"It's a relief that my father's last moments were not on a hospital bed" [Turning My Home into a Senior House]

The Right to Close One's Eyes at Home
Increasing Number of 'Hospital Deaths'
Long Road Ahead for 'Integrated Care'
to Help the Elderly Live in Their Own Homes
This Year's Budget Stagnates at Just 7 Billion KRW
Only 12 Pilot Regions Nationwide
Policies to Help People Die Where They Wish
Are Essential for Elderly Dignity

Yonhap News

‘Hosang (好喪)’. This term is used when an elderly person who has enjoyed good fortune and lived a long life passes away. It implies not only that they lived a full lifespan but also that the elder was in a happy state until their final moments. Therefore, in the past, meeting one’s death at home with family was considered a condition of hosang.

Min Kijeong (55), who lost her father to stomach cancer late last year, said, "The hospital said there was nothing more they could do, so we brought him home, and he passed away just two days after arriving." She added, "Still, I’m grateful that my father’s last moments were not on a hospital bed." Min’s father was fortunate to have family to care for him all day, but it is rare for someone to end their life at home like this.

According to Statistics Korea’s ‘Change in Place of Death,’ as of 2023, 15 out of 100 people die at home, while 75 die in hospitals. Compared to 1999, when 58 died at home and 32 in hospitals, the number of elderly people dying in hospitals has sharply increased. Although home deaths rose during the COVID-19 period, this was only a temporary increase due to limited hospital access.

On the other hand, Japan’s ‘Community-based Integrated Care’ policy shifted medical and caregiving services to focus on local communities and homes, increasing the home death rate from 13% in 2016 to 17.4% in 2022. Yoo Aejeong, director of the Integrated Care Research Center at the National Health Insurance Service, explained, "Japan also saw an increase in home deaths during the COVID period, but for reasons opposite to ours. The Japanese government expanded home medical visits, enabling elderly people to spend their final moments at home."

According to Japan’s Ministry of Health, Labour and Welfare, at the tail end of the COVID-19 pandemic in 2023, the number of daily home medical care users reached 239,000?the highest since statistics began in 1996?with 85.3% being late-stage elderly aged 75 and older.

Although ‘Integrated Care’ to restore the right to die at home will begin nationwide in local governments next year, much remains to be done. This year, the Ministry of Health and Welfare’s budget for integrated support of elderly medical care and caregiving is 7.13 billion KRW, a mere 3.6% increase from the previous year’s 6.88 billion KRW. Professor Kim Boyoung of Yeungnam University’s Department of Human Services pointed out, "This increase is roughly in line with inflation, so it cannot be seen as a real budget expansion. Also, only 12 out of 229 regions nationwide are pilot project sites."

Policies that help elderly people die in their preferred place at life’s end are necessary for human dignity. Professor Park Youngran of Gangnam University’s Silver Industry Department emphasized, "Through integrated care, we must guarantee individual choice, including the ‘right to die at home,’ and establish a home care infrastructure for the elderly without regional disparities."