Services for Elders

OBJECTIVES

7.1

Guided by the cornerstone principles of “Ageing in Place” and “Continuum of Care”, the mission of services for elders is to assist elders to remain living in the community for as long as possible. Residential care services will be the last resort to look after frail elders who require intensive personal and nursing care.

SERVICE PROVISION AND STATISTICS

7.2

The service provision and statistics are as follows:

HIGHLIGHTS OF THE PERIOD

COMMUNITY CARE AND SUPPORT SERVICES FOR ELDERS

7.3

Anticipating the challenges brought about by the ageing population, SWD adopted a more holistic and comprehensive promotion of active and healthy ageing through a series of public education and publicity programmes. Besides, to meet elders' preference to age at home and to support their families in taking care of them, SWD implemented numerous initiatives to enable more frail and cognitively impaired elders to benefit from the expansion of enhanced services which were tailor-made, innovative, appropriate and cost-effective in meeting their multifarious needs.

COMMUNITY SUPPORT SERVICES

Home Environment Improvement Scheme for the Elderly

7.4

To improve the quality of life of needy elders, a one-off funding of $200 million was earmarked in the 2008-09 Budget to implement the Home Environment Improvement Scheme for the Elderly for the subsequent five years. Its objective is to assist elders who lack financial means and family support to improve their dilapidated homes with poor fittings. District Elderly Community Centres are the delivery agencies to arrange for minor home maintenance and improvement services as well as purchasing essential household items for eligible elders based on home environment assessment results. As at 31 March 2013, about 35 000 households have been arranged for minor home maintenance and improvement services and/or provided with essential household items under this Scheme.

District-based Scheme on Carer Training

7.5

The Elderly Commission, the Labour and Welfare Bureau and SWD launched the “District-based Trial Scheme on Carer Training” in October 2007. This is to subsidise District Elderly Community Centres (DECC) to partner with community organisations in their districts to organise carer training programme and implement carer services to provide short-term relief to the carers of the elders. It has been extended to DECC and Neighbourhood Elderly Centres of all districts since 2009 and renamed as “District-based Scheme on Carer Training” (Scheme). 119 elderly centres participated in the Scheme and over 10 000 carers had been trained up under this Scheme as at 31 March 2013.

Pilot scheme on home care services for frail elders

7.6

In March 2011, SWD implemented the three-year Pilot Scheme on Home Care Services for Frail Elders. This Pilot Scheme aims to provide home-based support services for those frail elderly who are waiting for a subsidised nursing home place. The scope of home-based care and support services include medical, nursing and rehabilitation services, personal care and support services as well as environmental and psychosocial support services. On-site carer training is also provided to equip and enhance the care skills and knowledge of the carers, empowering them to continue to take care of their frail elderly at home. This Pilot Scheme runs in eight districts, namely Kwun Tong, Wong Tai Sin, Sai Kung, Kowloon City, Yau Tsim Mong, Sham Shui Po, Eastern and Kwai Tsing. As at 31 March 2013, about 590 cases had been served since its implementation.

Services Enhancement for District Elderly Community Centre and Neighourhood Elderly Centres

7.7

Since the implementation of service enhancement of outreaching programmes in 2007-08, over 19 000 hidden and vulnerable elders have been identified. About 7 000 active cases were being followed-up by the elderly centres.

Day Care Services

7.8

The SWD continued to increase the provision of day care service in the districts with high demand. As at 31 March 2013, 65 Day Care Centres/Units for the Elderly (DEs/DCU) provided a total of 2 669 day care places, with an increase of 110 places as compared with that as at 31 March 2012. A total of 3 549 elders, including full time and part-time users, were receiving day care services in these DEs/DCUs.

Home-based Services

7.9

In 2011-12 and 2012-13, service volume of Enhanced Home and Community Care Services (EHCCS) was increased by 1 500 and 500 places respectively. As at 31 March 2013, 24 EHCCS Teams provided a total of 5 579 places. EHCCS continues to deliver a wide range of care and support services to enable elders who have been assessed under the Standardised Care Need Assessment Mechanism for Elderly Services to have moderate or severe level of impairment to continue to live at home and to maintain their maximum level of functioning. Besides, 60 Integrated Home Care Services Teams served a total of 27 362 cases, including ordinary and frail cases in 2012-13.

