不相同，且往往同時出現多重挑戰。一般而言，挑戰可能涉及實際層面，例如徵狀控制、經濟壓力、日常生活及照顧安排；亦可能須處理情感、家庭關係，以及尋找社會支援資源。

患者和照顧者面對的挑戰及需要亦未必相同，透過精準的評估，切合需要的服務，才能提供適切有效的支援。

我們的項目

長者和家屬

殘疾人士和家屬

關鍵術語

紓緩治療

根據世界衛生組織，紓緩治療旨在幫助病人以及其家屬，在面對威脅生命的疾病時，提昇其生命質素 1。紓緩治療透過及早辨識、全面評估以及治療，來預防及減輕因疾病帶來的痛楚以至身、心、社靈的問題。紓緩治療既可以於疾病早期開始應用，也能與其他旨在延長壽命的治療同時進行。

參考資料

安寧照顧

世界各地對安寧照顧的定義各有不同，但都指向對步入生命最後階段的病人所提照顧和支援2。每個人的「生命晚期」所牽涉的時間均不盡相同：通常都指生命最後幾個月甚至幾個星期，但對部分人來說可長達數年，包括了：

  • 面對晚期、惡化中而無法治癒的疾病的病人或
  • 於12個月內，因身體衰老又或所患疾病而離世機會增多的病人。
參考資料

預設照顧計劃

預設照顧計劃通常指病人、醫療服務提供者、病人家屬或照顧者的一個溝通過程3,4。病人可就未來的醫療或個人護理及照顧表達價值觀、意願和意向，商討當沒有精神行為能力作出決定時，他/她所屬意的醫療及照顧方式，或作出拒絕接受維持生命治療的預設醫療指示 3,4。預設照顧計劃旨在讓病人及家屬或照顧者得到符合他們意願的晚期照顧 5。在香港，預設照顧計劃或作出預設醫療指示完全出於自願。

參考資料

預設醫療指示

「預設醫療指示」是一份具有法律約束力的文件，讓成年病人在有精神能力就維持生命治療作決定時，與家人及醫護人員進行深入討論，然後預先訂立指示 6。一旦病情轉差，只要符合指示中訂明的先決條件，包括罹患未期疾病、處於持續植物人或陷入不可逆轉的昏迷，又或於罹患其他晚期不可逆轉的壽命受限疾病，在病人沒有精神能力就維持生命治療作決定的時間，醫護人員便會遵從病人的意願，不提供或撤去相關的維持生命治療。

參考資料

香港紓緩治療及社區安寧照顧重事回顧

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參考資料

References

  1. World Health Organization. (2020, August 5). Palliative care.
    https://www.who.int/news-room/fact-sheets/detail/palliative-care
  2. National Institute for Health and Care Excellence (2019). End of life care for adults: service delivery.
    https://www.nice.org.uk/guidance/ng142/resources/end-of-life-care-for-adults-service-delivery-pdf-66141776457925
  3. Health Bureau. (2020). Consultation Papers. https://www.healthbureau.gov.hk/en/press_and_publications/consultation/190900_eolcare/index.html
  4. Food and Health Bureau. (2019). End-of-life Care: Legislative Proposals on Advance Directives and Dying in Place.
    https://www.healthbureau.gov.hk/download/press_and_publications/consultation/190900_eolcare/e_EOL_care_legisiative_proposals.pdf
  5. Sudore, R. L., Lum, H. D., You, J. J., Hanson, L. C., Meier, D. E., Pantilat, S. Z., … & Heyland, D. K. (2017). Defining advance care planning for adults: a consensus definition from a multidisciplinary Delphi panel. Journal of pain and symptom management, 53(5), 821-832.
    https://doi.org/10.1016/j.jpainsymman.2016.12.331
  6. Health Bureau. (2024). Other publications.
    https://www.healthbureau.gov.hk/en/press_and_publications/otherinfo/241100_adlto/index.html

