Day Care Centres and Respite for Older People
These two types of service have a fact that is not often said out loud: half of what they do is for the older person and half is for the carer. The older person gets a regular routine and social contact. The carer gets some hours each day, or some days each year, of room to rest. Both functions are formal ones, and there is no need to feel guilty about wanting a break. Whether a care arrangement can last often depends on that breathing space.
The difference between day care centres and respite services
Day care centre: sharing everyday care during the day
- This is a regular service. On the days the older person goes to the centre, the family can leave the older person in the centre's care in the morning and collect them to go home in the early evening.
- A day at the centre usually includes health monitoring, cognitive and physical activities, lunch and a nap, and group activities. Some centres also have nursing and rehabilitation staff.
- The service suits families where nobody is at home during the day and leaving the older person alone carries risk, and it also suits families who want to help the older person regain social contact and a regular life.
Respite service: coping with short-term, sudden care needs
- This is a short-term service. It comes as day respite (looked after during the day for a few days) and residential respite (a short stay in a residential home, from a few days to a few weeks).
- It is suitable when the carer needs surgery, is leaving Hong Kong, or has reached the limit of body and mind and must take a rest.
- Residential respite has an annual cap on the number of days, and once places are full there is a queue. If there is a chance it will be needed, apply in advance and do not wait until the need is urgent to start searching.
The starting point for applying for both types of service is mostly the same. A medical social worker or a District Elderly Community Centre makes a referral for the standardised care need assessment for elderly services. In other words, even if the service may not be needed right now, the assessment should be completed early, so that the family can join the queue straight away when respite is urgently needed. To find out how the assessment works, see the standardised assessment and waiting list for elderly care services.
Why services should be applied for in advance
The biggest structural problem with respite services is the time lag. The moments when the service is really needed (for example when the carer falls ill, is injured or breaks down emotionally) often come suddenly, but submitting an application and waiting for a place take time. If the application is made only when the crisis breaks out, the service is not yet in place and the whole family often cannot hold on. In the end the older person may have to be sent in a hurry to a private home, or left alone at home, which is an even worse situation.
The right way to use respite is therefore to treat it as insurance. Complete the assessment in advance, submit the application in advance, and find out in advance which service units in the district still have places, so that the carer's “shutting down”, which sooner or later happens, has a back-up plan that can be connected at any time. A carer's rest is not an extra reward. It is necessary maintenance, just as a machine that is never stopped for servicing will eventually break down completely at the worst time.
Three points to note when using the services
- Start with half a day—It is quite normal for the older person to resist going to the centre at first. In the first week or two a family member can go along for half a day, and choose a centre where there are familiar faces or people from the same hometown where possible. Once the older person has adjusted and settled, the time at the centre can be increased slowly. Pushing hard only makes the older person resist more and makes it harder to move forward.
- Use it together with a domestic helper or hourly carer—Use paid help only to cover the times the day centre cannot (early morning, early evening and holidays), which keeps the out-of-pocket cost lowest. For the options, see escort to appointments and hiring help.
- Treat it as a trial run—If the family is thinking about moving to a residential care home, day care centres and residential respite are in fact a low-cost trial run. How the older person responds in a group setting and how well they accept being cared for can be seen clearly here, which is better than deciding by imagining it. For the residential care step, see choosing a residential care home.
Among the six care gateways, day care and respite are often the last to be discovered, and many families struggle on to their limit before learning that these services exist. To follow the full picture of the other gateways, see the overview of carer resources.
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.