
When melody meets medicine: A look at Singapore's growing music therapy scene
Becoming a music therapist was a hope he held onto for more than seven years. Through being a primary school music teacher, getting married and becoming a father, the dream never wavered.
As he put it, "Music therapy connects music, psychology and health care."
A burgeoning scene here, the clinical and evidence-based profession uses music to improve physical, emotional, cognitive and social well-being. Its use ranges from palliative and dementia care to pain management and early childhood intervention.
Bakti encountered music therapy while doing research for an undergraduate assignment at Lasalle College of the Arts. He completed his degree in music composition in 2017.
But at the time, there was no music therapy program in Singapore for him to pursue his interest further.
"It's all based on my desire to help," said the 33-year-old. "I wanted to use whatever knowledge or background of music I have to create some change."
First postgrad course in Singapore
Bakti considered training in New Zealand. Then in 2024, Lasalle launched the country's first postgraduate program in music therapy, opening the door for aspiring practitioners to be trained locally.
"Its amazing, something that I've always wanted to do," he told The Straits Times in March while on an eight-week clinical placement with St Luke's Hospital, where he worked closely with dementia patients.
Dr. Indra Selvarajah, leader of Lasalle's music therapy program, said the two-year course arose in response to growing interest in the profession and was oversubscribed.
Of late, Singapore has seen a surge of curiosity surrounding music's role in community and wellness — seen, for example, in the growing popularity of sound baths. But music therapy, Selvarajah stressed, is a clinical profession which requires specialized training at a tertiary level.
The program took three years of planning, research and consulting with international music therapy experts to design. It was done in close collaboration with the Association for Music Therapy in Singapore.
"We have 19 students, a good mix of local and international students from countries such as Malaysia, Japan and the Philippines," she said, noting that regional interest in the field is growing.
Program lecturer Eta Lauw said the course marks a crucial step towards making music therapy more accessible in Singapore.
It allows locals keen on studying music therapy to do so at home, without the burden of hefty overseas tuition fees.
Key to this, she added, is that while music may be universal, its emotional and cultural resonance varies widely.
"There are a lot of very specific cultural elements to it," said the Australia-trained therapist, adding that many who studied abroad have to make significant adaptations to reshape their training to fit Singapore's context.
Now, students are able to learn within a local context, complete clinical placements and observe how music therapy is practised here.
Selvarajah said she is excited for the course to expand the presence and impact of music therapy in Singapore.
"Any kind of recognition that is forthcoming will rely on the growth and actual increase in music therapists. This is where our program plays a vital role."
An existing ecosystem
Music therapy has had a presence here long before Lasalle offered its course.
AMTS has been around since 2007. Even then, its president Tan Xueli noted, some of its members had been practicing in Singapore for more than two decades.
The association has grown steadily, from just 11 professional members at its founding to 44 today. Counting associate and student members, the total number stands at 74.
Most of its members work in acute and community hospitals, hospices as well as nursing homes, with a handful in private practice.
The field has a prominent presence in palliative care, as the broader health care community increasingly recognizes the importance of quality of life for terminal patients.
"When that shift happens, the creative arts often play a very big part. You bring in creative art therapies at that point, because you are looking at quality of life, comfort care, pain management and more of the psychosocial aspects," said Tan. She is the principal music therapist and music therapy lead at St Luke's Hospital's Rehabilitation Department.
At St Luke's Hospital, senior music therapist Camellia Soon, 37, specializes in palliative and dementia care.
With patients who are nearing the end of their lives, she said, much of the work involves helping them navigate grief — not just over death, but also over the inevitable loss of identity and ability.
It could be grief from no longer being able to do the things they used to do, such as going to work or cooking for their families, Soon said.
"If they have awareness of their illness, they also know that this might be their last New Year, last birthday," she added.
Physical, emotional and cognitive benefits
One of Soon's patients was a terminally ill elderly man with a neurological disorder. A stand-offish character, he was estranged from his family and was often caught in states of delusion.
Over the course of three months, he would sometimes weep when Soon played spiritual music, such as hymns — though he could never quite name which songs touched him most.
