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LCQ7: Ageing of persons with intellectual disabilities
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     Following is a question by Hon Cheung Kwok-che and a written reply by the Secretary for Labour and Welfare, Mr Matthew Cheung Kin-chung, in the Legislative Council today (January 21):

Question:

     The Special Topics Report No. 62 on social statistics released by the Census and Statistics Department at the end of December last year indicates that the total number of persons with intellectual disabilities (PIDs) in Hong Kong was in the region of 71 000 to 101 000. The problem concerning ageing of PIDs has been under discussion for more than a decade. The Rehabilitation Advisory Committee of the Labour and Welfare Bureau commenced a study on the trend of ageing of PIDs in March last year and completed the report concerned at the end of last year, but it has not yet published the report. In this connection, will the Government inform this Council:

(1) whether it will expeditiously publish in full the data obtained from the aforesaid study to let the public understand and grasp the situation of ageing of PIDs; if it will, of the details; if not, the reasons for that;

(2) as some members of the social welfare sector have noticed that PIDs show symptoms of deteriorating functional capacity when they are around 40 years old, whether the authorities will clearly define the degree to which PIDs' functional capacity has deteriorated for them to be treated as elderly PIDs; if they will, of the details; if not, the reasons for that;

(3) as the Government has never conducted a comprehensive study on the social support and services rendered to elderly PIDs and PIDs with deteriorating functional capacity, whether the Government will, in the form of case illustrations, study in depth the difficulties faced by and the needs of elderly PIDs and PIDs with deteriorating functional capacity, who reside in institutions and in the community respectively, as well as their carers; if it will, of the details; if not, the reasons for that;

(4) whether it will study the problems arising from the process of deteriorating functional capacity and the special physiological systems of PIDs (e.g. the identification and prevention of diseases, inadequate medical services for the elderly, etc.); if it will, of the details; if not, the reasons for that;

(5) as some members of the social welfare sector have pointed out that at present there are quite a number of families of elderly tripletons or elderly doubletons (i.e. families in which elderly PIDs or PIDs with deteriorating functional capacity live with their fathers and/or mothers), whether the authorities have conducted any in-depth studies on the number of such families, their caring and habitation patterns, the guardianship system, as well as the living and emotional support needed, so as to assess the need of such families for social support; if they have, of the details; if not, the reasons for that;

(6) as some members of the social welfare sector have pointed out that while the data involving cases of PIDs are being administered or kept by the Hospital Authority, the Education Bureau and the Social Welfare Department respectively at present, the lack of co-ordination among the institutions concerned has resulted in scattering of case data, whether the authorities will consider designating a government department to co-ordinate the administration of data concerning the cases of PIDs; if they will, of the details; if not, the reasons for that; and

(7) given that while the Government allocated an additional provision of about $10.6 million in 2014-2015 to strengthen the manpower of the 16 District Support Centres for Persons with Disabilities (DSCs), some members of the social welfare sector consider that this initiative is just a patchy fix as each DSC can only employ two additional social workers, coupled with the serious problem of ageing of PIDs at present, such DSCs, with their services, facilities, healthcare manpower, etc., cannot provide one-stop community support services for PIDs and persons with other disabilities as well as their carers, whether the Government will review afresh the positioning and the contents of the services provided by DSCs; if it will, of the details; if not, the reasons for that?

Reply:

President,

     Regarding the question raised by the Hon Cheung Kwok-che, I have consulted the Constitutional and Mainland Affairs Bureau, the Education Bureau (EDB) and the Food and Health Bureau. My reply is as follows:

(1) and (3) The Working Group on Ageing of Persons with Intellectual Disabilities (the Working Group) under the Rehabilitation Advisory Committee commissioned the Hong Kong Polytechnic University to conduct a study on the ageing trend of persons with intellectual disabilities (the study) in March 2014. The study, conducted in the form of a survey, collected from 230 service units under 29 rehabilitation service organisations the data of about 11 400 persons with intellectual disabilities who are users of day training centres, residential care homes and employment support services. The findings of the survey will allow the Working Group to get hold of the basic data of ageing of persons with disabilities (including type of service the users used, their level of intellectual disability, age profile, conditions of disabilities, medical conditions, job training performance, nursing needs and caring needs, etc.) from a macro perspective and in a more extensive and comprehensive manner. This will facilitate understanding of the needs of ageing persons with intellectual disabilities and planning of service provision and service delivery mode.

