Food and Eating in Hong Kong’s Hospice Landscape

Eating and the support of safe eating is woven through every setting of Hong Kong’s palliative and hospice care system — from dedicated inpatient hospice wards to home hospice visits, from community meals-on-wheels to the daily nursing care provided in residential care homes for the elderly.

Understanding what services exist, how to access them, and what each setting can provide in terms of food support and dysphagia management, helps families make better-informed decisions about where and how their loved one is cared for in the final chapter of life.

Inpatient Palliative Care and Hospice Services

Hospital Authority Palliative Care Wards

Selected HA hospitals have dedicated palliative care wards that provide specialist end-of-life care as part of multidisciplinary teams including palliative care physicians, nurses, SLPs, dietitians, and medical social workers:

Food and dysphagia in palliative wards:

• Texture-modified diets are prepared according to IDDSI standards
• SLP assessment of swallowing is available
• Dietitian input on nutritional support and supplement prescription is available
• Comfort feeding approach is supported by the multidisciplinary team
• Families are welcomed to bring in home-cooked food (subject to ward guidelines)

NGO Hospice Facilities

Bradbury Hospice (白普理寧養中心) — Shatin, operated by Haven of Hope Christian Service

• One of the only dedicated freestanding hospice facilities in Hong Kong
• 25 inpatient beds; offers both inpatient and day hospice services
• Referral through HA or attending physician
• Specialist palliative nursing, chaplaincy, and family support services

Our Lady of Maryknoll Hospital Palliative Care Unit — Wong Tai Sin

• Catholic mission hospital with dedicated palliative care unit
• Accepts both HA-referred and private patients

Home Hospice Services

For patients and families who choose to spend the end of life at home, the Hospital Authority Home Hospice Service provides community-based palliative support:

HA Home Hospice Service (醫管局家居善終服務)

What is provided:

• Regular doctor and nurse home visits
• 24-hour telephone advice line for symptom management
• Medication prescribing and delivery coordination
• Advice on comfort feeding, oral care, and positioning at home
• Carer education on practical end-of-life care tasks
• Medical social work support
• Coordination with community pharmacy and equipment loan

How to access:

• Referral from the patient’s attending hospital physician or specialist outpatient clinic
• Eligibility: patients with a life-limiting illness and prognosis typically less than 12 months
• Available across all HA clusters

Food support at home:

• The visiting SLP can assess swallowing at home and advise on safe textures
• The visiting dietitian can recommend appropriate supplements and calorie-dense foods
• Families receive practical guidance on meal preparation for texture-modified diets

NGO Home Hospice Providers

Several NGOs in Hong Kong provide complementary home hospice services:

• Haven of Hope Christian Service — home hospice nursing visits
• Pok Oi Hospital — community palliative care in New Territories North
• Caritas — community support including practical home care
• HCA Hospice Care — one of Hong Kong’s largest non-profit hospice charities; provides home care services across Hong Kong

Community Meals Services for Palliative Patients

Meals on Wheels (送飯到戶服務)

The Social Welfare Department’s subvented meals on wheels services deliver cooked meals to elderly and disabled persons at home who cannot cook for themselves. For palliative patients with dysphagia:

Key limitation: Standard meals-on-wheels services typically provide standard or mildly modified texture meals. They do not routinely prepare IDDSI Level 3–4 texture-modified meals to clinical specification.

What families can do:

• Request a social welfare assessment (through the patient’s medical social worker or local Social Welfare Department branch) to access subvented meals services
• Supplement with home preparation of texture-modified food for the specific texture-critical meal components
• Commercial food delivery services that offer texture-modified ready meals are available in Hong Kong for private purchase

Community Elderly Services Centres

Many District Elderly Community Centres and Neighbourhood Elderly Centres in Hong Kong provide lunch meals to elderly members. For palliative patients:

• Social worker at the centre can assess whether texture modification is possible with the catering contractor
• These services are not typically set up for clinical-grade IDDSI texture modification

RCHE End-of-Life Protocols

Current Landscape

Residential Care Homes for the Elderly (RCHEs) in Hong Kong house a large proportion of Hong Kong’s elderly population, and many residents die within these homes. The quality of end-of-life care in RCHEs — including food and dysphagia management — varies significantly between homes.

Preferred Place of Death (就地安老 / 就地善終)

The government and health system increasingly support the concept of “ageing in place” and “dying in place” — allowing RCHE residents to remain in their home setting rather than being transferred to hospital in the final stage of illness.

Key components of an effective RCHE end-of-life protocol for food and dysphagia:

1. Written care plan: A documented plan that specifies the resident’s preferred feeding approach, texture requirements, and comfort feeding goals — with family signature and regular review

2. DNACPR and ACP documentation: The care home should facilitate advance care planning discussions and ensure relevant documentation is in place and accessible

3. SLP involvement: Regular SLP review of residents with dysphagia; transition to comfort feeding approach when appropriate, with written guidance to care staff

4. Staff training: All care staff should be trained in comfort feeding, IDDSI texture descriptions, and oral care at end of life

5. Family communication: Regular family updates and a clear communication pathway — especially when the resident’s condition changes

6. Food provision: Where possible, texture-modified versions of the resident’s culturally meaningful foods should be offered — in small amounts, attractively presented, and with warmth

Standards and Oversight

• The Social Welfare Department’s Residential Care Homes for the Elderly Ordinance sets minimum standards for residential care homes
• The Hospital Authority’s community geriatric assessment teams (CGAT) visit RCHEs and can provide advice on dysphagia management and end-of-life food care
• NGOs including Caritas and the Evangelical Lutheran Church Social Service operate high-quality RCHEs with comprehensive end-of-life care standards

This page provides an overview of services available. Individual service availability, eligibility, and scope may change. Confirm current details with the relevant service provider or the patient’s medical social worker.