Eventually, he began to recognize Soon by name and told her he felt "lighter."
"My aim was not to make him happy, but to use music to allow him to open up, enable the grief to be expressed and find closure," she said.
Then, one day, seemingly out of nowhere, he shared two songs with her: "Fated" by Hong Kong singer Andy Lau and "First Of May" by English pop group the Bee Gees, both reflections on time and loss.
With what Soon described as "intense clarity," he walked her through specific, vivid memories from his life. He died the following week.
"Music can unlock something I cannot do through just talking," said Soon, adding that some patients may never have ventured into those memories without the emotional nudge of a particular song.
Music therapy also helps dementia patients in physical, emotional and cognitive ways, said Dr. Chan Kin Ming of Chan KM Geriatric and Medical Clinic.
Learning to play instruments can boost short-term memory and attention span, while using music to soothe agitation and aggression can be an effective alternative to medication, he said.
Music therapists do not just work with elderly patients.
At Thye Hua Kwan Moral Charities, music therapist Farhana Rizaini, 34, works with children with developmental needs.
Using a mix of musical activities — from playing instruments to learning prepositions through song cues to reading stories set to music — Farhana tailors each session to meet their needs.
She remembers working with a child who would cry from fear of the guitar and a sensitivity to fast-paced music.
With consistent encouragement from both the teacher and a psychologist, the child was gradually able to tolerate louder and faster-paced music, and actively participate in most activities.
"The child can now sing along to familiar tunes, functionally play on a variety of instruments, from shakers to drums to even the guitar," Farhana said, adding that the child is also able to play games such as "peek-a-boo" to accompanying music.
Push for safe practice and recognition
Tan pointed out, "Music is powerful. We can use music for all these benefits, but flip the coin — because music is powerful, you can also do harm."
She spent many years working in pain management at a burns and trauma hospital department in the US.
Certain songs tied to painful experiences can trigger distressing emotions or traumatic memories.
That is why music therapists require specialized training to assess each individual's emotional and psychological landscape, she said.
Where music may be triggering, therapists either avoid those cues or use them constructively to help patients process and work through deep-seated emotions.
Singapore's music therapy community has been steadily stepping up efforts to advocate for the profession's formal recognition as part of the allied health sector.
This recognition carries important implications, from enabling patient subsidies and student funding to broadening access to music therapy across the health care system.
Alongside the launch of Lasalle's program, AMTS has published several public resources in recent years. They include a Code of Ethics and Professional Standards, to guide local therapists and prepare the profession for integration into the allied health care framework.
In Singapore, said Tan, music therapy can be an entryway for emotional expression in a society that often shies away from confronting difficult feelings.
How Singapore's rich multiculturalism can be more deeply woven into music therapy is something Bakti hopes to explore in his practice.
"Perhaps the collaborative, community-building aspects of Malay music could be used in group music therapy sessions, or the five-tone Chinese scales could be used to induce certain moods for patients," he said.
When song lyrics speak about loss or longing, people are able to externalize their emotions and project themselves onto the music, Tan said. "It makes it, in a way, more acceptable to talk about negative emotions."
Soon added, "We are all musical beings. We have musical memories and there's resonance. You don't have to be able to play an instrument or sing to feel connected to music."

