South Korea's hospice care faces collapse as beds dwindle

A patient's family member expressed frustration, asking, "Why is it so hard to get admitted to hospice? The waiting list is two months long. I'll die waiting." This sentiment captures the dire reality for many facing end-of-life care in South Korea, particularly in Seoul.

The patient, whose condition had rapidly declined, had initially delayed hospice admission due to lingering hopes for further cancer treatment. However, increasing pain and a significantly weakened state made hospice care urgent. The family's question, "Why doesn't this hospital have a hospice ward?" highlights a common dilemma: patients treated for years at a familiar university hospital are reluctant to transfer elsewhere for end-of-life care.

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Why is it so hard to get admitted to hospice? The waiting list is two months long. I'll die waiting.

Seoul boasts numerous medical schools and affiliated hospitals, yet a stark majority offer no inpatient hospice services. While some provide advisory support, only one university hospital in Seoul operates a dedicated inpatient hospice ward. This leaves public hospitals and those run by religious foundations to manage the majority of inpatient hospice care for the city's nearly 10 million residents.

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Why doesn't this hospital have a hospice ward?

Patients and families accustomed to the facilities of large university hospitals often express reluctance to use public facilities, citing differences in amenities. This preference, combined with the scarcity of beds, fuels conflict as hospitals aim to discharge patients nearing the end of life and patients resist leaving familiar surroundings. Consequently, hospice care, intended to help patients live their remaining days meaningfully and without pain, is increasingly perceived as a place where patients are pushed out.

The situation forces families to consider options like nursing homes, which may lack expertise in managing severe symptoms, or emergency rooms, which are often overwhelmed. Doctors emphasize the need for proactive planning, comparing it to purchasing car insurance before an accident. Preparing for hospice care, including drafting advance directives for end-of-life medical care, is crucial, as the progression of cancer is often predictable, making timely admission essential for a peaceful and dignified end.

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Car insurance: when do you sign up? After an accident? Or right after buying the car? That's right. The latter. Preparation is done before a major accident occurs.