Opportunities for the Elderly Project

7.10

Under the Project, subsidies are provided to welfare agencies, district organisations, schools, volunteer groups and residents' associations to organise a wide range of programmes and activities, such as promoting life-long learning, community participation, inter-generational solidarity and volunteerism, etc. to promote a sense of worthiness among elders and to instill a spirit of care for elders in the community. A total of 513 projects were launched in 2011-12 and 2012-13 by various community organisations benefiting over 136 200 head count of elders. Commencing from 2012, projects lasting for two years, instead of the usual one-year projects, were also funded.

RESIDENTIAL CARE SERVICES FOR ELDERS

7.11

While the majority of our elders are healthy, some have varying levels of impairment and cannot be adequately taken care of at home. These frail elders are in need of residential care so that they can achieve the optimal level of independence and social participation through nursing and personal care and social activities. In order to target resources at elders with genuine care needs and to enhance their quality of life whilst staying in residential care homes for the elderly (RCHEs), SWD has implemented a number of service initiatives and buttressed the service quality monitoring.

Service Improvement Measures of Residential Care Homes for the Elderly

7.12

The Residential Care Homes (Elderly Persons) Ordinance, Cap. 459, provides for the control and monitoring of RCHEs through a licensing scheme managed by SWD. SWD has taken a number of service improvement measures to further upgrade the service quality of RCHEs. These initiatives include:

• The Administration has implemented a three-year Pilot Scheme on Visiting Pharmacist Services since June 2010 to provide and subsidise registered pharmacists to strengthen the drug management capability of RCHEs.
• SWD and Department of Health organised eight workshops in 2011 and 2012 to provide training for RCHE staff, and drug management was one of the major training items.
• The Code of Practice for RCHEs was updated in March 2013, providing the latest guidelines on management and healthcare services to RCHEs to facilitate them to enhance their service quality.

Provision of Residential Care Places

7.13

As at 31 March 2013, there were a total of 75 553 residential care places for elders with varying care needs in Hong Kong. Government subsidised places are provided through subvented RCHEs, contract homes, purchase of places from the private sector under the Enhanced Bought Place Scheme and from the self-financing sector under the Nursing Home Place Purchase Scheme. At the same time, self-care hostel and home-for-the-aged places are gradually transformed into care-and-attention places to provide a continuum of care to meet the care needs of the elders. The number of subsidised residential care places for the elderly has been increased from 25 834 as at 31 March 2011 to 26 309 as at 31 March 2013. Chart 11 below shows the provision of residential care places as at 31 March 2013.

Enrolled Nurse Training Programme for the Welfare Sector

7.14

SWD, with the assistance of Hospital Authority, launched another four classes of a two-year, full-time Enrolled Nurse (General)/Enrolled Nurse (Psychiatric) training programme for the welfare sector from October 2011 to February 2013 to address the nursing shortage in the sector, in particular elderly services and rehabilitation services. Since 2006, a total of twelve classes with 1 470 Enrolled Nurse training places have been provided, with priority accorded to individuals currently working in the sector. Tuition fees were fully subsidised by SWD, and graduates would have to work in the welfare sector for at least two years after graduation.

Contract Management

7.15

SWD continues to adopt competitive bidding for selecting suitable operators to provide residential care services for elders in purpose-built RCHE premises. The bidding of services is based on quality and service volume and is open to non-governmental organisations and organisations from the private sector. As at 31 March 2013, 20 RCHEs, with eight of them having Day Care Units, provided a total of 1 552 subsidised residential care places and 187 subsidised day care places. Moreover, 1 105 non-subsidised residential care places in these 20 homes charging reasonable fees were also provided.

7.16

The performance of services under contracts is monitored closely by the Contract Management Section. This includes:

• regular audits of service statistics and information;
• regular service reviews;
• unannounced spot checks; and
• complaints investigation.