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Korea Herald
17-06-2025
- Korea Herald
When melody meets medicine: A look at Singapore's growing music therapy scene
SINGAPORE (Straits Times/ANN) — It is not uncommon for musicians to have a dream stage. Perhaps a sold-out arena or a dim jazz bar steeped in soul. Bakti Khair's is a hospital ward. Becoming a music therapist was a hope he held onto for more than seven years. Through being a primary school music teacher, getting married and becoming a father, the dream never wavered. As he put it, "Music therapy connects music, psychology and health care." A burgeoning scene here, the clinical and evidence-based profession uses music to improve physical, emotional, cognitive and social well-being. Its use ranges from palliative and dementia care to pain management and early childhood intervention. Bakti encountered music therapy while doing research for an undergraduate assignment at Lasalle College of the Arts. He completed his degree in music composition in 2017. But at the time, there was no music therapy program in Singapore for him to pursue his interest further. "It's all based on my desire to help," said the 33-year-old. "I wanted to use whatever knowledge or background of music I have to create some change." First postgrad course in Singapore Bakti considered training in New Zealand. Then in 2024, Lasalle launched the country's first postgraduate program in music therapy, opening the door for aspiring practitioners to be trained locally. "Its amazing, something that I've always wanted to do," he told The Straits Times in March while on an eight-week clinical placement with St Luke's Hospital, where he worked closely with dementia patients. Dr. Indra Selvarajah, leader of Lasalle's music therapy program, said the two-year course arose in response to growing interest in the profession and was oversubscribed. Of late, Singapore has seen a surge of curiosity surrounding music's role in community and wellness — seen, for example, in the growing popularity of sound baths. But music therapy, Selvarajah stressed, is a clinical profession which requires specialized training at a tertiary level. The program took three years of planning, research and consulting with international music therapy experts to design. It was done in close collaboration with the Association for Music Therapy in Singapore. "We have 19 students, a good mix of local and international students from countries such as Malaysia, Japan and the Philippines," she said, noting that regional interest in the field is growing. Program lecturer Eta Lauw said the course marks a crucial step towards making music therapy more accessible in Singapore. It allows locals keen on studying music therapy to do so at home, without the burden of hefty overseas tuition fees. Key to this, she added, is that while music may be universal, its emotional and cultural resonance varies widely. "There are a lot of very specific cultural elements to it," said the Australia-trained therapist, adding that many who studied abroad have to make significant adaptations to reshape their training to fit Singapore's context. Now, students are able to learn within a local context, complete clinical placements and observe how music therapy is practised here. Selvarajah said she is excited for the course to expand the presence and impact of music therapy in Singapore. "Any kind of recognition that is forthcoming will rely on the growth and actual increase in music therapists. This is where our program plays a vital role." An existing ecosystem Music therapy has had a presence here long before Lasalle offered its course. AMTS has been around since 2007. Even then, its president Tan Xueli noted, some of its members had been practicing in Singapore for more than two decades. The association has grown steadily, from just 11 professional members at its founding to 44 today. Counting associate and student members, the total number stands at 74. Most of its members work in acute and community hospitals, hospices as well as nursing homes, with a handful in private practice. The field has a prominent presence in palliative care, as the broader health care community increasingly recognizes the importance of quality of life for terminal patients. "When that shift happens, the creative arts often play a very big part. You bring in creative art therapies at that point, because you are looking at quality of life, comfort care, pain management and more of the psychosocial aspects," said Tan. She is the principal music therapist and music therapy lead at St Luke's Hospital's Rehabilitation Department. At St Luke's Hospital, senior music therapist Camellia Soon, 37, specializes in palliative and dementia care. With patients who are nearing the end of their lives, she said, much of the work involves helping them navigate grief — not just over death, but also over the inevitable loss of identity and ability. It could be grief from no longer being able to do the things they used to do, such as going to work or cooking for their families, Soon said. "If they have awareness