제2차 저출산고령사회 포럼

Abstract

With the increase in the elderly population and the rise of chronic diseases, the number of deaths among older adults has grown, leading to heightened interest in dignified death. During the COVID-19 pandemic, lockdown measures, such as banning visitors in nursing facilities and hospitals, even for patients nearing death, raised awareness of the dying process and the quality of death. The terms “hospice,” “palliative care,” and “end-of-life care” are key concepts and systems related to dignified death. Although hospice and palliative care are distinct, these terms are often used interchangeably in the social security system. Recent years have seen a shift in terminology, gradually blurring the distinctions between hospice, palliative care, and end-of-life care. In South Korea, hospice care became covered by the national health insurance system in July 2015, and in 2017, the Act on Decisions on Life-Sustaining Treatment was implemented, which included the introduction of advance directives and the life-sustaining treatment decision system. However, terminal patients who do not use hospice services remain excluded from end-of-life care options. To ensure terminal patients a death with dignity, the healthcare environment must change to expand the range of and access to end-of-life care services. The introduction of the National Health Insurance and Long-Term Care Insurance for the elderly should help reduce the financial burden while also ensuring the quality of services. To die with dignity, individuals should be able to choose their place of care and death. To this end, it is essential to improve the hospice system and expand in-home and community support services under the National Health Insurance and Long-Term Care Insurance.