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This image shows elderly people in a care centre, Shek Tsai Leng, Kwu Tung. Photo: Sam Tsang

Change could be on the way for Hong Kong’s cramped care homes – but no time soon

  • Calls for action after reports of rooms as small as 32 sq ft
  • Government wary that too big an increase in floor space per person could restrict supply of places

Chloe Wong Tsz-yan fell suddenly into a coma in 2013, and only woke up after a month and a half.

She has never found out what caused it, but it left her with muscular atrophy and spinal problems.

Unable to care for herself, the 30-year-old had no choice but to enter a privately run residential home.

“This one in Sham Shui Po is the fourth home I am staying in,” she said. “They are all the same.”

Wong said the home was small, making it inconvenient for people with a disability like hers.

Fernando Cheung said he was “very disappointed” with the proposed increase in floor space. Photo: Edward Wong

“My room is only big enough for one personal care worker to come in to help me up, so I often have to strain my back to get up as the worker doesn’t have enough strength,” she said.

“It’s very uncomfortable, as I’ve got issues with my back.”

Some days Wong needs to use a wheelchair. But she said she often has to leave it outside because the room – whose cost eats up almost all of her HK$6,700-a-month government benefits – is too small.

Such struggles are common among residents in Hong Kong’s private homes for the elderly or disabled.

A study last year found that more than 60 such homes had cramped rooms, with some only 32 sq ft.

People in the social welfare sector have long called for authorities to raise the statutory minimum floor space for each resident from the current 6.5 square metres (70 sq ft) to 16 square metres, comparable to the Social Welfare Department’s guidelines.

Elderly care homes won’t use domestic helpers to fill labour shortage

For example, the guidelines say a 100-place residential home for the elderly should be 1,354 square metres, not including pantries and toilets.

But the situation looks unlikely to improve substantially any time soon, with authorities looking to increase the minimum area by only up to 3 sq m and allow a grace period of eight years for transition.

In 2017 the department established a working group to review the rules around residential care homes for both the elderly and people with disabilities. The group includes government representatives, legislators, residents or their carers, and people running homes.

Working group member Fernando Cheung Chiu-hung noted after the group’s meeting last week that it would suggest raising the minimum floor space for each resident to 9.5 sq m for homes offering a high

level of care and 8 sq m for those offering medium-to-low levels of care.

We hope that there will not be residents who have to leave because of this statutory minimum requirement
Director of Social Welfare Carol Yip

But the Labour Party lawmaker said he was “very disappointed with this proposal, as it offers no dignity to the residents”.

Lee Chi-yung, an advocate for better living conditions in residential homes, said 8 sq m was even smaller than a standard 134 sq ft Hong Kong parking space.

Cheung said having such a tight space also meant it was difficult to use wheelchairs, machines and technology to help residents.

But the department noted that boosting floor space could squeeze the overall supply of places.

The number of places at homes for the disabled with medium-to-low levels of care would decrease by 882 if the area increased to 9.5 sq m, compared with 443 for an increase to 8 sq m, it wrote in a paper for the working group. Similarly, places at elderly homes with medium-to-low levels of care would decrease by 46 if the area were increased to 9.5 sq m, compared with 16 if the area were raised to 8 sq m.

The city’s elderly and disabled face long waits for subsidised residential care. By January, the average waiting time for elderly homes was about two years.

A wheelchair is left in the hall of a care home for the elderly in Sham Shui Po. Photo: Handout

Cheung said the working group would propose changing the ratio of personal care workers to residents from the current 1-40 during the day to 1-20, and 1-60 at night to 1-40.

He said even that was insufficient, suggesting it should be 1-10 in the day and 1-20 at night.

Wong recalled having difficulty breathing and not being able to get help for at least 30 minutes because of a staff shortage.

“I only managed to go to the hospital after struggling to call a friend to come over,” she said.

Cheung said the group would only submit a report around May. The paper would then have to go through the relevant Legislative Council procedures.

With the proposed eight-year grace period, Cheung feared it would be as late as 2030 before the area changes come in.

Director of Social Welfare Carol Yip Man-kuen last week pointed out that the transition period was to avoid residents being asked to leave because homes do not meet the new requirements.

“We hope that there will not be residents who have to leave because of this statutory minimum requirement. Instead, we hope it will be through a process of natural loss,” she said.

This article appeared in the South China Morning Post print edition as: cramped care h omes to get bi g ger – but not until 2030
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