of their illness, they also know that this might be their last New Year, last birthday," she added. Physical, emotional and cognitive benefits One of Soon's patients was a terminally ill elderly man with a neurological disorder. A stand-offish character, he was estranged from his family and was often caught in states of delusion. Over the course of three months, he would sometimes weep when Soon played spiritual music, such as hymns — though he could never quite name which songs touched him most. Eventually, he began to recognize Soon by name and told her he felt "lighter." "My aim was not to make him happy, but to use music to allow him to open up, enable the grief to be expressed and find closure," she said. Then, one day, seemingly out of nowhere, he shared two songs with her: "Fated" by Hong Kong singer Andy Lau and "First Of May" by English pop group the Bee Gees, both reflections on time and loss. With what Soon described as "intense clarity," he walked her through specific, vivid memories from his life. He died the following week. "Music can unlock something I cannot do through just talking," said Soon, adding that some patients may never have ventured into those memories without the emotional nudge of a particular song. Music therapy also helps dementia patients in physical, emotional and cognitive ways, said Dr. Chan Kin Ming of Chan KM Geriatric and Medical Clinic. Learning to play instruments can boost short-term memory and attention span, while using music to soothe agitation and aggression can be an effective alternative to medication, he said. Music therapists do not just work with elderly patients. At Thye Hua Kwan Moral Charities, music therapist Farhana Rizaini, 34, works with children with developmental needs. Using a mix of musical activities — from playing instruments to learning prepositions through song cues to reading stories set to music — Farhana tailors each session to meet their needs. She remembers working with a child who would cry from fear of the guitar and a sensitivity to fast-paced music. With consistent encouragement from both the teacher and a psychologist, the child was gradually able to tolerate louder and faster-paced music, and actively participate in most activities. "The child can now sing along to familiar tunes, functionally play on a variety of instruments, from shakers to drums to even the guitar," Farhana said, adding that the child is also able to play games such as "peek-a-boo" to accompanying music. Push for safe practice and recognition Tan pointed out, "Music is powerful. We can use music for all these benefits, but flip the coin — because music is powerful, you can also do harm." She spent many years working in pain management at a burns and trauma hospital department in the US. Certain songs tied to painful experiences can trigger distressing emotions or traumatic memories. That is why music therapists require specialized training to assess each individual's emotional and psychological landscape, she said. Where music may be triggering, therapists either avoid those cues or use them constructively to help patients process and work through deep-seated emotions. Singapore's music therapy community has been steadily stepping up efforts to advocate for the profession's formal recognition as part of the allied health sector. This recognition carries important implications, from enabling patient subsidies and student funding to broadening access to music therapy across the health care system. Alongside the launch of Lasalle's program, AMTS has published several public resources in recent years. They include a Code of Ethics and Professional Standards, to guide local therapists and prepare the profession for integration into the allied health care framework. In Singapore, said Tan, music therapy can be an entryway for emotional expression in a society that often shies away from confronting difficult feelings. How Singapore's rich multiculturalism can be more deeply woven into music therapy is something Bakti hopes to explore in his practice. "Perhaps the collaborative, community-building aspects of Malay music could be used in group music therapy sessions, or the five-tone Chinese scales could be used to induce certain moods for patients," he said. When song lyrics speak about loss or longing, people are able to externalize their emotions and project themselves onto the music, Tan said. "It makes it, in a way, more acceptable to talk about negative emotions." Soon added, "We are all musical beings. We have musical memories and there's resonance. You don't have to be able to play an instrument or sing to feel connected to music."
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Korea Herald
21-05-2025
- Korea Herald
[Lisa Jarvis] MAHA pushes unneeded glucose tracking
