"Thank you for helping my mother fulfill her last wish." A few days after an elderly woman passed away due to cancer, her family members sent a message of gratitude to the caregivers at the Ci’en (Mercy and Grace) Elderly Care Center in Huadu District, Guangzhou, Guangdong, who had taken care of their mother during her final days.
In traditional Chinese culture, "death" has always been a heavy topic that people tend to avoid, especially when dealing with elderly individuals in their later years. Avoiding discussions about what happens after death seems to be an unspoken social etiquette in daily communications. However, as society evolves, helping these elderly individuals in the final stages of their lives bear the pain threshold and peacefully complete their life journey with dignity has become an increasingly important topic of concern for both the general public and the Christian community
Yao Wenfu, director of the center, and Sun Xiaomei, vice director, discussed hospice care with staff members of the Gospel Times, an online Chinese Christian newspaper. While gaining an understanding of its essence, they also revisited the truth and the beginning of God's creation, seeking to rediscover and reconstruct a renewed awareness of the dignity of life.
In June 2022, the center launched a comprehensive hospice care project called "Anxie Yizhan (Resting Station)." They established 20 end-of-life care beds and formed a professional team consisting of medical, social work, legal, and religious experts.
Director Yao explained, "The word 'Anxie' (rest) originates from the Bible, and we hope that each elderly person's life can rest in the love and grace of the Lord and ultimately find their home in heaven. 'Yizhan' (station) implies that the cessation of the physical body is just a stopover in each person's life journey, not a complete ending."
"Through our project, we aim to help elderly individuals in the terminal stage of life, along with their families and even more people, rebuild their understanding of the value and meaning of life. By doing so, we can eliminate the fear of death and allow each person to depart from this world with dignity and peace," Yao emphasized. The approach to achieving this goal is through spiritual care, an indispensable aspect of end-of-life care services. Yao continued, "If the person is a Christian, I will talk to them about the eternal home in heaven, letting them know that there is a Heavenly Father waiting for them to return home to enjoy eternal blessings." He further explained, "But for individuals with different religious backgrounds or those without faith, I will listen to their expectations regarding the afterlife."
"Our core goal is for individuals to leave this world not in fear and pain but with composure and dignity. This is the essence of our service."
Compared with the elderly care industry that started in the early days of the founding of the People‘s Republic of China (PRC) in 1949, hospice care has only been in the eyes of the Chinese public for 20 or 30 years, but its necessity and urgency have become increasingly apparent in people's daily lives.
According to Director Yao's recollection, in recent years, the center has admitted many elderly individuals in the terminal stage of life. Most of them were already in the late stages of illness upon admission. Their physical condition was too weak to be further extended through medical interventions such as chemotherapy, but they still retained some faint signs of life. However, whether from the perspective of hospitals or families, the situation of these elderly individuals in the final stages of life is heartbreaking.
"Generally speaking, regular hospitals, considering factors such as medical resource costs, the patient's physical condition, and the family's expenses, rarely follow through to the last moment of life for non-emergency terminal patients. In most cases, they would recommend conservative treatments to spare the elderly from further suffering and advise the family to take them home to spend their last moments," Director Yao explained. "However, once the elderly individuals return home, their families often lack the necessary caregiving skills, consistent time, and professional medical equipment to provide effective care. As a result, many terminal patients can only depart from this world in pain and torment while carrying feelings of guilt toward their families."
"For elderly individuals in the terminal stage, families often prepare for their departure but do not prepare for how to help them pass their final stage of life with dignity," Director Yao said. He witnessed many terminal elders and their families suffering from anxiety, sadness, and regret due to a lack of a proper understanding of life and death. In his view, this was because of the absence of end-of-life care services.
As a senior advanced social worker who has led multiple social elderly care service projects, Yao believed that although there has been a certain level of breadth and depth in social welfare and projects for the elderly in China today, there is still a significant gap and deficiency in the field of hospice care.
