Elderly care in Hong Kong – the challenges & opportunities

Can you imagine, if you intend to have a bed at a residential home for elderly in Hong Kong, you would have to wait for around 39 months? And, if you wish to apply for elderly care services, you would probably have to visit several offices of different Government departments before you are offered the services? 

Hong Kong has the highest rate of institutionalised elderly (of around eight percent), when compared with other countries like USA and UK who are around three percent to four percent. So why do elderly in Hong Kong love to be institutionalised?

According to the Census projection in Hong Kong, it is expected in about 25 years, the percentage of the elderly population here would increase to 25 percent to 28 percent, meaning about one fourth of the total population would be elderly in Hong Kong at 2033.


Challenges of elderly care

As a Chinese society, filial piety has been a long belief that can foster quality care to the elderly. However, the following challenges are faced by elderly care in Hong Kong:

  1. Busy working lives – Even as they age, the spouse and children of the elderly have to work long hours before they can go home to take care of the elderly.
  2. Limited residential space – This prevents the elderly from being properly cared in their own homes. Worse still, their homes cannot accommodate a wheelchair.
  3. Intention of not to bother family members by the elderly – Elderly in Hong Kong are very considerate that they do not want to bother their families, choosing instead to live by themselves.
  4. Increasingly frail elderly population – Around 15 percent of the elderly suffer from chronic illness, whilst eight percent of those aged 80 suffer from dementia. These figures are set to increase as the population continues to age.
  5. Shortage of para-professionals (such as occupational therapists and physiotherapists) and nurses – Elderly institutions are not granted license if they lack sufficient para-medical staff. This means an added pressure to existing elderly institutions with their waiting lists for the elderly continuing to grow and the wait becomes longer. 

All this has caused great challenges to the elderly care in Hong Kong and less actualization of filial piety in Hong Kong.

If you asked the family whether they would like to take care of the elderly, more than 100 percent would express that they would want to care for their elderly loved ones. Hence, you see a lot of full-time, informal carer formed by family members, such as the children or spouse, spending all their time caring for the chronic invalids and demented elders but they face the challenges mentioned earlier.


Opportunities of elderly care

Despite the above limitations, this situation has opened up a lot of opportunities of elderly care in Hong Kong.

Firstly, we need to stress that elderly prefer not to be institutionalised. Even at their last stages of life, they want to stay at their original home, preferring to stay at familiar environments to enjoy their last breath. Hence, we have to strengthen the homecare services for the elderly to enable them to be properly cared and supported at home. Hence, the following opportunities in elderly care at home can be considered in Hong Kong:

  1. Privatised homecare service – The only resolution to cut short the long waiting list of public service is to offer more supply of service. Indeed, children and families of the elderly would need to be willing to pay for the service. The private market homecare service can cater to those who can afford, whilst releasing the resources to those underprivileged elderly, allowing them to make use of Government subsidised elderly care.
  2. Offer elderly coupons to purchase homecare services – If the elderly are cared with appropriate services, it would lessen the load on the families/loved ones. Offering Means-Tested elderly coupons can help and this would enable the elderly to have earlier treatment or being offered the elderly care services early on. In the long run, this would strengthen the capacity of the elderly to reduce the reliance on service.
  3. Having a Case Manager help the elderly and family members in making the right choice – When there is a need for elderly care services, family members typically don’t understand what exactly the elderly needs, and are not aware of what services are available. The Case Manager could help assist the elderly and their family members in finding out their exact needs, so they can shop around in the market to find the right service for them. The Case Manager can also help to monitor the performance and quality of the service.
  4. Service agent to coordinate on the marketing of elderly care service – As mentioned above, to help the family members, it would be good to have a service agency in place to consolidate all the available elderly care resources so the families can make the right choice.
  5. Form an Elderly Consumer Council to quality check elderly care services – A Consumer Council could be formed by users of elderly care services to help monitor the elderly care services and bring the attention to mistreatment of elderly who are being cared. Currently, there is no such channel for the elderly and their families to express their concern over elderly care services.

We believe that caring for the elderly is a society’s obligation. We long for the challenges to be tackled, whilst giving the elderly a chance to enjoy their late and remaining lives with pride and respect.






Timothy Ma is the ex-executive director and now is a consultant of the Senior Citizen Home Safety Association (SCHSA). He is also a member of the Elderly Commission, HKSAR.


(** PHOTO: Courtesy of SCHSA.)


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