Casey Means, a Stanford-trained physician and wellness influencer nominated by US President Donald Trump for surgeon general, is convinced the US is experiencing an epidemic of metabolic dysfunction — a crisis silently unfolding inside the cells of millions of Americans. One solution, she says, is giving people a close-up view of that crisis. Coincidentally, Levels, a company she co-founded, sells a system that allows people to continuously track their blood glucose levels in real time. She claims this information can help people home in on food and lifestyle choices that will improve their metabolic health. It's a philosophy that other "Make America Healthy Again" movement members have pushed. Health and Human Services Secretary Robert F. Kennedy Jr. extolled glucose monitoring devices as only costing '$80 a month, and they've been shown to be extraordinarily effective in helping people lose weight and avoid diabetes.' Meanwhile, Food and Drug Administration Commissioner Marty Makary told senators at his confirmation hearing that glucose monitors should not require a prescription. He similarly talked up their promise to address obesity and prevent diabetes. There's just one problem: These claims aren't backed by science. They promise to lead Americans down a path to wellness but, without more evidence, could amount to a waste of our health care dollars. 'What is the utility there? The answer is zero,' says David Nathan, a Harvard Medical School professor who has led some of the most important studies on diabetes prevention. 'This, to me, is a scam.' In an information-rich age where our smartwatches can tell us the quality of our sleep, the number of steps we've taken, oxygen levels in our blood, heart rate and more, you might ask: Why not track blood sugar? More data is not always better. It doesn't always tell us something meaningful and, worse, could even cause harm by creating unnecessary anxiety or leading us to draw the wrong conclusions about our health. Continuous glucose monitoring, or CGM, has allowed people with Type 1 diabetes to better manage their blood sugar, which, in turn, can lead to fewer serious health complications like blindness, kidney failure and even death. People with Type 2 diabetes have also used CGM to prevent dangerous fluctuations in blood sugar, but the data is mixed on the long-term benefits. And then there's CGM in people who don't have diabetes. Levels is one of several companies that charge anywhere from $199 to more than $400 per month for CGM, which is often paired with diet coaching. 'I believe CGM is the most powerful technology for generating the data and awareness to rectify our Bad Energy crisis in the Western world,' Means wrote in a blog post on her company's website. Tracking glucose can 'alert us to early dysfunction, coach us on how to eat and live in a way that promotes Good Energy in our unique bodies, and promote accountability.' In reality, the data supporting constantly monitoring blood sugar in people who don't have diabetes, and even in those with prediabetes, is virtually nonexistent, Nathan says. One 2024 review of the literature on CGM in healthy people found scant evidence of its utility. The authors found the research gaps so significant that they concluded any commercial products claiming to offer a benefit 'be labeled as misleading.' Means, meanwhile, has argued that CGM offers important information about our metabolic health. 'An extra-large spike after a meal is a clear sign that the meal had too much refined grain or refined sugar and is creating a big stress of food energy for your cells to deal with,' she wrote on the company's website. But blood glucose is influenced by so much more than the last thing you ate, says Nicola Guess, a dietician and diabetes researcher at the University of Oxford. That includes whether you just finished a vigorous workout, slept poorly the night before, your stress levels, what other foods you ate recently or alongside a particular fruit or vegetable — even a woman's menstrual cycle. Moreover, doctors don't even have enough data to tell patients what a 'healthy' glucose fluctuation looks like in people without diabetes. We don't know, for example, if a spike after a meal is harmless if it comes back down soon after, or even what 'soon' would mean, says Nicole Spartano, a diabetes researcher at Boston University. 'I do worry that people have this technology and are making changes to their diet that do not truly improve their health,' Spartano says. 'For example, you could eat hot dogs (with no bun) for every meal, and your glucose data would look perfect. Very few people would suggest that is a good diet.' Similarly, there's little evidence that blood sugar tracking can prompt people to make long-term changes in their habits, which is the foundational tenet of companies like Levels. Studies of evidence-backed lifestyle interventions show that many can elicit short-term benefits. It's the long haul that people struggle with. The influx of companies pushing CGM has prompted a more intense study of its value in healthy or prediabetic people. But we're still years away from definitive answers. The MAHA movement likes to say it's about following 'gold-standard science.' For people with diabetes, blood sugar tracking is part of gold-standard care. But for everyone else? So far, there's nothing to suggest this would be a wise way to spend our money.


