Left to fend for themselves

The issues

Lack of places and long waiting times

There are 21,283 elderly people waiting for regular-care home places and 6,575 for nursing home places. The average waiting time for a regular-care place, which comes with basic care and limited nursing, is 22 months. The waiting time for nursing homes - which also provide medical and nursing care - can be up to 37 months. Each year, some 4,000 elderly Hongkongers die waiting for places in these homes.

Lack of nurses

The government shut down the Hospital Authority's nursing training programme in 1997 and raised nursing education to university level. Under the new system, the number of nursing graduates dropped by 70 per cent from 1,391 in 2001/02 to 416 the next year. There were only 300 graduates both in 2004 and 2005.

Public and private hospitals face chronic staff shortages. The Hospital Authority says it needs 1,000 nurses. It is the biggest employer of nurses in Hong Kong, employing 20,000 of the 40,000 nurses working here.

Last year the public system lost 1,010 nurses - or 5.3 per cent of its staff - to private hospitals. But these hospitals, too, need more nurses.

Addressing the case of the elderly couple in the news, Grace Li Fai, chairwoman of the Elderly Services Association of Hong Kong, said it highlighted the serious shortage of nursing staff. 'Aged-care homes are always the lowest priority for those who choose nursing as their career,' she said. 'We are competing with the lure of private and public hospitals and some NGOs to find the nurses we need.'

The Social Welfare Department has been working with the Hospital Authority since 2006 to train new nurses for the welfare sector.

The government approach: ageing in place

In a radio programme, Secretary for Labour and Welfare Matthew Cheung Kin-chung expressed concern for Ng and Lam. He said his department would follow up on the case, but added it would be difficult to find places for them immediately in the same home because of their different care needs.

Cheung also said that many elderly people were healthy and did not need a place in a nursing home. So the government would work on providing more support to help them stay at home through its 'ageing in place' programme.

'We must take bold steps to facilitate the elderly to remain at home and in a community setting. This is in keeping with the wishes of most elderly people and in line with our policy objective,' he said during a talk about the government's aged-care policy last month.

However, social workers have criticised the plan.

'There are many cases where 'ageing in place' does not work, and [the case of Ng and Lam] is only one of them,' says Ng Wai-tung, a social worker at the Society for Community Organisation. The couple's 59-year-old daughter has been their sole caretaker for the past 11 years, Ng noted. The woman herself needs treatment - for depression.

Ng criticised the government for using the 'ageing in place' approach to dodge responsibility for dealing with shortages and other problems at homes for the elderly.

Health-sector legislator Dr Joseph Lee Kok-long said the approach was an inevitable step, adding that the government should follow up its pledges with action.

He urged comprehensive measures to set up elderly-friendly communities to allow the aged to live safely and happily.

Another legislator, Peter Cheung Kwok-che, agreed the shortage was a problem. Yet he stressed that 'it doesn't mean the government can't first sort out the basics - like renovating care homes so they can accommodate elderly people with greater medical needs'.

The news

Ng King-yin, who is 100 years old, has been offered a place at an aged-care home after two years of waiting. But he won't take it because doing so would mean being separated from his wife Lam Sau-king, 95. She was denied a place in a regular care home because she is in poor health and needs special, round-the-clock care.

Some legislators said the elderly couple's plight highlights the serious shortage of places. There's also too much red tape in the city's care-home system, they added.

Last month the government announced that it would create an extra 1,000 subsidised residential care places. It also pledged to add 2,600 more by 2015.

It will also upgrade the quality of residential care for elderly people in private homes under the Enhanced Bought Place Scheme.

But the measures still fall short of demand. According to the Census and Statistics Department, there were 940,000 people aged 65 or older last year - as opposed to 200,000 a decade ago. In two decades the figure will likely soar to 2.1 million people, or one in four Hongkongers. That will place a great burden on welfare services.

Voices: What people are saying

'No, I won't go to the home. No way. Not if my wife is here, still waiting.'

100-year-old Ng King-yin

'The case of [Ng and Lam] is urgent as both of them are very advanced in age. We hope to help them secure places together in a subsidised home as soon as possible.'

Legislator Ronny Tong Ka-wah

'Regardless of the number of homes for the elderly built and the number of places the government subsidised, supply could never meet demand.'

Secretary of Labour and Welfare Matthew Cheung Kin-ching

'There is now an enhanced home-care service, providing physiotherapy exercises for the elderly at home. And the government has also started to improve certain homes for the elderly so that they will be able to accept residents with different nursing needs. [These are] small improvements, but there has been nothing significant.'

Legislator Peter Cheung Kwok-che

'We shall face a severe challenge of an ageing population, which may have an adverse impact on our economy. We may experience a shortage of worker supply in our labour force with an excess of economically inactive, dependent population of older people.'

Alvin WK Li, Census and Statistics Department

The articles are based on stories published in the South China Morning Post on February 7, 8, 12 and 22