Climbing costs hit elderly
ONCE, Hong Kong's elderly relied on their adult children and a social network for the care they needed. But with the middle-class boom and emigration and job transfers separating families, more and more people are finding that caring for their elderly parents has become largely a financial decision.
Even if adult children wanted to - and, unlike Singapore, there is no Hong Kong law requiring grown children to support their aged parents - many working families find caring for a mentally or physically weak parent impossible. During this year's Lunar New Year cold snap, more than 100 elderly people died in old-age homes or alone in their flats.
In Hong Kong, where property prices remain at a premium, money often dictates the choice.
There are more than 500 nursing homes in the territory, of which 400 are private, charging anywhere between $3,000 a month for a bed in a dormitory and more than $15,000 for an air-conditioned private room with care.
The rest are subvented, or government-subsidised, with an asking price of $1,100 to $1,500 per month for a non-bedridden person and slightly more if care, which covers feeding, bathing and hygiene, is needed.
That is cheap, and the quality is generally good. The problem is long queues: about 19,500 people are estimated to be waiting for a spot in these homes, and the wait could take up to three years.
Unfortunately, the subsidies doled out by the Government in its Comprehensive Social Security Assistance (CSSA) scheme are a pittance: just $1,805 a month for those living with their families, and $1,935 for single people.
In extreme cases, where an elderly person is abandoned by his family and has nowhere to go, the Housing Authority accords him a place in what is called 'compassionate housing', where up to 100 people are housed on one floor, with three to a cubicle. Applicants are likely to have to wait three months.
Of course, those with more money or generous health-insurance plans can always opt for private nursing homes, where waiting lists are shorter. But paying more does not always guarantee better care.
'Actually, most people in these private homes are waiting for admission to a subsidised home,' said Tsang Kam-yan, executive director of the Hong Kong Society for the Aged, an agency providing government-funded services.
Since June 1, finding a reputable nursing home has become slightly easier because the Residential Care Homes Ordinance requires all owners of homes for the elderly to obtain a licence or face a fine or jail term. The licence basically stipulates the need for stiffer safety standards, more staff and fewer beds.
'We give those who don't fulfil the requirements a certificate of exemption, but they have to upgrade their facilities before the end of the time allotted to them,' said Liu Chun-keung, senior information officer with the Social Welfare Department. So far, however, fewer than 100 of the territory's 595 homes have received one-year licences, and most of the rest have been given certificates of exemption.
If the territory's nursing homes are not good enough, there are always spots across the border. At about $2,000 per month, Chinese homes charge Hong Kong people three times the amount they would a mainlander. Even so, for a Hong Kong resident, it is relatively inexpensive, and sometimes better equipped.
'But according to present laws, anyone who stays out of Hong Kong for more than 180 days a year loses the CSSA [payment], although the Government is considering whether to change that,' Mr Liu said.
Nursing homes are not the only option. Home help, similar to the home-support system in the United States, has become increasingly popular, giving elderly people the comfort of home while easing their children's concerns about their plight.
'Many people don't want to enter a [nursing] home yet but still need some outside help,' Mr Tsang said. 'We send in trained staff to do almost anything, from cook meals, take the person to the doctor, to caring for the elderly person's personal hygiene.' At the community-support level, agencies like Mr Tsang's provide facilities for the elderly such as recreation and day-care centres.
'These centres help care for the elderly in the daytime while their family is working,' Mr Tsang said. 'With nurses and doctors around, these centres save the family from having to send a relative to an institution.' The government is also looking at setting up US-style retirement villages.