Korea Herald
12-05-2025
- Korea Herald
As China's population ages, cultural taboo of hospice care slowly lifts
BEIJING (China Daily/ANN) — On May 15, 2024, a family gathered at the palliative care ward of Gulou Hospital of Traditional Chinese Medicine in Beijing to take a cherished family photo. The moment was for 87-year-old Yang Nushi, who had suffered a stroke four years ago and had been admitted to the ward just days earlier. The hospital staff, upon learning of Yang's lifelong love for Peking Opera, decorated her room with photos from her younger days, including images of her performing in elaborate costumes. They added a touch of spring, with blooming pink peach blossoms and lush greenery. Yang's husband, Li Xiansheng, held a bouquet of pink flowers as he gazed tenderly into her eyes. The couple, both originally from Suzhou in Jiangsu province, shared a love spanning more than six decades. The two married in 1962. "We were classmates in high school and later attended Peking University together," Li said. "After graduation, we even worked at the same place." Three of Yang's nieces traveled from Suzhou to participate in the photo session, creating a moment of shared gratitude and connection. Though her speech was labored, Yang expressed her thanks in her own way. The medical team, a social worker and a volunteer also joined in for the photos, marking a poignant moment of unity and care. The family photo was one of many efforts to honor Yang's final chapter, supported by the medical professionals at the hospital's hospice care ward. New approach Gulou Hospital of Traditional Chinese Medicine is among Beijing's first pilot institutions offering hospice care. "We integrate traditional Chinese medicine techniques, such as acupuncture, moxibustion, and cupping therapy, to alleviate pain and symptoms like abdominal bloating and constipation," explained Han Danyang, director of oncology at the hospital. "Our multidisciplinary approach aims to help patients feel comfortable, peaceful and dignified in their final days," Han said. The palliative care ward provides holistic support for terminally ill patients and their families, addressing medical, physical, psychological, social and spiritual needs. "The goal is to help people facing the end of life to do so with comfort, peace and dignity," Han added. Hospice care emphasizes quality of life and dignity. It operates on the philosophy that death is a natural part of life and that people should live fully and comfortably for as long as they can, surrounded by loved ones. "We cannot control when life begins, but we can choose how we think about death," said Lu Guijun, director of the pain management department at Beijing Tsinghua Changgung Hospital. With 27 years of experience in palliative care, Lu has witnessed countless unique and meaningful farewells. "Some patients held personal photography exhibitions, others hosted farewell dance parties. Some wanted to spend their final moments with their pets or chose specific music for their funerals. Others simply asked for one last sip of cola or coffee," Lu recounted. For Lu, death is not a taboo. "Hospitals are places of healing, but they are also places of farewell. If we don't understand death, we cannot truly appreciate the boundaries of saving lives," he said. Since launching its palliative care ward in 2019, Lu's hospital has cared for over 300 patients, most of whom were in the late stages of solid tumors. The average survival time in the ward is about one month. "People at the end of life need more than just medication. They need a life that is calm, authentic and filled with love," Lu emphasized. "Relieving physical pain is the foundation of palliative care, but it is equally important to ease the emotional suffering of patients and their families." Palliative care, Lu noted, is about respecting the wishes of patients and their families while minimizing pain and maximizing comfort. Challenges and promises The hospice care movement traces its origins to Cicely Saunders, who founded St. Christopher's Hospice in the United Kingdom in 1967. It emerged in response to the limitations of modern medical technology, which, while capable of extending life, often prolonged the suffering of terminally ill patients. Hospice care offered an alternative — prioritizing comfort and dignity over curative treatments. China began to explore the concept of hospice care in the late 1980s. In 1988, Tianjin Medical College established the country's first hospice care research center. However, progress remained minimal until the last decade. In 2016, hospice care was included in a national health policy document for the first time. The following year, the National Health Commission issued guidelines for its implementation, spurring rapid growth. The number of medical institutions with hospice care departments expanded from 276 in 2018 to 4,259 by the end of 2022. Despite these strides, the need for palliative care far outweighs its availability. According to a 2024 report by the Ministry of Civil Affairs, China officially entered the "deep aging" stage in 2023, with over 14 percent of its population aged 65 and above. By 2035, the country is projected to become a super-aged society. China faces further hurdles in medication access. Of the country's 1 million registered medical institutions, only about 36,000 are authorized to prescribe painkillers, and fewer than 18,000 have intravenous pain medications. Fewer than 5,000 institutions nationwide have dedicated palliative care departments. These limitations severely constrain