*********************
Following is a question by Dr Hon Pan Pey-chyou and a reply by the Secretary for Labour and Welfare, Mr Matthew Cheung Kin-chung, in the Legislative Council today (January 13):
Question:
As the population is ageing, the number of elderly people in Hong Kong keeps increasing and many of them suffer from chronic illnesses, with dementia (also known as "Alzheimer's Disease") being one of the diseases suffered by an increasing number of patients. In this connection, will the Government inform this Council:
(a) whether the authorities have compiled statistics on the number of dementia patients in Hong Kong and their age distribution in the past 10 years; and whether they have projected changes in the number of such patients in the next decade; if they have, of the outcome; if not, the reasons for that; whether the authorities will establish a database of dementia patients to facilitate more in-depth studies on the conditions of such patients and to enable them to receive assistance more expeditiously when they encounter accidents;
(b) of the respective average waiting time at present for elderly people suffering from dementia to be admitted to subsidised residential care homes for the elderly and day care centres as well as to receive government or subsidised outreach services; whether the authorities will draw up a waiting list specifically for them in order to minimise their waiting time as far as possible; and
(c) what support is provided at present to carers of dementia patients by the authorities to reduce their mental and financial burden, and whether they will consider granting a "carer allowance" to those taking care of their family members who suffer from dementia, so as to alleviate their financial pressure?
Reply:
President,
Like other developed economies, Hong Kong is facing the challenges of an ageing population. Hence, the Government has been allocating additional resources in recent years to enhance the care services for elders, including the support for demented elders and their carers. The Government's expenditure on elderly services has also increased from $1.62 billion in 1997 to $3.98 billion in this financial year (i.e. 2009/10), representing a rise of 145%.
My reply to Dr Hon Pan Pey-chyou's questions is as follows:
(a) According to a study conducted jointly by the Department of Health and the Department of Psychiatry of the Chinese University of Hong Kong in 2006, around 9.3% of elders aged 70 or above living in the community suffered from dementia. Based on the elderly population (aged 70 or above) of about 678,000 in mid-2009, it is estimated that some 63,000 demented elders are living in the community at present.
According to the projection of the Census and Statistics Department, our elderly population aged 70 or above will reach 830,000 in 2019. Based on the current incidence rate of dementia, it is projected that 77,000 demented elders aged 70 or above will be living in the community by 2019.
For dementia patients who receive treatment at the service units of the Hospital Authority (HA), their information (including their conditions and treatment progress) will be captured in HA's Clinical Management System, and the health care practitioners concerned can retrieve the information for reference for medical purposes.
(b) Since 2000, the Social Welfare Department (SWD) has been implementing the Standardised Care Need Assessment Mechanism for Elderly Services. Under the mechanism, SWD adopts an internationally recognised assessment tool for assessing elders' abilities in looking after themselves, their physical functioning, memory, communication skills, behaviour and emotion, health conditions, living environment and abilities in coping with their daily activities, etc., and recommends appropriate care services to match the elders' needs. Since this set of tools is effective in assessing the actual conditions and care needs of people suffering from dementia, we do not see the need for creating a separate waiting list for demented elders.
At present, the Government provides a range of subsidised care services for dementia patients with long-term care needs. These services include residential care services, day care services and home-based care services. The waiting time is about 24 months, 7 months and 2 months respectively.
The symptoms of dementia patients actually vary according to their conditions, and the differences can be substantial. Therefore, it is more important to provide the patients with a continuum of care services that suit their needs at different stages. At present, the subsidised elderly service units will draw up individual care plans for service users having regard to their health conditions and needs. The plans will be reviewed and updated regularly to cater for their changing health conditions.
In addition, we have made special arrangements for services frequently used by demented elders. On residential care services, the Government provides a Dementia Supplement (DS) to all subvented residential care homes for the elderly (RCHEs) and private RCHEs participating in the Enhanced Bought Place Scheme. RCHEs can use it to employ additional professional staff to provide care services and arrange training activities for demented elders. The allocation for DS amounts to $42.5 million a year.
At the same time, subsidised RCHEs and day care centres for the elderly will provide disease-specific training for demented elders, including cognitive training, memory training, reality orientation and reminiscence therapy, etc. These institutions will also provide a suitable environment so as to avoid exerting pressure (caused by noise or lighting, for instance) on demented elders and offer a suitable level of stimulation (e.g. using directional signs).
In addition to providing direct services to dementia patients, the Government has allocated resources to various service providers in recent years for improving the facilities of subsidised RCHEs and day care centres, such as installing anti-wandering systems and multi-sensory facilities, etc. The Government also provides regularly a series of training programmes on caring for demented elders for the staff of elderly service units (including social workers, nurses, occupational therapists, physiotherapists, care workers and home helpers, etc.), so as to enhance their knowledge of dementia and strengthen their skills in caring for demented elders, with a view to providing better care for demented elders.
(c) Cherishing the family is one of the core values of our society. The Government has therefore been promoting mutual family support, and we value contribution made by carers to their elderly family members. The Government has put in place a wide range of support services and measures for carers of elders, which aim at helping them discharge their family responsibilities and easing their stress. For example, the District-based Scheme on Carer Training (the Scheme) is to equip participants with basic knowledge of elderly care, including the skills in caring for demented elders. Our aim is to enhance carers' capability through training so as to ease their stress in caring for the elders. The Scheme has been well received since its implementation and the first round of training was completed with 750 carers trained. The second round of training commenced in March last year and it is expected that another 1,500 carers will be trained in a year's time. SWD will further extend the Scheme to Neighbourhood Elderly Centres in April this year.
In addition, the 158 elderly centres, 58 day care centres and 85 home care service teams throughout the territory provide support services for carers, including the provision of information, training and counselling, assistance in forming carers' mutual-assistance groups, setting up of resource centres, and provision and loan of rehabilitation equipment, etc. At present, all subsidised RCHEs and day care centres also provide relief for carers through their respite services, so that carers can take a break or attend to other businesses.
At the same time, the current social security and welfare systems can offer different forms of protection and support for elders and their carers who are not engaged in employment. At present, people in financial difficulties can apply for financial assistance under the Comprehensive Social Security Assistance Scheme. Moreover, the Government has provided a wide range of subsidised services such as public housing, medical services and social welfare services for those in need. On top of that, the Inland Revenue Ordinance (IRO) allows for tax deduction in respect of Elderly Residential Care Expenses up to a maximum of $60,000 per year. Dependent Parent/Grandparent Allowance are also granted under the IRO and taxpayers who reside with the dependants throughout the year are entitled to a $60,000 allowance. These measures can encourage fellow family members to help look after their elders, and can provide additional support to the carers.
While we fully recognise the importance of carers in taking care of the elderly, we also understand that demented elders require different kinds of care, many of which involve professional knowledge and skills. Family members or individuals may not be able to fully address these care needs. We believe that, compared to providing cash subsidies to the carers, the range of support services subsidised by the Government can better address their needs.
Ends/Wednesday, January 13, 2010
Issued at HKT 14:55
NNNN
