Ageing society

‘I just want someone who understands grandma’s needs’: how can Hong Kong get better carers for its ageing population? 

With growing numbers of elderly – and a trend of more people living past the age of 100 – the city urgently needs younger people as geriatric care workers

PUBLISHED : Saturday, 31 March, 2018, 11:17am
UPDATED : Saturday, 31 March, 2018, 11:33am

On a warm spring afternoon in March and strapped to a wheelchair, 107-year-old Lee Tsz-yau showed barely any reaction as her daughter Tse Pui-king tried to tempt her with a plate of dim sum.

“Is being picky with food one of the reasons for her longevity?” Tse mused, as she put down the plate and fed her mother, who can hardly speak, hear or see, water from a plastic cup.

“She’s always refused to eat leftover food or anything tangy,” the 65-year-old said, adding that her mother used to reminisce about growing up in a wealthy landowning family on the mainland, with maids to prepare her lunch and feed her fruits picked from the family’s garden.

All that changed when Lee fled to Hong Kong in the 1950s to escape the political situation that destroyed her home and killed her father. She got married and had three children, including Tse. Her oldest has died, and her youngest lives on the mainland.

Today, Lee is among the city’s few thousand centenarians. There were 3,645 of them according to the 2016 by-census, almost 1.5 times more than 2006, with 85 per cent – or 3,111 – female. Like Lee, one-third do not live with their families but in “non-domestic households” such as care facilities.

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If she could get into a government-run caring house, I would be less worried
Tse Pui-king, on her mother Lee Tsz-yau

Lee is among 94 residents – four of them centenarians – living at the privately-run Hong Shui Garden of Aged in Tuen Mun.

Tse, who is unmarried, stopped working to devote herself to her mother. Money is a constant cause for concern, although she said her worries would be eased if her mother could get into a government-run facility.

That seems unlikely. As of February, 37,954 elderly people were on a waiting list for 32,500 residential caring places subsidised by the government. The average waiting time is nearly two years, according to the Social Welfare Department, which has been trying to create more than 10,000 new residential care places and 2,000 day care places.

The government-appointed Elderly Commission projected that about 48,000 subsidised residential care service places, and 26,000 subsidised community care service places, would be needed to meet demand by 2022, when roughly one in five Hongkongers will be above the age of 60. 

Besides subsidised residential care, the issue of sufficient numbers of well-trained carers is also cause for concern.

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Rebecca Chau Tsang, chairwoman of the Cedar Seeds Foundation, which runs the Hong Shui Garden of Aged, said it had 12 carers looking after the home’s residents. They will soon get six new residents but no new carers, even though the home placed job advertisements in newspapers “all year round”.

They seldom received applications, as “the systems [of compensation and accreditation] were not sufficiently motivating, and the industry’s social image also affects people’s willingness to join,” she said.

A survey of 64 subsidised elderly service NGOs conducted by the Social Welfare Department last August found that more than 1,500 staff vacancies remain unfilled.

Chau believes that Hongkongers are unwilling to join the  industry and that immigrants from mainland China avoid such jobs. The 49-year-old former accountant has worked in the sector since closing her plastics factory in Malaysia and returning to the city in 2011.

“Without proper professionalisation, the industry can’t attract young people because they can’t bargain for better payment without a ladder to higher and widely-recognised qualifications,” Chau added.

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The department’s survey last August also found that the average monthly wage for a personal care worker ranged between HK$13,157 and HK$16,449; for a ward attendant, it was HK$12,349 to HK$14,703. In contrast, workers in utility industries earned an average of HK$26,500, with construction workers making HK$22,100.

A more deeply rooted obstacle, Chau said, was local society’s negative image of carers’ work. 

Chau said Hong Kong should educate its younger generation about elderly needs and how to protect them, and those who are vulnerable.

A department spokesman said the government was introducing a scheme to encourage 1,000 young adults to join the industry through a two-year training programme.

Chan Mong-wah, whose 101-year-old grandmother Chu Fung lives at the Hong Shui home, said he wished she could have a carer who understood her needs. However, carers at the home were just too busy to spend quality time with residents, he said.

Chu is paralysed on the right side of her body and has impaired speech after suffering a stroke last year. But she still tries to speak, said Chan, who also looks after his chronically-ill mother, who is in her 80s.

If she could get into a government-run caring house, I would be less worried
Tse Pui-king, on her mother Lee Tsz-yau

As Chu mumbled, clutching a lollipop, Chan leaned towards her, softly stroking her silver hair and murmuring “yes, yes, of course”. He said he had guessed his grandmother liked to suck on lollipops and pearl barley biscuits for their stronger flavours. 

“The most important thing for me is to have someone to learn about her needs and follow up on them regularly,” Chan said.