References

  1. World Health Organization. (2020, August 5). Palliative care.
    https://www.who.int/news-room/fact-sheets/detail/palliative-care
  2. National Institute for Health and Care Excellence (2019). End of life care for adults: service delivery.
    https://www.nice.org.uk/guidance/ng142/resources/end-of-life-care-for-adults-service-delivery-pdf-66141776457925
  3. Health Bureau. (2020). Consultation Papers. https://www.healthbureau.gov.hk/en/press_and_publications/consultation/190900_eolcare/index.html
  4. Food and Health Bureau. (2019). End-of-life Care: Legislative Proposals on Advance Directives and Dying in Place.
    https://www.healthbureau.gov.hk/download/press_and_publications/consultation/190900_eolcare/e_EOL_care_legisiative_proposals.pdf
  5. Sudore, R. L., Lum, H. D., You, J. J., Hanson, L. C., Meier, D. E., Pantilat, S. Z., … & Heyland, D. K. (2017). Defining advance care planning for adults: a consensus definition from a multidisciplinary Delphi panel. Journal of pain and symptom management, 53(5), 821-832.
    https://doi.org/10.1016/j.jpainsymman.2016.12.331
  6. Health Bureau. (2024). Other publications.
    https://www.healthbureau.gov.hk/en/press_and_publications/otherinfo/241100_adlto/index.html

References

  1. World Health Organization. (2020, August 5). Palliative care.
    https://www.who.int/news-room/fact-sheets/detail/palliative-care
  2. National Institute for Health and Care Excellence (2019). End of life care for adults: service delivery.
    https://www.nice.org.uk/guidance/ng142/resources/end-of-life-care-for-adults-service-delivery-pdf-66141776457925
  3. Health Bureau. (2020). Consultation Papers. https://www.healthbureau.gov.hk/en/press_and_publications/consultation/190900_eolcare/index.html
  4. Food and Health Bureau. (2019). End-of-life Care: Legislative Proposals on Advance Directives and Dying in Place.
    https://www.healthbureau.gov.hk/download/press_and_publications/consultation/190900_eolcare/e_EOL_care_legisiative_proposals.pdf
  5. Sudore, R. L., Lum, H. D., You, J. J., Hanson, L. C., Meier, D. E., Pantilat, S. Z., … & Heyland, D. K. (2017). Defining advance care planning for adults: a consensus definition from a multidisciplinary Delphi panel. Journal of pain and symptom management, 53(5), 821-832.
    https://doi.org/10.1016/j.jpainsymman.2016.12.331
  6. Health Bureau. (2024). Other publications.
    https://www.healthbureau.gov.hk/en/press_and_publications/otherinfo/241100_adlto/index.html

References

  1. World Health Organization. (2020, August 5). Palliative care.
    https://www.who.int/news-room/fact-sheets/detail/palliative-care
  2. National Institute for Health and Care Excellence (2019). End of life care for adults: service delivery.
    https://www.nice.org.uk/guidance/ng142/resources/end-of-life-care-for-adults-service-delivery-pdf-66141776457925
  3. Health Bureau. (2020). Consultation Papers. https://www.healthbureau.gov.hk/en/press_and_publications/consultation/190900_eolcare/index.html
  4. Food and Health Bureau. (2019). End-of-life Care: Legislative Proposals on Advance Directives and Dying in Place.
    https://www.healthbureau.gov.hk/download/press_and_publications/consultation/190900_eolcare/e_EOL_care_legisiative_proposals.pdf
  5. Sudore, R. L., Lum, H. D., You, J. J., Hanson, L. C., Meier, D. E., Pantilat, S. Z., … & Heyland, D. K. (2017). Defining advance care planning for adults: a consensus definition from a multidisciplinary Delphi panel. Journal of pain and symptom management, 53(5), 821-832.
    https://doi.org/10.1016/j.jpainsymman.2016.12.331
  6. Health Bureau. (2024). Other publications.
    https://www.healthbureau.gov.hk/en/press_and_publications/otherinfo/241100_adlto/index.html

