When his sister was hospitalised for three weeks because of her diabetes, he sought help from a friend’s wife and domestic helper to care for his mother.

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The family survives on welfare handouts. Their dire situation in caring for Aishah Hussain is not uncommon among Hong Kong’s ethnic minority communities.

Like the rest of the city’s population, the ethnic minority groups have a rising number of elderly, including those who need a high level of care, day and night.

According to the 2021 census, there were 301,344 people from ethnic minority communities – excluding foreign domestic helpers – and 8.6 per cent were over 65. Slightly more than 15 per cent of those over 60 needed “long-term care”.

Unlike other Hongkongers, however, ethnic minority families find it harder to access the range of elderly care services available in the city.

For one, there is the language barrier – the staff at the service providers speak mainly Cantonese, which many of the elderly among the ethnic minority groups do not.

It is also rare to find residential care homes that cater to Muslims or Hindus, and that means most do not provide halal meals for Muslims, no-beef or vegetarian meals for Hindus, or prayer rooms.

The result is that many ethnic minority families struggle to care for their own elderly, saying it is what they prefer doing anyway.

Those who do seek community care struggle to navigate the system, with long waiting times for the services and places in residential homes.

For some of the elderly among these communities, there is no living out their last days in dignity.

Aishah Hussain has access to free public care services provided by an NGO, including physiotherapy, occupational therapy and diaper-changing, but the help comes only once or twice a week.

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Her children still have to provide most of her care while her condition deteriorates and she remains on a waiting list for daily help from a government community care service.

Peggy Lau Wai-hang who runs Support to Ethnic Elderly (SEE), a project under the NGO Hong Kong Christian Service, said Aishah needed a skilled worker to move her from her bed to her wheelchair, to shower her, help change her diapers and accompany her on regular hospital visits.

Lau said it could take several months or up to a year for people to get to the top of the list for public services, because of the manpower shortage and the level of care needed.

As of November 30, there were 7,696 applicants on the waiting list for various types of subsidised community care services for the elderly with an average waiting time of seven months, a Social Welfare Department spokesman said.

Anita Gidumal, vice-president of the India Association Hong Kong, which advocates on behalf of the local Indian community and other minority groups, said people from these groups faced barriers to accessing elderly care.

“If you are non-Chinese, trying to access the services is a struggle,” she said.

At residential care homes, she said, staff generally did not speak enough English and the ethnic minority residents did not have sufficient Cantonese language abilities to express care needs.

She said the association had met the Social Welfare Department to raise its concerns and asked for more care facilities that catered to ethnic minority groups.

“When a care home has only one non-Chinese resident, the priority to cater for non-beef or halal dietary needs and provide religious spaces and English-speaking staff isn’t as high,” she said.

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The association suggested that the government designate a few government-funded care homes to take in ethnic minority residents alongside ethnic Chinese ones.

That would create an incentive for the homes to hire staff who spoke languages other than Cantonese and provide meals that were more palatable and cater to religious needs, Gidumal said.

She stressed that her group was not calling for care homes that took in only ethnic minority residents, but for some of the city’s 811 public and private homes to accommodate them and be sensitive to their needs.

Raheel Ahmed, chairman of the United Muslim Association of Hong Kong and manager of Hong Kong’s only public care home providing halal meals, agreed that the city needed more facilities catering to the ethnic minority communities.

The Haji Omar Ramju Sadick Care and Attention Home in Tuen Mun has 40 residents, including three who are Pakistanis, two Nepalese and six Chinese Muslims.

The rest of the residents are Chinese. Ahmed said it would be hard for a care home to survive if it only took in those from ethnic minority communities.

He said his home had its challenges, as the costs of halal food and getting a chef to cook non-Chinese food were getting more expensive.

It serves Chinese-style halal food and has a space where residents can pray, though it is not a dedicated room.

Ahmed said he had some English-speaking staff, but it was getting harder to hire them as young people did not want to do care work.

He also said a lot of ethnic minority families were reluctant to place their elderly in care homes as many regarded that as “abandoning their parents”.

“But I have to explain to them that paying tens of thousands to give their parent the best care possible is not abandoning them,” he said.

Nepalese Ratna Devi, 73, is a carer for her 90-year-old mother. They live in a three-bedroom flat in Jordan with Devi’s brother, his wife and their two daughters.

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Devi said “about 95 per cent” of the care for her bedbound and incontinent mother fell on her. Her brother is the sole breadwinner, working night shifts in a restaurant.

Devi herself uses a walking frame to get around and worsening knee pain has made it harder for her to move her mother around their home.

“I need to change her diaper every few hours and wake up every four hours through the night to check on her,” she told the Post through an interpreter.

The Hong Kong Christian Service said Devi and her family were reluctant to send the mother to a care home or even use home services.

Lau said it was a struggle for ethnic minority families to make the decision to leave the care of their elderly to community services or a residential home.

“If the mother goes into a facility but cannot be cared for as well as at home because of language barriers, then they have made the wrong choice,” she said.

*Names changed at interviewees’ request.