     A task force under the Working Group is now analysing the data collected from the study. It will, after collating the data, meet with stakeholders and other interested parties and individuals to share the relevant data and collect their views for reference in preparing the study report and making recommendations to the Government. Analysis of the data collected is expected to be completed in the first half of 2015.

     The Government will, having regard to the findings of the study and the views collected, duly consider whether it is necessary to conduct further study under other approaches as appropriate.

(2) Studies conducted by different countries in the past attempting to define ageing of persons with intellectual disabilities and their average life expectancy did not provide any conclusive evidence. The medical field has not reached any consensus on this issue either. In fact, persons with intellectual disabilities encompass a highly heterogeneous group with varying degrees of intellectual disabilities, functional capabilities and need complexities. There is no universal definition of ageing of persons with intellectual disabilities.

     Whilst persons with different disabilities require different rehabilitation services, persons with disability of the same category may also require different services having regard to their own capabilities and situations. In view of this, we have all along adopted a "people-oriented" approach when developing rehabilitation services in order to address the different needs of individuals, thereby facilitating full integration of persons with disabilities into the community.

(4) The multi-disciplinary psychiatric team of the Hospital Authority (HA) provides integrated and continuous medical care and rehabilitative services to patients with intellectual disabilities having regard to their individual clinical needs. The scope of services includes medical and infirmary care, clinical assessment and diagnosis, functional training, treatment and community support services, which aim to enhance their quality of life, maximise their self-care abilities and improve their physical mobility. HA will continue to review and monitor its service provision to ensure that its services are in keeping with the needs of patients.

(5) The Social Welfare Department (SWD) provides services for persons with disabilities (including persons with intellectual disabilities) and their families through various service units (e.g. integrated family service centres, medical social services units, district support centres for persons with disabilities (DSCs), and parents/relatives resource centres for persons with disabilities). Social workers following up the cases will, having regard to the social support needs of the persons with disabilities and their families, arrange for them appropriate services such as casework counselling, community support services, day training services, residential care services and home care services etc., and refer them to HA for clinical assessment and treatment where necessary. The social workers will also keep in view the progress of their use of services and adjust the service arrangements according to their needs. SWD will continue to closely monitor and timely review the delivery of services.

(6) Due to personal privacy considerations, centralised storage and co-ordination of data of persons with intellectual disabilities are deemed inappropriate. At present, HA, EDB and SWD maintain close liaison to ensure delivery of well-suited services to users. If there is a need to transfer an individual's data (such as professional assessment reports and records) to other departments, prior consent of the person concerned will be obtained.

(7) The 16 DSCs in the territory provide rehabilitation training, nursing care, personal care services, social skills training, psychological treatments and personal development activities for persons with disabilities (including ageing persons with intellectual disabilities) and their family members or carers. The DSCs also organise training programmes, education courses, talks, workshops, etc. for the families or carers of persons with disabilities.

     In 2014-15, the Government strengthened the manpower of social workers in the DSCs so as to introduce a case management service approach for co-ordinating the services required by persons with disabilities and their families. The DSCs maintain liaison, communication and collaboration with stakeholders in their districts, and provide suitable services to cater for the needs of persons with disabilities, including referring them to home care service for persons with severe disabilities, integrated support service for persons with severe physical disabilities, transitional care and support centre for tetraplegic patients, community rehabilitation day centres and other relevant welfare services, with a view to providing service users with more comprehensive support.

     SWD will closely monitor the implementation of these services, review from time to time the service contents, and meet with the operators and service user groups to ensure that the services can fulfil the needs of users.

Ends/Wednesday, January 21, 2015
Issued at HKT 14:15

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