Provisional LegCo Panel
on Welfare Services

Subvented Residential Care Places for the Elderly

Purpose

The purpose of the paper is to inform Members of the various types of subvented residential care services for the elderly in Hong Kong.

Types of Residential Care Services for the Elderly

2.The objective of Government's elderly policy is to improve the quality of life of old people so that they can enjoy a comfortable and dignified old age. We encourage elderly people to live at home for as long as possible by providing various types of community support services. For those who can no longer be cared for at home, residential care services are provided.

3.Residential care services are either subvented by Government, operated on a non-profit making self-financing basis or provided by the private sector. At present, there are 16,483 subvented, 2,097 non-profit making self-financing and about 20,000 private residential care places. As far as government-subvented residential care services are concerned, a range of institutions including self-care hostels, homes for the aged, care-and-attention homes and nursing homes are provided. There are no such classifications for the self-financing and private residential care institutions. These institutions look after elderly with a wide spectrum of health conditions under one roof.

Self-care Hostels

4.A self-care hostel provides communal living accommodation, organized programmes and round the clock staff support to elderly persons who are capable of self-care. At present, there are 968 subvented hostel places. The admission criteria is at Annex A.

5.With the introduction of sheltered housing scheme in 1995 operated by the Housing Authority, it was found that this scheme overlapped considerably with the self-care hostel programme. The Social Welfare Department has therefore ceased planning for new self-care hostels after 1987. In 1994, the Working Group on Care for the Elderly recommended that the provision of self-care places should be phased out gradually. From 1991/92 to November 1997, 930 hostel places have been converted into 143 home for the aged places and 656 C&A places to meet the needs of elderly requiring a higher level of care.

Homes for the Aged

6.A home for the aged provides residential care for elderly persons who have a social or housing need and are unable to live independently. The services provided include meal service, laundry service, limited personal care and social activities. At present, there are 6,678 subvented home for the aged places. An addition of about 1,300 home for the aged places will be provided in the coming four years 1998-2002. The admission criteria is at Annex B.

Care-and-attention Homes

7.A care-and-attention (C&A) home provides accommodation with general personal care and some nursing care to elderly people who suffer from poor health or physical/mental disabilities. In September 1997, 8,837 subvented places were available. An addition of about 2,000 will be provided in the four years 1998-2002. The admission criteria is at Annex C.

8.A Bought Place Scheme was introduced in October 1989 which aims to provide financial incentives to existing private homes for the elderly with a view of raising their standard and expanding the supply of care-and-attention places. A total of 1,200 places are purchased. We plan to purchase an additional 2,400 places through the enhanced Bought Place Scheme in the three years 1998-2001.

Nursing Homes

9.While C&A homes provide care for elderly people who suffer from general weak health or functional disability and the infirmaries under the Hospital Authority provide constant medical and nursing care for the elderly with chronic disability who require long stay for active rehabilitation, there are a number of elderly who, because of their health conditions cannot be adequately cared for in C&A homes, but do not require the intensive medical care provided in infirmaries. Nursing home is an intermediary type of residential care service to fill the service gap by providing the appropriate level of medical, nursing and personal care to this target group. A total of six nursing homes providing 1,400 places will be completed by 1998/99. The admission criteria is at Annex D.

Conclusion

10.The Chief Executive, at his Policy Address in October 1997, has tasked the Elderly Commission to assess the demand for residential care services and to recommend a strategy to meet the long-term needs. It is expected that a comprehensive strategy for meeting the demand for residential care will be drawn up by autumn of 1998. Government will work closely with the Elderly Commission to monitor the situation of residential care services in Hong Kong and devise effective measures to meet the needs of elderly requiring residential care.


Health and Welfare Bureau
December 1997

Annex A

Admission Criteria of Self-care Hostels

To qualify for admission to a self-care hostel, an applicant should be:

  1. aged 60 or over; and

  2. experiencing a housing need, and/or suffering from any of the following social problems :

    1. absence of family members/close kins living in Hong Kong capable of providing care when required;

    2. serious relationship disharmony with family members;

    3. insecurity with a need for supervision which is available only in a residential setting;

  3. willing to accept group living; and

  4. physically and mentally suitable for communal living; and

  5. capable of personal hygiene, and able to manage activities of daily living including marketing, cooking/cleansing and laundry of personal clothing; and

  6. total household income not exceeding the financial criteria for normal application for public housing.

Annex B

Admission Criteria of Homes for the Aged

To qualify for admission to a home for the aged, an applicant should be:

  1. aged 60 or over; and

  2. experiencing a housing need, and/or suffering from any of the following social problems :

    1. absence of family members/close kins living in Hong Kong capable of providing care when required;

    2. serious relationship disharmony with family members;

    3. insecurity with a need for supervision which is available only in a residential setting;

  3. willing to accept group living; and

  4. physically and mentally suitable for communal living; and

  5. capable of personal hygiene, and able to manage laundry of personal clothing and light cleansing of bedrooms, but have difficulties in managing other activities of daily living such as marketing, cooking heavy laundry and cleansing; and

  6. total household income not exceeding the financial criteria for normal application for public housing.

Annex C

Admission Criteria of Care-and-attention Homes

To qualify for admission to a care-and-attention home/unit, an applicant should be:

  1. normally 65 years of age or over;

  2. in poor health or suffering from functional disabilities to the extent that assistance with daily living activities is necessary;

  3. able to move around with a walking aid or in a wheelchair;

  4. without family members to provide the necessary assistance, or causing great stress to the family; and

  5. mentally suitable for communal living;

    and should not be:

  6. requiring constant medical treatment and intensive professional nursing care, such as frequent injections and complicated dressing.

Persons aged between 60 and 64 can apply if there is a proven need for care-and-attention care based on health and/or social grounds. Priority should be given to those with low income.

Admission Criteria of Nursing Homes

To qualify for admission to a nursing home, an applicant should be:

  1. normally 65 years of age or over;

  2. satisfying at least one of the following conditions, but would not require a higher level of care than would be needed in either of the two conditions:

    1. with a medical condition which is stabilized but still requires regular basic medical and nursing care;

    2. with chronic disability who, in order to move around, requires, with or without a walking aid or wheelchair, one person to assist him/her but who is in any event not totally chairbound;

  3. mentally suitable for communal living and do not have persistent tendency to violence, self-destruction/self-injury or disruptive behaviour.

Those aged over 60 but below 65 will continue to have access to the service subject to their meeting the admission criteria stated above.