Media

"Open Communication & Death Preparation between
Adult Children & Elderly Parents"
Basic Ingredients for Peace & Harmony at the End-of-Life

A first-of-its-kind trans-generational study on the comparison of death attitudes and beliefs among three generations of Hong Kong Chinese shows that young and middle-age adults are much more afraid of death and are more likely to avoid the topic of death compared to older adults. Conversely, not only are older adults much more accepting of death as a natural process of life, they are also open and keen in talking about death-related issues such as advance directives, death preparation and funeral arrangements.

The study was conducted with 792 Chinese in 2007 by the team of the ENABLE Project (Empowerment Network for the Adjustment to Bereavement and Loss in the End-of-Life). ENABLE Project was launched by the Centre on Behavioral Health (CBH) of The University of Hong Kong (HKU) in 2006, with generous funding from The Hong Kong Jockey Club Charities Trust.

The study also examined the effect of different death attitudes and beliefs on the end-of-life experiences among families with old-age parents, as well as the grieving outcomes of bereaved families.

Mr. Andy Ho, head researcher, said the inter-generational disparity over death attitudes impedes communication between adult children and elderly parents, and prevents adequate preparation as one approaches death.

He pointed out that open communication and death preparation are the two essential tools that not only help reduce distress and sorrow, but also lead to greater sense of peace and harmony at the end of life. Such open dialogue can also provide the platform for the sharing of life wisdom, resolving long standing grudges, finishing unfinished business, and passing on a living legacy where both the dying and the bereaved can face mortality with hope and greater positivity.

Professor Cecilia Chan, project director, added that lived experiences from bereaved families vindicate that talking about death is not a curse, but rather, a display of genuine love and compassion.

Previous repeated studies have estimated that between 10%-20% of bereaved individuals will experience chronic grief for years beyond the loss, while the detrimental impact of grief poses many clinical and public health concerns including elevated risks for suicide and mortality. With over 37,000 deaths in Hong Kong annually, the number of bereaved families suffering from the destructive effect of grief at any given time is innumerable.

Regrettably, in traditional Chinese culture, death has long been a taboo topic met with avoidance and resistance leading to lack of open communication and active preparation on death related-issues and may thus pose great familial discourses, conflicts and resentments. In effect, the negativity surrounding death could ultimately add greater burden to individuals' dying experiences as well as the families' grieving experiences.

Professor Chan said the findings of the trans-generational study would help greatly in the development of life and death education programmes for the general public of Hong Kong. In fact, knowledge gained from this study had already been applied in a series of educational workbooks and training materials made available through the ENABLE project. Moreover, the results also contributed to the death research knowledge base on a global context.

Aiming to enhance service models for the terminally ill and bereaved families for the Chinese population, the ENABLE Team is now recruiting participants for a further cross-cultural comparison study that focuses on understanding the bereavement processes amongst resilience families. It will target on Chinese individuals aged 55 or above, who have successfully coped with the loss of their spouse within the past 18 months.

ENABLE Project

Background Information
Death is an inevitable part of life. When death occurs in a family, every individual member is affected psychologically, physically, spiritually and socially. Yet, we do not talk about death nor do we prepare for it. The lack of knowledge as well as the lack of preparation for our own death or the death of our loved ones inevitably adds more pain and sufferance to the death, dying and bereavement process to both the deceased as well as the bereaved.

The Centre on Behavioral Health of The University of Hong Kong has established an Empowerment Network for Adjustment to Bereavement and Loss in End-of-life (ENABLE), a project funded by The Hong Kong Jockey Club Charities Trust. Through a societal-wide campaign which serves to educate the general public on effective death preparation as well as to promote enhanced adjustment to bereavement and loss, we believe that life can become much more beautiful and fulfilling, while death can be peaceful and at the same time manifest a blissful sense of life completion.

Project Mission
The mission of the ENABLE is to:
A. Promote public awareness on death, dying and bereavement;
B. Facilitate the elderly population, people with chronic and terminal illnesses as well as their families members in preparing for death, dying and bereavement; and
C. Develop overall competence of professionals in supporting dying patients and bereaved persons.

For media enquiries, please contact :-
• Mr Andy Ho, Centre on Behavioral Health, HKU (Tel: 2589-0507 / E-mail: andyho@hku.hk); or
• Ms Denise Wong, External Relations Office, HKU (Tel: 2859 2600 / E-mail: denise.wong@hku.hk ).