The Age of Un­cer­tainty

Hong Kong con­tin­ues to strug­gle with so­lu­tions to the ag­ing cri­sis. But many ex­perts say even with those ef­forts, el­derly peo­ple are cer­tain to suf­fer. An­drea Deng re­ports.

China Daily (Hong Kong) - - POLICY REVIEW - Con­tact the writer at an­drea@chi­nadai­

Grow­ing de­mand for pub­lic el­derly res­i­den­tial care homes Why pro­mot­ing “age­ing in place” is nec­es­sary? 33,368

Wong Chor-pat is a re­tired driver liv­ing alone in Fu Cheong Es­tate, Sham Shui Po. He drove trucks, tourist buses and pub­lic mini­vans. His re­tire­ment sav­ings amounted to a sliver of the real costs he faces. What lit­tle he had was se­ri­ously pared by ac­cu­mu­lat­ing med­i­cal bills from his chronic ill­nesses.

Wong had a stroke a few years ago. Some­times he can’t walk. He has heart dis­ease, di­a­betes and high blood pres­sure. Some­times he gets dizzy and his eye­sight is de­te­ri­o­rat­ing.

“Some­one asked me the other day if I’d like to drive a minibus. I said no. I don’t dare. I’ve fainted twice. It doesn’t mat­ter if any­thing hap­pens to me, but I can’t en­dan­ger oth­ers. I have no idea when I’ ll lose con­scious­ness,” said Wong.

As Ng set foot in Wong’s sin­gle-liv­ing, pub­lic hous­ing unit, Wong burst into tears, re­count­ing his rapidly wors­en­ing health, with no one to take care of him.

Wong’s wife left him a few years ago. Now, he has only his sis­ter who calls some­times. Oth­er­wise he talks to tele­phone op­er­a­tors who take his emer­gency calls when he needs help, or so­cial work­ers who visit from time to time.

“On the cold­est day last week, I couldn’t move my leg,” Wong told Ng. “I had to ring the (emer­gency) bell. An am­bu­lance came. I was in hos­pi­tal for three days.”

Wong sur­vives on the HK$3,100 from the gov­ern­ment’s Com­pre­hen­sive So­cial Se­cu­rity As­sis­tance Scheme ev­ery month. There are many old peo­ple like Wong, liv­ing alone, lack­ing care, and suf­fer­ing from chronic ill­nesses.

“There are ap­prox­i­mately 70,000 el­derly in the com­mu­nity with de­men­tia and need­ing some level of care. Many oth­ers have had strokes or other chronic ill­nesses and are vir­tu­ally bedrid­den.

“Those who can af­ford it hire helpers. Those who can’t have to re­sort to in­sti­tu­tions,” said Ng. That brings us back to the prob­lem of long queues for pub­lic fa­cil­i­ties, and the poor qual­ity of ser­vice or the al­ter­na­tive of ex­or­bi­tant pric­ing in the pri­vate ones. On­line Watch the video by scan­ning the code.

All these (fac­tors of an ag­ing so­ci­ety) com­ing to­gether ac­tu­ally makes it very chal­leng­ing to meet the fu­ture needs of man­power. The con­se­quence is ba­si­cally, those who are in need will suf­fer. I don’t think the gov­ern­ment has that sense of cri­sis.” Law Chi-kwong, as­so­ciate pro­fes­sor, Depart­ment of So­cial Work and So­cial Ad­min­is­tra­tion, Uni­ver­sity of Hong Kong

Nurs­ing homes are in­evitable, said Law from the Uni­ver­sity of Hong Kong, adding that ef­forts should be made to re­duce the need for el­derly peo­ple to seek help from in­sti­tu­tion­al­ized fa­cil­i­ties.

“The way to do it is through what we call ‘health man­age­ment’, such as early iden­ti­fi­ca­tion (of ill­nesses), to re­duce rapid de­te­ri­o­ra­tion and the on­set of frailty. When el­derly peo­ple start to de­velop early stage ill­nesses, health man­age­ment or mon­i­tor­ing can pre­vent fur­ther de­te­ri­o­ra­tion. That has to come from tech­nol­ogy,” Law told China Daily.

Apart from be­ing wheel­chair-friendly, Tan­ner Hill has state-of-the-art, ex­per­i­men­tal tech­nol­ogy to safe­guard the health of el­derly res­i­dents.

