Social relationships and community end of life care in Hong Kong

Abstract

In Hong Kong, like other modern societies, death and dying are identified as a crucial public health issue. Given developments in the Hong Kong healthcare system, some of the work of caring for dying people and their families has shifted to cross-disciplinary collaboration in community settings. This trend corresponds with a growing policy and practice emphasis on social relationships in non-medical forms of community-based care for dying people and their families. In the present study, abductive grounded theory methodology was used to examine the complex dynamics and mechanisms involved in social relationships between dying people (and their families) and volunteers and professionals in community-based social service agencies. The goal was to contribute to knowledge about how social relationships influence the experiences of dying people and their families, and to explore and engage theoretically with the concept of social capital as a dynamic, relational process. Relationships between social service agency staff and medical professionals were also explored. Through contacts with two community-based end-of-life (EOL) service agencies in Hong Kong, qualitative data were collected using 14 in-depth interviews with practitioners and 2 service users. The findings were used to develop a clear and parsimonious three-stage model of relational social capital development. In this model, relationships between service agency workers and families can be seen as addressing a key precondition of social capital through establishing trust, facilitating the accessibility of social capital through cultivating mutuality, and mobilizing social capital through fostering collaboration; all of these processes contribute to mitigating community detachment. Lastly, this study elucidates implications for policy and practice related to both health promotion and community engagement in the care of dying people and their families in Hong Kong communities.