the development of home-based palliative care, which forms the backbone of services in countries like the United States, Japan, and Australia, where over 70 percent of palliative care is delivered at home. "Palliative care is not about giving up on patients; it's about balancing the length and quality of life," said Chen Yan, a physician in the Palliative Care Department at Fuzhou First Hospital. "It's about focusing on the patient — considering their wishes and addressing their needs." Fuzhou First Hospital's Palliative Care Department is the only one of its kind in a tertiary hospital in Fujian province. The multidisciplinary team includes doctors, nurses, social workers, volunteers and nutritionists. They offer therapies such as aromatherapy, music therapy, and lymphatic care to provide patients with comprehensive support. Yet even as the number of hospice facilities increases, the gap between need and availability remains vast. According to Lu Guijun of Beijing Tsinghua Changgung Hospital, more than 10 million people die annually in China, with approximately 3 million deaths from cancer. "Two-thirds of these individuals require palliative care services, but the actual coverage rate is extremely low," Lu said. Although precise statistics are unavailable, industry experts estimate that less than 10 percent of terminally ill patients in China access palliative care each year. Even those fortunate enough to access such services often face significant hurdles, including long waitlists and limited resources. Overwhelmed system At Beijing Tsinghua Changgung Hospital, the palliative care ward consists of just eight beds: four single rooms and two double rooms, the latter often used for day patients requiring short-term pain management. The limited capacity underscores the severe shortage of hospice care services across the country. Traditional beliefs also play a role. Many Chinese families prioritize prolonging life at any cost, reflecting the sentiment captured in the saying: "It's better to live a wretched existence than to experience a good death." This cultural mindset often leads to aggressive medical interventions, even in the face of terminal diagnoses. "Pain can range from mild to severe," explained Li Zhigang, an attending physician in the Pain Management Department at Beijing Tsinghua Changgung Hospital. "Severe pain usually requires advanced treatments, such as spinal cord stimulation, nerve blocks, or intrathecal pain pump implantation." Cancer-related pain is a significant challenge. In 2022, China reported 4.8 million new cancer cases, the highest number in the world. Among late-stage cancer patients, 60 to 80 percent experience pain, with one-third suffering from severe symptoms. "Late-stage cancer patients often have complex needs. Beyond pain, they may experience shortness of breath, nausea, bowel obstruction, or edema," said Li Yaling, head nurse of the hospital's palliative care ward. "Only with specialized care can we provide the comfort these patients deserve." A path forward As China grapples with an aging population and a rising demand for end-of-life care, the country must continue to expand hospice services while addressing systemic and cultural barriers. Han Qide, an academician of the Chinese Academy of Sciences, has long championed the development of palliative care in China. He identifies a significant cognitive barrier: the prevailing mindset that insists, "Even with a one-in-ten-thousand chance, we must try to save the patient in the ICU." Gao Huatian, a professor at Sichuan University's West China Hospital, highlighted a common scenario: terminally ill patients sent to ICUs, their bodies connected to tubes and machines in a desperate bid to prolong life. While intended to fulfill filial duties or uphold a doctor's mission, such measures often cause immense suffering. Globally, 136 countries and regions have established palliative care institutions, with 20 incorporating palliative care into their social health insurance systems. Foundational and continuing medical education, as well as team development, have steadily advanced in these nations. In recent years, China has shown increasing support for palliative care. The Healthy China 2030 blueprint promotes integrated health and eldercare services, including inpatient treatment, rehabilitation, daily living assistance, and palliative care. In 2020, palliative care was formally included in the Basic Healthcare and Health Promotion Law. In 2022, Shenzhen became the first city in China to pass legislation allowing terminally ill patients to decline excessive lifesaving treatments, safeguarding their right to a dignified death. The city's revised medical regulation stipulates that medical agencies must respect a patient's living will regarding traumatic rescues, life-supporting machines, or primary disease treatments at the end of life. For some, the journey into hospice care begins with small, personal steps. Zhang Xuemei first encountered the concept of hospice care during a charity walk in 2019. Inspired, the then-thirtysomething volunteered at institutions providing end-of-life services. By 2021, Zhang had become a full-time social worker at a hospice ward in Beijing's Tongzhou district affiliated with Luhe Hospital. Her day begins with morning meetings, where doctors and nurses exchange updates on patients and plan their care. Zhang has built close relationships with each patient in the ward. "We're here to help patients live as well as possible until they die — and to ensure they die with dignity," Zhang said.