References

  1. Lam, W. M. (2019). Palliative care in Hong Kong–past, present and future. Hong Kong Practitioner, 41(2), 39-46.
  2. Society for the Promotion of Hospice Care. (n.d.). About us | Society for the Promotion of Hospice Care. Retrieved from
    https://www.hospicecare.org.hk/about-us.php?lang=en
  3. Chan, I. K., Fong, C. H., Wong, Y. E., Lou, V. W., & Chan, C. L. (2019). Innovation. Impact: The Foundation of Community-based End-of-Life Care in Hong Kong (pp. 15-28). The Jockey Club End-of-Life Community Care Project. Retrieved from
    http://www.socsc.hku.hk/JCECC/case_book/HKU_SS_JCECC_book.pdf
  4. LCQ11: Palliative care services for terminally-ill patients. (2016, March 16). [Press release]. Retrieved from
    https://www.info.gov.hk/gia/general/201603/16/P201603160553.htm
  5. Food and Health Bureau. (2019, September). End-of-life Care: Legislative Proposals on Advance Directives and Dying in Place – Consultation Document. Retrieved from
    https://www.healthbureau.gov.hk/download/press_and_publications/consultation/190900_eolcare/e_EOL_care_legisiative_proposals.pdf
  6. Jockey Club End-of-Life Community Care Project. (n.d.). Background and Objectives. Retrieved from
    https://foss.hku.hk/jcecc/en/about-us/background-and-objectives/
  7. Society for the Promotion of Hospice Care. (n.d.). Palliative Care Service. Retrieved from
    https://www.hospicecare.org.hk/service-detail.php?id=22&lang=en
  8. Hospital Authority. (2017). Strategic Service Framework for Palliative Care. Retrieved from
    https://www.ha.org.hk/haho/ho/ap/PCSSF_1.pdf
  9. Jockey Club Bereavement Care and Support Alliance Project. (n.d.). About JCBeCARE. Retrieved from
    https://jcbecare.hk/en/about-us

Disclaimer

The information provided on this web site is presented solely for general public knowledge only and is deemed as accurate as possible at the time of publication. All information on this site is provided in good faith, however, we make no representation or warranty of any kind, express or implied, regarding the accuracy, adequacy, validity, reliability, availability, or completeness of any information on the site. The Faculty of Social Sciences and the Department of Social Work and Social Administration of the University of Hong Kong do not assume any responsibility for any risks associated with the information on this website or websites to which it is linked.

參考資料

  1. World Health Organization. (2020, August 5). Palliative care.
    https://www.who.int/news-room/fact-sheets/detail/palliative-care
  2. National Institute for Health and Care Excellence (2019). End of life care for adults: service delivery.
    https://www.nice.org.uk/guidance/ng142/resources/end-of-life-care-for-adults-service-delivery-pdf-66141776457925
  3. Health Bureau. (2020). Consultation Papers. https://www.healthbureau.gov.hk/en/press_and_publications/consultation/190900_eolcare/index.html
  4. Food and Health Bureau. (2019). End-of-life Care: Legislative Proposals on Advance Directives and Dying in Place.
    https://www.healthbureau.gov.hk/download/press_and_publications/consultation/190900_eolcare/e_EOL_care_legisiative_proposals.pdf
  5. Sudore, R. L., Lum, H. D., You, J. J., Hanson, L. C., Meier, D. E., Pantilat, S. Z., … & Heyland, D. K. (2017). Defining advance care planning for adults: a consensus definition from a multidisciplinary Delphi panel. Journal of pain and symptom management, 53(5), 821-832.
    https://doi.org/10.1016/j.jpainsymman.2016.12.331
  6. Health Bureau. (2024). Other publications.
    https://www.healthbureau.gov.hk/en/press_and_publications/otherinfo/241100_adlto/index.html

參考資料

  1. World Health Organization. (2020, August 5). Palliative care.
    https://www.who.int/news-room/fact-sheets/detail/palliative-care
  2. National Institute for Health and Care Excellence (2019). End of life care for adults: service delivery.
    https://www.nice.org.uk/guidance/ng142/resources/end-of-life-care-for-adults-service-delivery-pdf-66141776457925
  3. Health Bureau. (2020). Consultation Papers. https://www.healthbureau.gov.hk/en/press_and_publications/consultation/190900_eolcare/index.html
  4. Food and Health Bureau. (2019). End-of-life Care: Legislative Proposals on Advance Directives and Dying in Place.
    https://www.healthbureau.gov.hk/download/press_and_publications/consultation/190900_eolcare/e_EOL_care_legisiative_proposals.pdf
  5. Sudore, R. L., Lum, H. D., You, J. J., Hanson, L. C., Meier, D. E., Pantilat, S. Z., … & Heyland, D. K. (2017). Defining advance care planning for adults: a consensus definition from a multidisciplinary Delphi panel. Journal of pain and symptom management, 53(5), 821-832.
    https://doi.org/10.1016/j.jpainsymman.2016.12.331
  6. Health Bureau. (2024). Other publications.
    https://www.healthbureau.gov.hk/en/press_and_publications/otherinfo/241100_adlto/index.html

