The Search for a Holistic Care Model for Supporting Elderly People: The Case of Hong Kong

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The Search for a Holistic Care Model for
Supporting Elderly People The Case of Hong Kong

• Professor Nelson W S Chow
• Department of Social Work and
• Social Administration
• The University of Hong Kong

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Western Findings on Supporting the Elderly

• The needs of the elderly may be physical, social
  or psychological in nature and their satisfaction
  involves the contributions of different
  professions.
• The State has the primary responsibility, at
  least in terms of planning, in supporting the
  elderly, though the role of the family and the
  community cannot be neglected.

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Western Findings on Supporting the Elderly (II)

• Institutional care provides a most comprehensive
  form of support for the elderly, though
  home-based/community care can be considered as an
  alternative.
• Community care often implies family care or women
  care.
• A public policy to support the elderly is based
  on a concept of the right of every individual to
  living in dignity.

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Features of Support System for the Elderly in
East Asian Societies

• The family remains the primary support system for
  the elderly.
• Home-based care (or community care) is seen as
  the most desirable form of care a detest or a
  resistance for institutional care.

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Features of Support System for the Elderly in
East Asian Societies (II)

• Support efforts must give due respect to the
  traditional role and status of the elderly.
• The source of help makes a difference to the
  elderly in need of care best coming from
  children, followed by other family members,
  friends and outsiders.

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Stages of Development of Support System for the
Elderly in East Asian Societies

• Stage 1 Elderly people in need of care receive
  support entirely from their families, relatives
  or friends.
• Stage 2 Care institutions, homes and centers for
  elderly people are established by private or
  charitable organizations as an alternative, and
  often an inferior one, to family care.

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Stages of Development of Support Systemsfor the
Elderly in East Asian Societies (II)

• Stage 3 Public services for needy elderly are
  seen as necessary supplements to family care A
  rapid development of public financial and care
  provisions.
• Stage 4 The search for an integrated model and a
  mix of different public, private and family
  efforts in enhancing the quality of life of the
  elderly.

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Development of Support for the ElderlyThe Case
of Hong Kong

• Stage 1 (End of WWII - 1965) The care of the
  elderly was entirely the responsibility of the
  family.
• Stage 2 (1965 1973) Institutions began to be
  set up by charitable and religious organizations
  to take care of the elderly who were lonely or
  their families were unable to support them.

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Development of Support for the Elderly The Case
of Hong Kong (II)

• Stage 3 (1973 1994) The Care in the
  Community approach adopted and began the
  provision of public services to supplement family
  and community efforts in supporting the elderly.
• Stage 4 (1994 now) The principles of Ageing
  in Place and Continuum of Care adopted in an
  effort to combine the contributions of the formal
  and the informal sectors in meeting the needs of
  the elderly.

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The Sharing of Roles in Supporting the Elderly in
Hong Kong

• Families in Hong Kong are still playing the major
  role in supporting the elderly 1.6 million
  adults (out of a population of 7 million) are
  financially supporting their parents.
• Public provisions, including health care, social
  security, housing and welfare, together form the
  safety-net for needy elderly HK SAR Government
  is annually spending HK40 billion (about 20 of
  total Government budget) on various public
  services for the elderly.

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The Sharing of Roles in Supporting the Elderly in
Hong Kong (II)

• Individuals are saving for their retirement with
  the introduction of the Mandatory Provident Fund
  in 2001 5 each of salary from both employee
  and employer.
• Fee-paying institutions and services for elderly
  people begin to appear as alternatives to public
  provisions.

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The Sharing of Roles in Supporting the Elderly
A Dynamic Process

• Family support is predicted to decrease from
  around 55 of total resources to 10
• Self support is predicted to increase from 22 to
  65
• Public support is predicted to increase from 23
  to 25

100
()
Family
50
Self
0
2005
2035
Public
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Conceptualizing a Holistic Care Model for the
Elderly

• Objective It is a care model aiming at helping
  the elderly requiring care in a comprehensive
  manner a combination of institutional and
  home-based care.
• Underlying Values A holistic care model
  considers all the care needs, physical, social
  and psychological, of the elderly in an attempt
  to improve their entire quality of life.

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Conceptualizing a Holistic Care Model for the
Elderly (II)

• Stakeholders The model recognizes that the
  meeting of the care needs of the elderly must be
  the result of the combined efforts of all
  parties, including the government, the community,
  the family, and the elderly themselves, with each
  supplementing and complementing one another.
• Delivery System The delivery system under the
  holistic care model is a seamless system crossing
  over both institutional and home-based services.

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A Holistic Care Model for the Elderly A Mix
of East West Ideals

• It is a model that takes into consideration all
  the research findings in the West regarding the
  needs of the elderly and finds ways to enhance
  their overall quality of life.
• It is a model that particularly suits the special
  circumstances of East Asian societies where the
  family and the community are still playing an
  important role in caring the elderly.

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A Holistic Care Model for the Elderly A Mix
of East West Ideals (II)

• It provides a chance for every party to play its
  role and represents the best way to deploy and
  utilize available resources, as well as not to
  over-burden any party.
• It concurs with values held dear in East Asian
  societies where elderly people feel most happy
  and dignified when they are treasured and loved
  by their families.

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• Conceptualizing the Holistic Care Model for the
  Elderly