Caregiver support · Guide to the Hong Kong systemCaregiver Resources
When looking after an older person, the hard part is often not the care itself, but working out the whole system: what to prepare before discharge, how residential care homes are graded, which allowances can be claimed, what the standardised assessment assesses, how to arrange an escort and how to use a respite place. This section is organised around the six checkpoints where caregivers actually get stuck. For each one it explains what it is, who is responsible and who to turn to next.
- Organised by six system checkpoints
- Dates and sources of information stated
- Everyday terms matched with official terms
Why this section exists
Long-term care in Hong Kong does not run through a single window. Hospitals, the Social Welfare Department, non-governmental organisations and the private market each carry a part. For a family that suddenly has to take on care, this means asking several different offices about the same matter, and each office answers only the part it is responsible for. The most common situation is that the family learns about the “standardised assessment” only a few days before the older person is discharged. By the time they understand that the assessment must come first before they can wait for a place, the older person has already gone home.
Another difficulty is the gap in the words used. Caregivers use everyday words among themselves, such as “old people’s home” and “helper”, while government documents and service directories use official terms. The same thing has two names, so it is hard to match them when searching online. This section therefore lists both the everyday and the official names, so that after asking other caregivers in a chat group, you can still look up the official information accurately.
Six main checkpoints
The six items below follow the order of the care journey, but in real life few people meet them one after another. In most cases several things arrive at the same time. Readers can start with whichever is most urgent.
Hospital dischargeFrom the moment the hospital sets the discharge date, there are usually only a few days. What needs handling includes the home environment, aids, medication, follow-up appointments and who will look after the older person at home. The special feature of this checkpoint is that the time pressure is greatest and the preparation time is shortest. See preparing an older person for discharge. Choosing a residential care homeFirst understand how homes are graded and what the fee structure is, and then judge which level matches the older person’s actual care needs. Subsidised places need the standardised assessment and a wait, while private places can be negotiated directly. Whether to stay at home or move into a home is often not only a question of ability, but also a question of family relationships. See choosing a residential care home. Allowances and subsidiesThe disability allowance, the old age living allowance, CSSA and the various service vouchers each have their own eligibility thresholds, application departments and means of checking, and they sometimes conflict with one another. Working out which category you belong to saves more time than applying for each one in turn. See allowances and subsidies for older people. Standardised assessment and waitingThe Standardised Care Need Assessment Mechanism for Elderly Services is the entry checkpoint for applying for subsidised long-term care services. The result decides which type of service the older person can wait for, and the older person’s condition usually keeps changing during the wait. How to get through this gap is the hardest part in practice. See standardised assessment and waiting lists for elderly services. Hiring help and escortsFrom hourly carers and live-in domestic helpers to escorts to appointments, the services differ in nature, fee model and suitable situations. Escorting looks simple, but it involves transport, wheelchair transfers and handing over information for the appointment, and the real requirements are higher than expected. See escort services and hiring care help. Day care centres and respiteThe main function of day care centres and respite services for older people, besides looking after the older person, is to give the caregiver room to rest. Places are limited and applications have preconditions, so it is usually better to plan early and not to look when it is urgent. See day care centres and respite. Three things caregivers most often misunderstand
Misunderstanding 1: queuing for a service only needs you to register yourself
- To apply for government-subsidised long-term care services, the older person must first take the standardised care need assessment, and is then placed on the matching service waiting list according to the result.
- Without this assessment, the older person has in effect never entered the queue. This is the most common misunderstanding among caregivers, and the one that wastes the most time.
Misunderstanding 2: once the older person is discharged, all the problems are solved
- The first one to two weeks after discharge are critical. This is when physical function is most likely to decline quickly, and when the risk of falling is highest.
- The hospital’s responsibility for care ends the moment the patient is discharged, but the care challenges facing the family only formally begin then.
Misunderstanding 3: the caregiver does not need to think about their own body and emotions
- A caregiver who lifts, transfers and bathes an older person over a long time can easily strain the back. Whether the caregiver’s body can keep going often decides whether the whole care arrangement can be kept up.
