National Taiwan University Hospital's (NTUH) Hospice & Palliative Care Unit (HPCU) has treated 3,000 terminally-ill patients since its establishment in 1995.
The unit, located on the sixth floor of the university hospital, has 17 beds, a kitchen, a playroom, a counseling room, a living room with pianos, karaoke and a mahjong table, among other facilities.
A corridor connected to the living room leads to a lush roof garden. Glass windows enclose the corridor to keep it warm so that weak patients can enjoy outdoor views even in the winter.
The unit also has a bathroom equipped with a bath machine specially designed for terminally ill patients, who also enjoy aromatherapy sessions there.
Terminally-ill patients often were not able to take baths at all for up to three months because of crippling pain, said Chiu Tai-yuan (邱泰源), medical director of the unit and staff physician of the hospital's Department of Family Medicine.
The bathroom is therefore a real boon for the patients. With the bath machine, they do not experience much pain when their bodies are cleaned.
However, for 60 to 70 percent of patients' families, it is "very painful" to decide to send their loved ones to the HPCU, Chiu said.
"For the families, sending patients to the unit means giving up on their lives," Chiu said.
The public still has misconceptions about hospice and palliative care, according to Chiu.
"Taiwan has around 32,000 terminally ill cancer patients every year. But only one-tenth of them, about 3,000, receive hospice and palliative care," Chiu said.
The acceptance of hospice and palliative care in Taiwan is low compared with other Asian regions or countries with advanced medical services, Chiu said.
"Sixty percent of terminally-ill patients receive hospice and palliative care in Hong Kong and 50 percent in Singapore," he said.
In Chiu's unit, the average period between patients' admission and their deaths is three weeks. Chiu said the relatively short period of survival is partly a result of late referral.
The average survival period of patients undergoing hospice and palliative care in the UK is two months, he said.
In Japan, said Chiu, a hospital needs to reserve at least 5 percent of its wards for terminally ill patients.
"Our hospital has 2,000 beds now. According to Japan's ratio, our hospital should have 100 beds for terminally ill patients," he said.
Although Chiu's unit's 17 beds are often fully occupied, the hospice and palliative care wards provided by hospitals in central and southern Taiwan are mostly vacant.
Currently, 20 hospitals across Taiwan provide hospice and palliative care accredited by the Department of Health.
While some hospitals have been accused of refusing to admit dying patients, it is also true that many families are unwilling to send their dying relatives to hospice and palliative care wards.
"It is a contradictory phenomenon. I believe half of our terminally- ill cancer patients, about 16,000, are badly in need of hospice and palliative care. But only 3,000 of them receive the treatment every year," Chiu said.
People who send their parents to hospice and palliative care wards are often accused of filial impiety. They are accused of sending their parents to "the places to wait for death," Chiu said.
The public's misconceptions about hospice and palliative care needs to be adjusted through education, he said.
In fact, patients are highly respected in the wards. Their individual and particular needs are carefully tended to, Chiu said.
He said his unit has helped several patients realize their last wishes before death. A male patient went home to see his parents and even managed to stand up on his own -- something he had been unable to do for a long time.
Photos pasted on a board in the unit featured a reunion between a Buddhist master and an elderly patient who suffered from lung cancer.
The old lady, after being admitted to the unit, said she wanted to see the Buddhist master who converted her 40 years ago.
An ambulance ferried the old lady, who needed assistance with her breathing, to Taipei County's Shiji to meet with the master, Chiu said.
The unit also extends its care to patients' families, in the belief that "family is also a patient." The bereavement counseling the unit provides for families can last two to three years after their relatives have died.
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