The news of the treatment of elderly residents in the Cambridge Nursing Home, in Tai Po, where they were forced to wait naked outdoors for a shower, understandably caused outrage among both officials and the public. However, for the relatives of many elderly people, it is often a difficult if not impossible situation. No adult son or daughter wants to admit that they cannot provide the care their parents need. Most families eventually have to deal with such a complicated and heart-wrenching issue. Thus, even though they know that the residential care might not be all they desire for their parents, they choose to accept it. Some say the Tai Po incident was an isolated case. Others believe the problem had been going on for a while. Most people believe frontline care workers and the licensee should be held responsible if they are in violation of the Residential Care Home (Elderly Persons) Ordinance, which came into effect in 1996. It covers requirements for the operation and supervision of elderly care homes. There have long been calls for an update; critics say the statutory requirements, such as on minimum space and the number of staff, are obsolete today. An Audit Commission report in 2014 showed a big contrast between space and staffing level requirements in private homes and government-subsided homes. In government-subsided homes, the ratio of staff is 41 per 100 residents, and the average net floor area per resident is 17.5 square metres. In a private home, not under the Enhanced Bought Place Scheme, it is around 16 staff per 100 residents, with an average net floor area of 7.5 sq m. For those in the scheme, the ratio of staff is 32 per 100 residents, and the average floor area per resident is 8.9 sq m. The government should take this opportunity to revisit the ordinance and related inspection system, as well as conduct a comprehensive evaluation of the Enhanced Bought Place Scheme, under which the government buys places from private homes with the view to strengthening their staffing and space provision. As our population profile continues to age, current long-term care for the elderly, especially those aged 85 and over, will be overwhelmed. This includes home care, day care, residential home and dementia care. Thus, it's vital to not only address the increase in numbers but also build in quality assurance and risk management mechanisms. In practice, this should include certification of service providers, benchmarking of quality indicators, certification of care management and integrated information systems. Our elderly and their families desperately need to see changes. Grace Chan Man-yee is chief officer of elderly service at Hong Kong Council of Social Service
