South Korea faces a growing shortage of hospice care infrastructure as requests to forgo life-sustaining medical treatments increase.
“My mother’s doctor says she has only two to three weeks left, and while I checked three hospice institutions, they all say I have to wait two to three months,” Kim Moon-gyu told The Hankyoreh regarding his 85-year-old mother who is suffering from terminal gallbladder cancer.
Kim’s mother signed a pledge in March 2024 to refuse life-sustaining procedures such as cardiopulmonary resuscitation or mechanical ventilators. Her condition deteriorated a month ago, prompting her family to stop all treatments and provide round-the-clock care at home.
New registrations for advance statements refusing life-sustaining treatment rose from 100,529 in 2018 to 499,961 last year, according to annual data released by the National Agency for Management of Life-Sustaining Treatment. Meanwhile, 29,557 life-sustaining care plans were registered by terminal patients alongside medical staff last year.
Hospice care teams involving doctors, nurses, and social workers aim to relieve physical pain and provide emotional support for terminal patients and their families. Eligible conditions currently include cancer, acquired immunodeficiency syndrome, chronic obstructive pulmonary disease, chronic liver cirrhosis, and chronic respiratory failure.
The nationwide count of hospice institutions reached 194 last year, comprising 104 inpatient facilities, 40 home-based programs, 44 consultative services, and six nursing-hospital facilities. Gyeonggi Province houses the most at 46, followed by Seoul with 35, Busan with 14, and Gwangju-Jeonnam with 10, while Sejong records zero hospice facilities.
Inpatient hospice facilities reported an average of 12.7 waiting patients per institution nationwide as of August, according to data from the National Hospice Center provided to the office of Representative Seo Young-seok. Seoul recorded the longest average queue at 33.7 patients, followed by Daegu at 27.5, Incheon at 20.1, and Gyeonggi at 11.5.
“My mother said, ‘Don’t bother with all these treatments, just let me go comfortably,’ but I am sorry I couldn’t get her hospice services,” said Park So-young, who ultimately placed her terminal mother in a standard nursing hospital after three inpatient hospice centers reported indefinite waitlists.
The Ministry of Health and Welfare announced plans in April 2024 under its second comprehensive hospice plan to raise the utilization rate to 50% by 2028. The initiative aims to expand facilities to roughly 360 locations and gradually broaden eligible diseases to include renal failure, cardiovascular disease, and Alzheimer’s disease.
“Western countries have already established and implemented national strategies for end-of-life care,” said Kim Dae-gyun, head of the hospice and palliative care center at Incheon St. Mary’s Hospital, pointing to the need for a national control tower.