"At the beginning of the world, every person was created in the image of God. No matter which stage of life a person is in, the image of God is always in each person who is precious in God's eyes," Director Yao explained.
Therefore, at the elderly care center, whether an elderly person has lived there for ten years or just one day, regardless of the pain and scars they may have from their illnesses, the caregivers clean their bodies to let the elderly individuals leave this world with a dignified body.
"Respecting the dignity of life"—this is the core philosophy that runs through the entire end-of-life care project and the process of serving elderly individuals as whole beings. In Director Yao's heart, he firmly believed that this dignity of life came from God and should not be subject to arbitrary judgment or disrespect by anyone.
"In this project, our practice of end-of-life care is primarily through dialogues and conversations, forming a curriculum of life education," Director Yao explained. The elderly individual with advanced-stage colon cancer mentioned at the beginning of the article, in the final ten days of her life, underwent a profound transformation through this life education curriculum. She had been transferred to the center after hospitals refused further treatment.
"The first thing she said was whether we could give her an injection for euthanasia, so she wouldn't have to suffer from the illness anymore," Yao recalled. Although nearly a year has passed since the elderly woman's passing, the memory remains vivid in his mind. He said, "While I can understand and empathize with the elderly person's suffering, both morally and legally, we couldn’t fulfill such a request."
To care for this elderly individual, the caregivers at the center took shifts around the clock, not only to manage her pain but also to prevent any suicidal thoughts. Additionally, Sun Xiaomei maintained communication with the elderly woman, whose hearing had almost completely deteriorated, using paper and pen to help her rediscover the value of life and the meaning of death.
Through their efforts, the elderly woman gradually abandoned her thoughts of ending her life. She expressed her desire to return to her hometown in Inner Mongolia. After reaching an agreement with her family, the center arranged transportation and accompanied her on a journey of over a thousand kilometers, fulfilling her final wish. A few days after returning to the center, the elderly woman completed her journey on Earth.
"Through life education, we aim to help terminally ill elderly individuals establish a rational view of life and death. This is the fundamental purpose of our spiritual care. However, our care is not limited to the elderly," Director Yao emphasized. In fact, while this elderly individual with colon cancer received care and guidance at the center, life education courses for her family members were also conducted concurrently.
After explanations, the family of this elderly individual finally awakened to the fact that her request for euthanasia was a manifestation of her extreme fear of death. Subsequently, the two directors and the caregivers held discussions with her family members, helping them navigate their grief and feelings of guilt toward the elderly woman and providing guidance on funeral arrangements. Eventually, her relatives understood the elderly woman's wishes, emerged from their self-blame, and accepted the reality of her passing with peace in their hearts.
Yao explained that at the center, end-of-life care was not limited to serving the elderly individuals alone but also included their families. The services provided encompass diverse aspects, including pre-death life education, palliative care, fulfilling the final wishes of the elderly, setting up wills, arranging post-mortem matters, organizing funerals, and providing psychological counseling for caregivers.
Although they still face some societal misunderstandings and practical pressures, such as the lack of funding and facilities, Yao and Sun believe that this project is necessary and worth persisting with.
When asked about the reasons, Sun, who had previously traveled to Hong Kong for exchanges and learned about elderly care and end-of-life care services, shared her perspective based on her first-hand experiences.
In her view, in terms of service content, end-of-life care services in Hong Kong were more detailed and specialized in both ideology and practice. Furthermore, when it came to participants, it involved not only the elderly but also their family members, social workers, and different sectors of society that contributed to and supported efforts to improve the quality of life for the elderly in their terminal stages.
Regarding the current situation of end-of-life care services in China, Yao frankly admitted, "This has brought us a direction for improvement, which is to enable all levels of society to establish a correct and comprehensive consensus on the value of life, allowing each person to view death with a more peaceful mindset."
