Hong Kong continues to struggle with solutions to the aging crisis. But many experts say evenwith those efforts, elderly people are certain to suffer. Andrea Deng reports.

In North Point, a prime Hong Kong residential area, stands a brand new, premium housingdevelopment, combining residences with top-notch amenities. There's a gym, a swimming pool,a theater, all sorts of function and business meeting rooms, and naturally, mahjong rooms tosuit the Chinese culture.

Its target customers are elderly people over 65.

The Tanner Hill compound opened earlier this year under the Hong Kong Housing Society, astatutory body charged with finding housing solutions for different groups within the broadercommunity.

This project was meant to meet the ideal for "aging in place", which means, elderly living inprivate homes, rather than in the city's overburdened eldercare institutions.

Beneath its grandiose facade and brand-new interior are designs to suit the needs of elderlyresidents. Corridors have handrails. Elevators have chairs and floor space enough that theycan easily accommodate wheelchairs. There are emergency bells in bathrooms and bedroomsso tenants in distress may call a nurse.

The compound also provides standard facilities one expects in eldercare institutions. Thatincludes an eldercare home. There are clinics, offering both Western and Traditional ChineseMedicine, a rehabilitation center and an elderly daycare center, all in one same building. Withthe residential care facility, those who become too enfeebled to take care of themselves maymove into the home and still be close to familiar settings.

A project like Tanner Hill is idealfor elderly people who want to ageat home. Still, it's for the wealthy.The cost of a short lease starts atHK$11,800($1,521) a month. Allshort lease options are taken now.Long lease options are available,starting at a lump sum of HK$1.5million to provide lifetimeaccommodation for the tenant.

Aging-friendly housing
In recent years, talk of "aging inplace" has grown louder in HongKong. The availability of public,residential care homes is seriouslyshort of demand. Also, thereputation of private residentialcare homes has been tarnished byscandals and poor service. Therehave been shocking reports of caregivers abusing elderly residents. Last year, a privateresidential care home was caught as elderly residents had to queue up and stand naked in anopen-air podium, waiting to take showers.
It takes on average of 25 months to get into government's residential care homes, according tothe Social Welfare Department. Statistics show that every year, between 5,000 and 6,000elderly people on the waiting list die before ever getting into the homes. The waiting list keepsgrowing.

Nevertheless, the rate of institutionalization in Hong Kong is remarkably high at 6.8 percent.The international average is 3 to 4 percent, according to Law Chi-kwong, associate professorof the Department of Social Work and Social Administration at the University of Hong Kong.

Noting a public residential care home usually takes about 11 years to build, Law added that theshortage of facilities is not even the most acute problem.

The biggest challenge, Law said, is manpower. In the care industry, over half of frontlineworkers are over 50. In 10 or more years, those workers will retire, and few young people arebeing recruited. By 2019 Hong Kong expects a contraction of the labor force, owing to theaging population. By 2041, one person in three will be over 65 in Hong Kong.

"All these coming together actually makes it very challenging to meet the future needs ofmanpower. The consequence is basically, those who are in need will suffer. I don't think thegovernment has that sense of crisis," said Law.
"Aging in place" has become a chosen remedy of the government in response to theinsufficient numbers of care homes. "'Aging in place' as the core, institutional care as 'back-up'is the government's primary policy," the Secretary for Transport and Housing Anthony CheungBing-leung wrote, responding to a Legislative Council query.
Currently, the government's principal strategy for "aging in place" has been to design newpublic housing estates and renovate older ones, so that residential units are more wheelchair-friendly. Social workers, such as Ng Wai-tung from the Society for Community Organization,however, criticize the government over the limited services actually reaching elderly people.

Alone and miserable
Wong Chor-pat is a retired driver living alone in Fu Cheong Estate, Sham Shui Po. He drovetrucks, tourist buses and public minivans. His retirement savings amounted to a sliver of thereal costs he faces. What little he had was seriously pared by accumulating medical bills fromhis chronic illnesses.

Wong had a stroke a few years ago. Sometimes he can't walk. He has heart disease, diabetesand high blood pressure. Sometimes he gets dizzy and his eyesight is deteriorating.