- Lack of sleep and emotional exhaustion also directly affect how long this model of care can last, and they are definitely not a minor issue.
Accuracy of information and updates
For anything involving amounts, asset limits and waiting times, each page in this section states the date and source of the information. These figures change with policy, so before submitting a formal application, always follow the latest announcements of the Social Welfare Department and the relevant departments. The structure of the system, such as the responsible departments, the procedures every application must go through and which services cannot be applied for together, changes less and can be used as a longer-term reference.
After reading this section, if you judge that what is needed is home rehabilitation or nursing services, see the corresponding service pages on this site. If you need to apply for a Social Welfare Department subsidised service, the next step is to contact the District Elderly Community Centre (DECC) in your area or the medical social worker at the hospital, and not to ask a private service provider.
What kind of problem do caregivers most often get stuck on?
What causes the most trouble is often not the treatment itself, but the system behind it. From an older person’s admission to discharge home, family members meet one question after another: the discharge timetable, the standardised assessment for elderly services, waiting for a place, applying for allowances, hiring help and respite places. Each has its own application route, responsible department and deadline, and they depend on one another. Many families hear these terms for the first time only a few days before discharge, and under that time pressure it is hard to sort them out one by one. This section takes them apart following these six checkpoints.
What is the difference between an “old people’s home”, a “residential care home”, a “care and attention home” and a “convalescent home”?
The first three belong to the Social Welfare Department’s classification of residential care homes for the elderly, which is graded by the residents’ care needs. The intensity of care and the fees differ greatly between levels, and the waiting situation for subsidised places and private places is also quite different. A “convalescent home” (療養院) is not in this classification, although Hong Kong does have convalescent services. They come under the Hospital Authority and not the Social Welfare Department. The Hospital Authority has a general convalescent service (一般療養服務) and a Central Waiting List for Convalescent Services (中央療養服務輪候冊), for people with chronic illness and severe disability who cannot get suitable care at home or in an ordinary residential care home, or who have a terminal illness and need continuing medical care. The application must be submitted through a referral office designated by the Social Welfare Department, and is then assessed by the Hospital Authority’s Community Geriatric Assessment Team. The two systems have different entrances, and mixing them up leads to approaching the wrong department. Note also that the “private homes” commonly mentioned among caregivers mostly mean private residential care homes, and not private hospitals.
What is the standardised assessment? Is it compulsory?
To apply for subsidised long-term care services (including subsidised places and some community care services), the older person must first go through the Standardised Care Need Assessment Mechanism for Elderly Services. A trained assessor uses a standard tool to assess the older person’s care needs, and the result decides which type of service the older person can wait for. The assessment is required to apply for subsidised services, and wholly private services have no such restriction. Many families wrongly think that “joining the queue” means registering with a department themselves. In fact the assessment must be completed first, and the older person is then placed on the waiting list that matches the result.
Is the caregiver’s own physical and mental condition something that needs attention?
Definitely, although caregivers often put their own needs last. Long-term caregivers commonly suffer from lack of sleep, back strain and emotional exhaustion, but because of the attitude that “it is the elder who is ill and not me”, they rarely ask for help until they are worn out. In practice this can be tackled from two sides. First, make good use of services such as day care centres or residential respite to make room to rest. Second, hand the tasks that easily strain the body, such as lifting, transfers and bathing, to trained staff, or learn the correct lifting techniques to lower the risk of injury.
Will the information in this section go out of date?
It will change, and the amounts of subsidies and the waiting times change most often. Allowance amounts, asset limits and the number of months on waiting lists all change with policy. Our pages note the date and source of the information, but before making an actual application, always follow the latest announcements of the Social Welfare Department and the relevant departments. The overall structure of the system (such as the responsible departments and the checkpoints that every application must pass) changes less, and can be used as a longer-term reference.
Disclaimer: This article is general health information and is not professional medical advice. If you have any health concerns, please consult a qualified healthcare professional.
