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LCQ18: Policy on support for dementia patients
     Following is a question by the Hon Doreen Kong and a written reply by the Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (June 1):
     The Government mentioned in the Mental Health Review Report published in 2017 that the number of dementia patients in Hong Kong was estimated to be 100 000, and a study conducted in 2012 estimated that with an ageing population, there would be more than 300 000 dementia patients of 60 years old or above in Hong Kong by 2039. In this connection, will the Government inform this Council:
(1) whether it has compiled statistics on the latest number of patients diagnosed with dementia in Hong Kong and, among them, the number of those who obtained the diagnosis in the private healthcare system; and
(2) apart from providing existing services (e.g. the Dementia Community Support Scheme), whether the Government has further formulated a long-term policy on the nursing care and support for dementia patients, so as to cope with the needs of a growing number of such patients arising from the ageing population; if so, of the details; if not, the reasons for that?
     In consultation with the Labour and Welfare Bureau and the Hospital Authority (HA), the consolidated reply to the question raised by the Hon Doreen Kong is as follows:
(1) According to the latest statistics of the HA, in 2020, there were around 79 400 patients with dementia who were receiving treatment in the HA (provisional figure). The HA does not keep the number of patients who obtained diagnosis in the private healthcare system. 
(2) To further enhance mental health services and map out the future direction of the mental health policy in Hong Kong, the Government set up the Review Committee on Mental Health (the Review Committee) in 2013. The Review Committee promulgated the Mental Health Review Report (the Report) in 2017.
     The Report made the following 10 suggestions with regard to the provision of nursing care and support to the elderly with dementia:
(a) public education should be strengthened to promote healthy lifestyle, better understanding and awareness of dementia, encourage help-seeking and reduce stigma associated with dementia;
(b) territory-wide prevalence studies of dementia should be conducted regularly to provide information for service planning;
(c) a common reference should be developed to support primary healthcare professionals in the diagnosis and management of dementia;
(d) the role of primary healthcare in treating dementia should be enhanced through capacity building of healthcare professionals;
(e) the capacity of specialist services in the HA should be strengthened to facilitate timely intervention of dementia cases through the implementation of a refined intervention model so as to reduce the waiting time for specialist services; 
(f) there is a need to increase the supply of healthcare manpower and strengthen their training. Training for healthcare and social care service providers should be enhanced, so that they can be equipped with the necessary skills and knowledge in providing care to persons with dementia;
(g) social care infrastructure should be strengthened to allow persons with dementia to stay in the community for as long as possible;
(h) there is a need to enhance medical-social collaboration and further integrate the delivery of healthcare and social care services so as to provide patient-centered support;
(i) end-of-life care service and palliative care in the community setting should be promoted to minimise unnecessary and repeated hospitalisation; and 
(j) support for carers of the elderly should be enhanced, including providing them with structured and accessible information, skills to assist in caring for patients and respite services to enable the carers to engage in other activities, so that they can continue in their role of carers of the elderly effectively.

     The Government established the Advisory Committee on Mental Health in December 2017 to give advice to the Government concerning mental health policies, including following up on and monitoring the implementation of the recommendations of the Report. Regarding the 10 suggestions related to the elderly with dementia in the Report, the measures initiated by various bureaux/departments and the HA are as follows:
(a) the Food and Health Bureau (FHB), in collaboration with the HA and the Social Welfare Department, launched the two-year Dementia Community Support Scheme (the Scheme) in February 2017 to provide support services to the elderly with mild or moderate dementia and their carers in the community through 20 subvented District Elderly Community Centres (DECCs) and four HA clusters. The Scheme had been regularised since February 2019 and extended to all 41 DECCs and all seven HA clusters territory-wide since 2019-20. The Scheme serves more than 2 000 elderly annually;

(b) the multi-disciplinary team of the HA, comprising doctors (geriatrics and psychogeriatrics), clinical psychologists, nurses, occupational therapists, medical social workers, etc., have been providing holistic and continuative healthcare services for the elderly with dementia, including hospitalisation, out-patient clinics, day rehabilitation training and community support services. Having regard to the conditions of the patients, the multi-disciplinary team will formulate individualised treatment plans in order to provide them with holistic and continuative healthcare services. The healthcare workers will provide appropriate medication, cognitive training, behavioural and emotional management, rehabilitation services as well as support for families and carers of the elderly with dementia according to the needs of individual cases, so that the elderly can age in place and enjoy better living quality while reducing the burden on carers;

(c) for the elderly with dementia residing at residential care homes for the elderly (RCHEs), the HA will provide outreach services through its community geriatric assessment teams and psychogeriatric outreach service teams. The services provided include assessments, check-ups, formulation of treatment plans, monitoring of patients' physical and mental conditions, follow-up consultations and prescriptions of medication where necessary. When needed, training on nursing skills for elderly with dementia will be provided to RCHE staff to enable better care to the patients; and

(d) the Research Office of the FHB has commissioned the Chinese University of Hong Kong to conduct a mental health prevalence survey on the elderly. The survey is in progress and is expected to be completed within 2022. The findings will form the basis for bureaux/departments to continue enhancing their services and support to the elderly (including those with dementia).
Ends/Wednesday, June 1, 2022
Issued at HKT 14:55
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