There’s self-ser­vice equip­ment ten­ants can use to mea­sure blood pres­sure, pulse rate and body tem­per­a­ture. Read­ings can be trans­mit­ted through Wi-Fi to a cen­tral­ized mon­i­tor­ing counter man­aged by the prop­erty. In cases of ab­nor­mal­ity, ten­ants or fam­ily mem­bers will be no­ti­fied. It’s up to the ten­ants whether they want to share their per­sonal health data.

Self-ser­vice equip­ment could ben­e­fit peo­ple liv­ing in their own homes. In Hong Kong, mar­ket de­vel­op­ment of el­der­care prod­ucts and tech­nol­ogy has taken off only in re­cent years, and it will take a few more years to bring prices down, Law said.

The so­cial en­ter­prise Longevity De­sign House, of­fers al­ter­na­tive so­lu­tions to help el­derly peo­ple stay home. The com­pany retrofits houses so as to lower risks of in­jury to el­derly peo­ple.

De­signs in­clude con­cealed doors to hide kitchens and ex­its to keep de­men­tia suf­fer­ers from en­coun­ter­ing sharp im­ple­ments or from wan­der­ing away. Toi­lets can be ren­o­vated to make things eas­ier for wheel­chair bound res­i­dents.

Ray Tang, an in­te­rior de­signer and co-founder of Longevity De­sign House, said the com­pany can con­vert a bed­room into an in­ten­sive care unit. That was done for an el­derly res­i­dent who needed breath­ing de­vices and other ma­chines to mon­i­tor blood pres­sure and heart rate af­ter a se­ri­ous stroke. The com­pany retro­fit­ted the room and in­stalled tracks for a pa­tient hoist, so that fam­ily mem­bers could help the per­son move be­tween the bed­room and the toi­let.

The ser­vice is aimed pri­mar­ily at the mid­dle class, in­clud­ing peo­ple who own a pub­lic hous­ing unit but have no re­tire­ment sav­ings. The com­pany broke even on its books three months af­ter the start up late last year.

“We have about 50 or 60 en­quiries each month. This is a huge num­ber for (reg­u­lar) in­te­rior de­sign firms. Usu­ally they have 10 (en­quiries) each month. In our pro­jec­tions, we will have around 500 to 600 per­cent of growth per month in the next five years, be­cause more and more peo­ple are aware that el­derly peo­ple should live at home rather than in el­der­care cen­ters or hos­pi­tals,” said Tang.

Tang ad­mit­ted there’s not much his com­pany can do for the poor­est el­derly peo­ple. A con­cealed door costs HK$8,000 to HK$10,000. Ren­o­vat­ing a bath­room costs about HK$60,000. Even with the gov­ern­ment’s build­ing’s main­te­nance grant of HK$40,000 for el­derly own­ers, a ren­o­va­tion on that scale may be be­yond the means of many mid­dle class peo­ple. The com­pany plans to raise fund­ing in Jan­uary, to pro­vide some ser­vice to the city’s des­ti­tute.

For so­cial worker Ng, the least the gov­ern­ment should do is to in­crease com­mu­nity health ser­vices for el­derly peo­ple.

“Hong Kong has a stu­dent health ser­vice, but there’s no such uni­ver­sal pro­gram for the el­derly. Among 1.17 mil­lion el­ders in the city, only 40,000 have ac­cess to an an­nual med­i­cal ex­am­i­na­tion from the gov­ern­ment’s el­derly health cen­ters. This is what the gov­ern­ment should im­prove,” said Ng.


By 2041, one in three Hong Kong peo­ple will be above 65 years old. The city is pro­mot­ing “ag­ing in place” as a so­lu­tion to the grow­ing de­mand for res­i­den­tial care homes.

Law Chi-kwong, as­so­ciate pro­fes­sor of the Depart­ment of So­cial Work and So­cial Ad­min­is­tra­tion, at the Uni­ver­sity of Hong Kong, be­lieves the key to en­able more el­derly peo­ple to age at home is to main­tain their health through tech­nol­ogy and com­mu­nity health ser­vice.

Tan­ner Hill is the Hong Kong Hous­ing So­ci­ety’s (HKHS) lat­est hous­ing so­lu­tion to “ag­ing in place”. How­ever, Daniel Lau King-shing, direc­tor of HKHS, said the project is tar­get­ing “those with bet­ter af­ford­abil­ity”.

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