Media

HKU Centre on Behavioral Health releases survey findings on Hong Kong people’s changing attitude towards death
New Trend towards Eco- and Co-burial

27 Apr 2015

(From left) BMCPC Executive Director Ms. Brenda Lo, HKU Department of Social Work and Social Administration, Head and Professor Cecilia Chan Lai Wan, United Christian Hospital Assistant Social Work Officer Ms. Vikie Wong

Funded by the Board of Management of the Chinese Permanent Cemeteries (BMCPC), the Centre on Behavioral Health (CBH) of the University of Hong Kong launched “The Centennial Evolution of Funeral and Burial Practices in Hong Kong: A Research and Education Initiative” project in 2013 to promote and enhance life and death education in Hong Kong.

Under the project, over one thousand members of the public attended public talks, and about 400 frontline practitioners took part in professional training workshops. The frontline professionals in turn held life and death workshops for more than 5,500 members of the general public.

Moreover, a documentary was produced to feature the centennial evolution of the funeral industry, interviewing scholars and professionals in the field, and people who have made preparation for death. The documentary seeks to encourage reflection on the meaning of life and foster discussion on death-related issues.

A survey on 1,123 participants enrolled in the public talks and workshops was conducted between June and December in 2014 to understand the community’s attitude towards death, advance directives and end-of-life care preferences, organ and body donations, and funeral/burial arrangements.

Major findings from survey
(1) More positive attitude towards death, more social support needed
A great majority of the respondents showed an open attitude towards death.  Only 7-16% of individuals still agreed with traditional beliefs on death, such as “seeing a dead body or a coffin can bring bad luck”, “a parent should not attend the funeral of one’s child” and “talking about death in front of a dying person could accelerate death” (see Table). Moreover, over 30% of the respondents agreed that bereaved families should stay socially inactive for months after a death, which limits the social support they could obtain during their hard time.

(2) Limited knowledge of Advance Directives (AD)
Although 74% of the respondents supported the use of AD, 30% of the respondents had never heard of AD and 24% had no idea about it. Regarding the place of receiving end-of-life care, half of them preferred to be at home, only 23% preferred hospitals.

(3) Insufficient communications on death preparation
Respondents were positive towards organ and body donations. 40% of the respondents had registered as an organ donor, whereas 66% of them who had not registered expressed willingness to be one. Comparatively, only 10% of the respondents had registered for body donation, 47% had the preference. Although more people are willing to spread the love, only 52% and 31% of the respondents respectively had communicated to family members or friends their wish to donate organs or bodies after death.

(4) To spend less in funeral and more open attitude adopted towards eco burial
More than half of the respondents wished to spend less than $20,000 in funeral services. Only about 20% were willing to spend more than $40,000. They were also open to innovative eco burial methods: 67% preferred eco coffins. On a 10-point scale, burials by scattering ashes over water or in a garden of remembrance were rated high at 6.8 and 5.3 respectively.

(5) Acceptance of Co-burials
52% of respondents were willing to have their cremains put in the niche of family members departed earlier, while 51% of them agreed to have their relatives’ cremains put in their own niche.

Development of life and death education and the funeral industry
Professor Cecilia Chan, Project Director and Professor and Head of the Department of Social Work and Social Administration at the University of Hong Kong, stressed that even though the community has become more open in the discussions about death, patients with terminal illness and bereaved families may not get sufficient social support due to existing taboos of death. “We have to continue to actively promoting life and death education, which should focus not only on death preparation, but also on encouraging people to communicate their end-of-life care wishes with family members and friends,” she said.

Professor Chan added that death preparation should go beyond funeral and burial arrangement, to discussions on the type of end-of-life care one would like to receive, in particular on advance directives and end-of-life care preferences. The quality of death should be safeguarded. While most deaths are now occurring in hospitals, the community should consider whether one can receive end-of-life care at places they prefer? The community should also discuss the need to legislate for advance directives.

According to BMCPC Executive Director Ms. Brenda Lo, burial facilities at CPC’s four cemeteries currently allow co-burial of family members, which is little known by the public. About 76% (or 170,000 units) of the ordinary niches (can house urns of two deceased) and family niches (of four deceased) in the columbaria, and approximately 55% (about 44,000) of the grave spaces, have spare capacities to accommodate more deceased in the family. The BMCPC encourages co-burial to make use of the ordinary and family niches and grave plots to hold remains of members of the same family. The move can make available hundreds of thousands of burial places which can alleviate the acute shortage problem of columbarium facilities. Members of the public can refer to information included in the terms of service of BMCPC.

Moreover, to promote eco burial, BMCPC established a garden of remembrance in December, 2011 at the Junk Bay Chinese Permanent Cemetery. Since its establishment, BMCPC has promoted the service through various means using videos, brochures and organizing site visit etc., utilisation of the service keeps rising. More people are attracted to the garden’s beautiful environment and have expressed wish to have their cremains scattered there after death. Meanwhile, as an environmental friendly initiative, BMCPC has decided to stop the use of burners in its columbaria starting from the Chung Yeung Festival in 2016. People are encouraged to use flowers to pay homage to their ancestors.

The BMCPC has also collaborated with the Chinese University of Hong Kong and the University of Hong Kong to promote the body donation programme. Starting from 2013, those who have registered as body donors can choose to scatter their cremains in the area specifically for body donors at the Junk Bay Garden of Remembrance. The universities will keep reminding their donors to communicate their wish to their family members. The programme has drawn wider public participation in recent years.

Documentary on “The Centennial Evolution of Funeral and Burial Practices in Hong Kong”
The documentary DVDs will be given to the public free of charge, and distributed at the Centre on Behavioral Health (Address: 2/F, The Hong Kong Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam) and the Board of Management of the Chinese Permanent Cemeteries (Address: 34/F, Wu Chung House, 213 Queen’s Road East, Wan Chai).

About the Centre on Behavioral Health
Founded in 2002, the Centre on Behavioral Health is a sub-division of the Faculty of Social Sciences of the University of Hong Kong. Its vision is to promote the betterment of mental, emotional and behavioral welfare of the community as well as aspiring towards achieving international recognition in the field. Over the years, the Centre has been integrating Eastern and Western philosophies in a holistic approach to provide wide-ranging healthcare resources for professionals as well as the public to deal with issues arising from physical, personal and relational difficulties. The Centre is heavily involved in empirical research which pioneered and advances holistic health practices, and has collaborated closely with organizations from different sectors to enhance both individual and community well-being.

About BMCPC
The Board of Management of the Chinese Permanent Cemeteries (BMCPC) was established in 1913 and became a statutory body under the Chinese Permanent Cemeteries Ordinance (Cap. 1112) enacted in 1964.  BMCPC provides different kinds of burial lot, niche and ash scattering services for persons of the Chinese race residing permanently in Hong Kong, and is responsible for the operation, management and development of its four Chinese permanent cemeteries located at Aberdeen, Tsuen Wan, Chai Wan and Junk Bay.

For more details, please contact Ms. Amy Choi (Centre on Behavioral Health, HKU; Tel: 2831 5163; email: amychoi@hku.hk), or Ms. Yee Wa Hong (Centre on Behavioral Health, HKU; Tel: 2831 5579; email: hongyw@hku.hk).