- Translated by Abigail Wu
“谢谢你们帮助我妈妈完成了最后的愿望……”在一位母亲因罹患癌症离世的几日后，老人的家属向生前曾照顾关怀母亲的广州市花都区基督教慈恩护老院护理人员送出了如此致谢留言。
在许多中国人的传统观念中，“死”历来是人们想要避而远之的沉重话题，尤其在面对步入晚年的长者时，“莫谈身后事”似乎成为了中国人日常交流过程中心照不宣的社交礼仪。但随着时代发展，如何让这些处于生命末期的长者能够跨越肉体的病痛，在尊严中安然无憾的走完生命旅程，也成为越来越多社会人士以及基督教界关注的议题。
姚文富院长与孙晓梅副院长就临终关怀的话题与福音时报进行交流，临终关怀致力于回到真理与神创造之初，找寻并重建对于生命尊严的再认知。（==当summary）
2022年6月，在姚文富院长的牵头组织下，慈恩护老院启动了名为“安歇驿站”的全人临终关怀项目。依托设立的20张临终关怀床，组建起医疗、社工、律师、宗教等专业人员团队。
姚院长介绍，“‘安歇’一词源于圣经话语的记载，希望每一位老人的生命能够安歇在主的爱与恩典当中，最终安居在天。而‘驿站’则意味着肉体的消亡仅仅只是每个人生命路程中的一个节点驿站，并不是完全的终结。
“借着我们的项目，就是希望让处在终末期的老人及其家属，甚至更多人重新构建起对于生命价值和意义的认识。从而破除对于死亡的恐惧，让每个生命能够带着尊严与平安离开世界。”姚院表示，而实现这一目的的途径，就是通过临终关怀工作中不可或缺的一环——灵性关怀。
“如果是基督徒的话，我就会对老人交流关于永恒天家的事情，让他知道天上还有一位父在等待着他们回家永享福乐，”他说，“但若是其他信仰背景或是无信仰的老人，我也会听一听他们所期待的身后世界。”
“在离世的时候不是带着恐惧与痛苦，而是坦然且有尊严离开世界，这才是我们做服务最核心的目的 。”
相较于早在新中国初期即已肇端的养老行业，临终关怀走进中国公众的视野仅有短短二三十年时间，但是其必要性与紧迫性已经愈发显现于人们的日常生活中。
据姚院长回忆，近年来，慈恩护老院曾先后接收过不少处于弥留阶段的老人，他们在入院时大多数已处于疾病晚期。其身体状况已虚弱到不适合再通过化疗等医疗介护的方式延缓病情，但他们仍旧存留一些微弱的生命体征。然而不论是从医院还是家庭来看，这些老人生命末期的处境却令人倍感痛心。
“一般来说，常规医院出于医疗资源成本投入、患者身体状况以及患者家庭开销的考虑，基本很少能够跟进到非危急重症的临终老人生命的最后一刻。多数情况会建议家属采取保守治疗的方式，让老人少遭些罪，趁早接回家里度过最后时光。”姚院长向笔者介绍道。但是老人回到家里之后，又会因为家属缺乏相应的护理技能、稳定的时间和专业的医护设备而无从提供有效的照料，最终不少弥留期的老人只能是在病痛折磨与内心对家人亏欠自责中离开人世。
“对于临终的老人，家属们往往只是做好了随时离世的准备，却没有做好怎样让他们带着尊严度过生命最后阶段的准备。”看着许多临终长者与家属因着缺乏对于生命与死亡的正确认识，双双陷入焦虑不安与忧伤痛悔的境况。姚院长内心就愈发地迫切，“归根结底，这就是临终关怀服务的缺位。”
作为曾带领过数个社会养老服务项目的资深高级社工师，姚院长认为尽管如今对于老年群体的公益慈善项目广度与深度都达到了一定的水平，但在临终关怀领域，国内仍然存在着极大的滞后与欠缺。
“自创造之初，每个人生命里都有着神的形像。所以不论是出生还是死亡，不论处在生命的哪一个阶段，神的形像永远存在，都是神所看为宝贵的孩子。”姚院向笔者表示。
所以，在慈恩护老院，不论老人是住了十年还是住了一天，不论在临终时被何样病痛折磨，身体有何样骇人的疮疤，何等枯槁扭曲。护老院的护理人员都会为老人洁净身体，让老人以最体面的样子并带着尊严离开世界。
