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Tsang Shing-kit had modified the family’s flat to look after his mother, Mary. Photo: Edward Wong

Medical game-changer: Hong Kong to expand transitional care service for elderly

Post-hospital support teams will now help patients who have suffered a stroke or fall

Jennifer Ngo

Transitional care for elderly patients discharged from hospital – a service that lowers their chances of readmittance – will expand to cover those who suffer a stroke or a fall, the Post has learned.

The support service, hailed a game-changer, has been proven to save millions of taxpayer dollars every year, prevent the elderly from being prematurely thrown into care homes, and to ease the strain on the public health system.

Sources told the Post that the government’s budget increase from HK$176.2 million to HK$185.6 million for the service in the coming year would expand it to cover all elderly patients who suffered a stroke or a fall.

That would allow for caseworkers to shadow patients for two to three months. Home visits, meal deliveries and physiotherapy at home, among other services, could also be arranged according to the needs of the elderly.

Around 33,000 elderly patients benefit from the service annually– eligible through a medical assessment to see if they are deemed at “high risk” of readmittance .

Taking care of an elderly person recently discharged from hospital, is seen as a daunting task even for the city’s more resourceful middle class.

Secondary school teacher Tsang Shing-kit said his family altered their entire daily schedule and modified their apartment to keep his mother, Mary Tsang Chan Ying-kiu, 86, at home, after she suffered a crippling stroke about three months ago.

“Yes, it is difficult,” Tsang admitted. He said they were lucky to have a domestic helper and four siblings pitch in to do the job: “Or else it would’ve been impossible to care for her.”

When elderly people fail to recover well and fast, they often think of themselves as a burden and as useless. They give up on themselves
Tsang Shing-kit, who helps to look after his mother

Tsang explained that his wife and the helper did most of the work, from measuring his mother’s urine output and water intake every hour, to several bouts of exercise and massage every day.

Travelling to and from rehabilitation and doctors’ clinics three to four times a week was the hardest part, Tsang said. And in the beginning, she could hardly move, requiring two people just to transfer her into a wheelchair.

Despite having a chance to recover, elderly patients often get admitted into residential homes after being treated for a stroke or a fall because they can’t immediately live independently.

“Half of those who enter our homes do so due to a stroke or a fall,” said Danny Chan Ka-ming, whose company operates a number of private homes. “After a stroke or fall, it becomes quite difficult for the elderly to be looked after at home, so residential care becomes the only choice.”

Residential care, which also costs the most, is usually the least preferred option for most families and the elderly themselves.

Tsang’s wife, Savanna Tsang Or Man-yuk, said the family never thought of putting her mother-in-law into a home because it would “break her heart”. “She brought up five children. It would have never crossed her mind that she wouldn’t be cared for,”she said.

The road to recovery also includes emotional hurdles.

“When elderly people fail to recover well and fast, they often think of themselves as a burden and as useless. They give up on themselves,” Tsang said. “If transitional care was provided, it would definitely help the elderly and the family, physically and emotionally, especially in the first few months back at home.”

The transitional service has already proven to greatly reduce hospital readmittance – cutting down those patients’ Accident and Emergency Unit attendance by 40 per cent, acute hospital admissions by 47 per cent, and hospital bed days by 31 per cent, according to a 2015 Hong Kong Medical Journal research report.

The research covered more than 1,000 patients who used transitional care, and proved that it saved the government HK$22.5 million a year. Only 26 had to be put in homes for the elderly six months after having the service.

“This is a success story of integrating medical and social service,” said Dr Lam Ching-choi, chief executive officer of Haven of Hope and chairman of the Elderly Commission. “But lots of work needs to be done to make the systems seamless.”

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