參考資料

  1. World Health Organization. (2020, August 5). Palliative care.
    https://www.who.int/news-room/fact-sheets/detail/palliative-care
  2. National Institute for Health and Care Excellence (2019). End of life care for adults: service delivery.
    https://www.nice.org.uk/guidance/ng142/resources/end-of-life-care-for-adults-service-delivery-pdf-66141776457925
  3. Health Bureau. (2020). Consultation Papers. https://www.healthbureau.gov.hk/en/press_and_publications/consultation/190900_eolcare/index.html
  4. Food and Health Bureau. (2019). End-of-life Care: Legislative Proposals on Advance Directives and Dying in Place.
    https://www.healthbureau.gov.hk/download/press_and_publications/consultation/190900_eolcare/e_EOL_care_legisiative_proposals.pdf
  5. Sudore, R. L., Lum, H. D., You, J. J., Hanson, L. C., Meier, D. E., Pantilat, S. Z., … & Heyland, D. K. (2017). Defining advance care planning for adults: a consensus definition from a multidisciplinary Delphi panel. Journal of pain and symptom management, 53(5), 821-832.
    https://doi.org/10.1016/j.jpainsymman.2016.12.331
  6. Health Bureau. (2024). Other publications.
    https://www.healthbureau.gov.hk/en/press_and_publications/otherinfo/241100_adlto/index.html

參考資料

  1. World Health Organization. (2020, August 5). Palliative care.
    https://www.who.int/news-room/fact-sheets/detail/palliative-care
  2. National Institute for Health and Care Excellence (2019). End of life care for adults: service delivery.
    https://www.nice.org.uk/guidance/ng142/resources/end-of-life-care-for-adults-service-delivery-pdf-66141776457925
  3. Health Bureau. (2020). Consultation Papers. https://www.healthbureau.gov.hk/en/press_and_publications/consultation/190900_eolcare/index.html
  4. Food and Health Bureau. (2019). End-of-life Care: Legislative Proposals on Advance Directives and Dying in Place.
    https://www.healthbureau.gov.hk/download/press_and_publications/consultation/190900_eolcare/e_EOL_care_legisiative_proposals.pdf
  5. Sudore, R. L., Lum, H. D., You, J. J., Hanson, L. C., Meier, D. E., Pantilat, S. Z., … & Heyland, D. K. (2017). Defining advance care planning for adults: a consensus definition from a multidisciplinary Delphi panel. Journal of pain and symptom management, 53(5), 821-832.
    https://doi.org/10.1016/j.jpainsymman.2016.12.331
  6. Health Bureau. (2024). Other publications.
    https://www.healthbureau.gov.hk/en/press_and_publications/otherinfo/241100_adlto/index.html

參考資料

  1. Lam, W. M. (2019). Palliative care in Hong Kong–past, present and future. Hong Kong Practitioner, 41(2), 39-46.
  2. Society for the Promotion of Hospice Care. (n.d.). About us | Society for the Promotion of Hospice Care. Retrieved from
    https://www.hospicecare.org.hk/about-us.php?lang=en
  3. Chan, I. K., Fong, C. H., Wong, Y. E., Lou, V. W., & Chan, C. L. (2019). Innovation. Impact: The Foundation of Community-based End-of-Life Care in Hong Kong (pp. 15-28). The Jockey Club End-of-Life Community Care Project. Retrieved from
    http://www.socsc.hku.hk/JCECC/case_book/HKU_SS_JCECC_book.pdf
  4. LCQ11: Palliative care services for terminally-ill patients. (2016, March 16). [Press release]. Retrieved from
    https://www.info.gov.hk/gia/general/201603/16/P201603160553.htm
  5. Food and Health Bureau. (2019, September). End-of-life Care: Legislative Proposals on Advance Directives and Dying in Place – Consultation Document. Retrieved from
    https://www.healthbureau.gov.hk/download/press_and_publications/consultation/190900_eolcare/e_EOL_care_legisiative_proposals.pdf
  6. Jockey Club End-of-Life Community Care Project. (n.d.). Background and Objectives. Retrieved from
    https://foss.hku.hk/jcecc/en/about-us/background-and-objectives/
  7. Society for the Promotion of Hospice Care. (n.d.). Palliative Care Service. Retrieved from
    https://www.hospicecare.org.hk/service-detail.php?id=22&lang=en
  8. Hospital Authority. (2017). Strategic Service Framework for Palliative Care. Retrieved from
    https://www.ha.org.hk/haho/ho/ap/PCSSF_1.pdf
  9. Jockey Club Bereavement Care and Support Alliance Project. (n.d.). About JCBeCARE. Retrieved from
    https://jcbecare.hk/en/about-us

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