“尊重生命的尊严”——这是慈恩护老院贯穿于整个临终关怀项目以及长者全人服侍过程中的核心理念。而在姚院长的内心，他也始终坚信，这份生命的尊严正是由神而来，因此不容任何人去肆意论断与践踏。
“在我们的安歇驿站项目中，我们对于临终关怀的实践更多的是依托于商谈对话的基础上构建的生命教育课程。”姚院长介绍。而文章开头提到的那位肠癌晚期的老人正是借助生命教育课程，在生命的最后十天，完成了生命的全然蜕变。
这位老人是由于医院不再收治之后才被转运到慈恩护老院度过最后的时光。
“阿姨一见到我们，第一句话就是能不能给她打一针（安乐死），让自己不要再受疾病的折磨。”尽管老人离去已经过去近一年时间，姚院长至今仍旧历历在目，“虽然能理解体会老人的痛苦，但是于法于理，我们不能答应这样的请求。”
为了照顾这位老人，护老院的护工们24小时昼夜轮班守候在老人床前，一方面担心老人轻生，兼顾做好痛症管理，另一方面，护老院的孙晓梅副院长则不断用纸和笔与听力近乎消失的老人保持交流，帮助其重新认识生命的价值与死亡的意义。
在护理人员的照料以及两位院长的引导勉励下，老人放弃生命的念头被逐渐打消。提出了想要返回内蒙家乡看一看的心愿。在与家属协商一致后，护老院安排转运车，陪同老人一起跨越上千公里，完成了老人最后的心愿。在回到护老院的几天后，老人结束了地上的最后一程。
“借助生命教育帮助临终长者树立理性的生死观，这是我们灵性关怀最基本的宗旨。但是，我们关怀的对象绝不仅仅限于这一个群体。”姚院长向笔者补充道。实际上，在这位肠癌老人在护老院接受关怀与引导的同时，护老院对于老人家属的生命教育课程也在同步开展。
在姚院长以及护理人员解释与教导后，这位老人的家属这才幡然醒悟，原来，老人要求安乐死是对于死亡极度恐惧的体现。在此之后，两位院长与护理人员与老人家属商谈，帮助他们疏导哀伤以及对于老人愧疚的情绪，并为他们提供丧葬指导。最终帮助家属明白了老人的心意，走出了自责的阴霾，以坦然的心接受了老人离世的事实。
他介绍称，在慈恩护老院，临终关怀，就服侍对象而言，其既包括老年人个体，也包括老年人的家属。而从服侍内容而言，包括前期的生命教育、安宁疗护、老人归天前的心愿满足、遗嘱设立，后事安排，丧礼举办，护理人员的心理医治疏导。
尽管依旧面临着社会些许不理解的声音与资金设施等方面的现实压力，但是姚院长与孙院长却始终认为，“安歇驿站”有必要也值得坚持做下去。
而提及原因，几年前曾赴港交流学习养老及临终关怀服务的孙晓梅院长结合亲身见闻向笔者给出了自己的看法。
在她看来，从服务内容上看，香港的临终关怀服务在理念及实践层面都更加细致与专业化；而从参与主体来看，从长者到家属，再到社工，乃至参与奉献支持的社会各界，共同努力提升长者终末期的生命质量。
对于当前国内临终关怀服务所面临的处境，姚院长坦言，“这为我们带来了需要努力的方向，那就是让全社会阶层都能够建立正确整全的生命观共识，让大家以更平和的心态去看待死亡。”
接受临终关怀，长者带着尊严“谢幕”
"Thank you for helping my mother fulfill her last wish." A few days after an elderly woman passed away due to cancer, her family members sent a message of gratitude to the caregivers at the Ci’en (Mercy and Grace) Elderly Care Center in Huadu District, Guangzhou, Guangdong, who had taken care of their mother during her final days.