"Someone asked me the other day if I'd like to drive a minibus. I said no. I don't dare. I'vefainted twice. It doesn't matter if anything happens to me, but I can't endanger others. I have noidea when I'll lose consciousness," said Wong.
As Ng set foot in Wong's single-living, public housing unit, Wong burst into tears, recounting hisrapidly worsening health, with no one to take care of him.

Wong's wife left him a few years ago. Now, he has only his sister who calls sometimes.Otherwise he talks to telephone operators who take his emergency calls when he needs help,or social workers who visit from time to time.

"On the coldest day last week, I couldn't move my leg," Wong told Ng. "I had to ring the(emergency) bell. An ambulance came. I was in hospital for three days."

Wong survives on the HK$3,100 from the government's Comprehensive Social SecurityAssistance Scheme every month. There are many old people like Wong, living alone, lackingcare, and suffering from chronic illnesses.

"There are approximately 70,000 elderly in the community with dementia and needing somelevel of care. Many others have had strokes or other chronic illnesses and are virtuallybedridden.

"Those who can afford it hire helpers. Those who can't have to resort to institutions," said Ng.That brings us back to the problem of long queues for public facilities, and the poor quality ofservice or the alternative of exorbitant pricing in the private ones.

Tech support
Nursing homes are inevitable, said Law from the University of Hong Kong, adding that effortsshould be made to reduce the need for elderly people to seek help from institutionalizedfacilities.

"The way to do it is through what we call 'health management', such as early identification (ofillnesses), to reduce rapid deterioration and the onset of frailty. When elderly people start todevelop early stage illnesses, health management or monitoring can prevent furtherdeterioration. That has to come from technology," Law told China Daily.
Apart from being wheelchair-friendly, Tanner Hill has state-of-the-art, experimental technologyto safeguard the health of elderly residents.

There's self-service equipment tenants can use to measure blood pressure, pulse rate andbody temperature. Readings can be transmitted through Wi-Fi to a centralized monitoringcounter managed by the property. In cases of abnormality, tenants or family members will benotified. It's up to the tenants whether they want to share their personal health data.
Self-service equipment could benefit people living in their own homes. In Hong Kong, marketdevelopment of eldercare products and technology has taken off only in recent years, and it willtake a few more years to bring prices down, Law said.

The social enterprise Longevity Design House, offers alternative solutions to help elderlypeople stay home. The company retrofits houses so as to lower risks of injury to elderly people.

Designs include concealed doors to hide kitchens and exits to keep dementia sufferers fromencountering sharp implements or from wandering away. Toilets can be renovated to makethings easier for wheelchair bound residents.
Ray Tang, an interior designer and co-founder of Longevity Design House, said the companycan convert a bedroom into an intensive care unit. That was done for an elderly resident whoneeded breathing devices and other machines to monitor blood pressure and heart rate after aserious stroke. The company retrofitted the room and installed tracks for a patient hoist, so thatfamily members could help the person move between the bedroom and the toilet.

The service is aimed primarily at the middle class, including people who own a public housingunit but have no retirement savings. The company broke even on its books three months afterthe start up late last year.

"We have about 50 or 60 enquiries each month. This is a huge number for (regular) interiordesign firms. Usually they have 10 (enquiries) each month. In our projections, we will havearound 500 to 600 percent of growth per month in the next five years, because more and morepeople are aware that elderly people should live at home rather than in eldercare centers orhospitals," said Tang.

Tang admitted there's not much his company can do for the poorest elderly people. Aconcealed door costs HK$8,000 to HK$10,000. Renovating a bathroom costs aboutHK$60,000. Even with the government's building's maintenance grant of HK$40,000 for elderlyowners, a renovation on that scale may be beyond the means of many middle class people.The company plans to raise funding in January, to provide some service to the city's destitute.

For social worker Ng, the least the government should do is to increase community healthservices for elderly people.
"Hong Kong has a student health service, but there's no such universal program for the elderly.Among 1.17 million elders in the city, only 40,000 have access to an annual medicalexamination from the government's elderly health centers. This is what the government shouldimprove," said Ng.