Ageing in Hong Kong : care arrangements for the aged

Population ageing only has become an issue of concern for the Asia Pacific Region for the past ten years, mainly due to the rapid increase of the aged population and the record low fertility in the Region, and partly because of the observed inability in most European countries including the so-called developed economies such as the US in sustaining the present level of expenditure for aged care. This becomes the new challenge in public policy to balance supply and demand on one side, and sustainability on the other. Developed countries have been relying more on a network of caring professionals (i.e. care givers with formal trainings such as doctors, nurses and social workers) and less with families and neighbours in meeting the needs. The change to an elderly-focused (i.e. with chronic illnesses) health care system also requires a shift from acute curative operation to one that encourages health promotion and illness prevention at an early age, supported in parallel with a firm system of community rehabilitation care. In the personal care service front, winning back the family to share the care, in particular to replace institutional care, is almost impossible with the many faces of the new families (e.g. increasing single parents, divorce and re-marriage rates) and the lack of caring commitments as a result of individualism. The need for more women to enter and stay in the workforce also argues against family care. What is needed first and foremost is a change of mindset at the service delivery front – a thinking and an acceptance that ordinary people including our relatives and neighbours (so called informal care givers) could provide certain level of care in complement to the highly skilled, expensive and numbers-limited, professional care givers (e.g. social workers, nurses, OTs, PTs).