In traditional Chinese culture, "death" has always been a heavy topic that people tend to avoid, especially when dealing with elderly individuals in their later years. Avoiding discussions about what happens after death seems to be an unspoken social etiquette in daily communications. However, as society evolves, helping these elderly individuals in the final stages of their lives bear the pain threshold and peacefully complete their life journey with dignity has become an increasingly important topic of concern for both the general public and the Christian community
Yao Wenfu, director of the center, and Sun Xiaomei, vice director, discussed hospice care with staff members of the Gospel Times, an online Chinese Christian newspaper. While gaining an understanding of its essence, they also revisited the truth and the beginning of God's creation, seeking to rediscover and reconstruct a renewed awareness of the dignity of life.
In June 2022, the center launched a comprehensive hospice care project called "Anxie Yizhan (Resting Station)." They established 20 end-of-life care beds and formed a professional team consisting of medical, social work, legal, and religious experts.
Director Yao explained, "The word 'Anxie' (rest) originates from the Bible, and we hope that each elderly person's life can rest in the love and grace of the Lord and ultimately find their home in heaven. 'Yizhan' (station) implies that the cessation of the physical body is just a stopover in each person's life journey, not a complete ending."
"Through our project, we aim to help elderly individuals in the terminal stage of life, along with their families and even more people, rebuild their understanding of the value and meaning of life. By doing so, we can eliminate the fear of death and allow each person to depart from this world with dignity and peace," Yao emphasized. The approach to achieving this goal is through spiritual care, an indispensable aspect of end-of-life care services. Yao continued, "If the person is a Christian, I will talk to them about the eternal home in heaven, letting them know that there is a Heavenly Father waiting for them to return home to enjoy eternal blessings." He further explained, "But for individuals with different religious backgrounds or those without faith, I will listen to their expectations regarding the afterlife."
"Our core goal is for individuals to leave this world not in fear and pain but with composure and dignity. This is the essence of our service."
Compared with the elderly care industry that started in the early days of the founding of the People‘s Republic of China (PRC) in 1949, hospice care has only been in the eyes of the Chinese public for 20 or 30 years, but its necessity and urgency have become increasingly apparent in people's daily lives.
According to Director Yao's recollection, in recent years, the center has admitted many elderly individuals in the terminal stage of life. Most of them were already in the late stages of illness upon admission. Their physical condition was too weak to be further extended through medical interventions such as chemotherapy, but they still retained some faint signs of life. However, whether from the perspective of hospitals or families, the situation of these elderly individuals in the final stages of life is heartbreaking.
"Generally speaking, regular hospitals, considering factors such as medical resource costs, the patient's physical condition, and the family's expenses, rarely follow through to the last moment of life for non-emergency terminal patients. In most cases, they would recommend conservative treatments to spare the elderly from further suffering and advise the family to take them home to spend their last moments," Director Yao explained. "However, once the elderly individuals return home, their families often lack the necessary caregiving skills, consistent time, and professional medical equipment to provide effective care. As a result, many terminal patients can only depart from this world in pain and torment while carrying feelings of guilt toward their families."
"For elderly individuals in the terminal stage, families often prepare for their departure but do not prepare for how to help them pass their final stage of life with dignity," Director Yao said. He witnessed many terminal elders and their families suffering from anxiety, sadness, and regret due to a lack of a proper understanding of life and death. In his view, this was because of the absence of end-of-life care services.
As a senior advanced social worker who has led multiple social elderly care service projects, Yao believed that although there has been a certain level of breadth and depth in social welfare and projects for the elderly in China today, there is still a significant gap and deficiency in the field of hospice care.
"At the beginning of the world, every person was created in the image of God. No matter which stage of life a person is in, the image of God is always in each person who is precious in God's eyes," Director Yao explained.
Therefore, at the elderly care center, whether an elderly person has lived there for ten years or just one day, regardless of the pain and scars they may have from their illnesses, the caregivers clean their bodies to let the elderly individuals leave this world with a dignified body.
"Respecting the dignity of life"—this is the core philosophy that runs through the entire end-of-life care project and the process of serving elderly individuals as whole beings. In Director Yao's heart, he firmly believed that this dignity of life came from God and should not be subject to arbitrary judgment or disrespect by anyone.
"In this project, our practice of end-of-life care is primarily through dialogues and conversations, forming a curriculum of life education," Director Yao explained. The elderly individual with advanced-stage colon cancer mentioned at the beginning of the article, in the final ten days of her life, underwent a profound transformation through this life education curriculum. She had been transferred to the center after hospitals refused further treatment.
"The first thing she said was whether we could give her an injection for euthanasia, so she wouldn't have to suffer from the illness anymore," Yao recalled. Although nearly a year has passed since the elderly woman's passing, the memory remains vivid in his mind. He said, "While I can understand and empathize with the elderly person's suffering, both morally and legally, we couldn’t fulfill such a request."
To care for this elderly individual, the caregivers at the center took shifts around the clock, not only to manage her pain but also to prevent any suicidal thoughts. Additionally, Sun Xiaomei maintained communication with the elderly woman, whose hearing had almost completely deteriorated, using paper and pen to help her rediscover the value of life and the meaning of death.
Through their efforts, the elderly woman gradually abandoned her thoughts of ending her life. She expressed her desire to return to her hometown in Inner Mongolia. After reaching an agreement with her family, the center arranged transportation and accompanied her on a journey of over a thousand kilometers, fulfilling her final wish. A few days after returning to the center, the elderly woman completed her journey on Earth.
"Through life education, we aim to help terminally ill elderly individuals establish a rational view of life and death. This is the fundamental purpose of our spiritual care. However, our care is not limited to the elderly," Director Yao emphasized. In fact, while this elderly individual with colon cancer received care and guidance at the center, life education courses for her family members were also conducted concurrently.
After explanations, the family of this elderly individual finally awakened to the fact that her request for euthanasia was a manifestation of her extreme fear of death. Subsequently, the two directors and the caregivers held discussions with her family members, helping them navigate their grief and feelings of guilt toward the elderly woman and providing guidance on funeral arrangements. Eventually, her relatives understood the elderly woman's wishes, emerged from their self-blame, and accepted the reality of her passing with peace in their hearts.
Yao explained that at the center, end-of-life care was not limited to serving the elderly individuals alone but also included their families. The services provided encompass diverse aspects, including pre-death life education, palliative care, fulfilling the final wishes of the elderly, setting up wills, arranging post-mortem matters, organizing funerals, and providing psychological counseling for caregivers.
Although they still face some societal misunderstandings and practical pressures, such as the lack of funding and facilities, Yao and Sun believe that this project is necessary and worth persisting with.
When asked about the reasons, Sun, who had previously traveled to Hong Kong for exchanges and learned about elderly care and end-of-life care services, shared her perspective based on her first-hand experiences.
In her view, in terms of service content, end-of-life care services in Hong Kong were more detailed and specialized in both ideology and practice. Furthermore, when it came to participants, it involved not only the elderly but also their family members, social workers, and different sectors of society that contributed to and supported efforts to improve the quality of life for the elderly in their terminal stages.
Regarding the current situation of end-of-life care services in China, Yao frankly admitted, "This has brought us a direction for improvement, which is to enable all levels of society to establish a correct and comprehensive consensus on the value of life, allowing each person to view death with a more peaceful mindset."
- Translated by Abigail Wu
Receiving Hospice Care, the Elderly Pass Away With Dignity
