22 Sep 2006, 9:30 a.m.

Symposium on Quality Residential Care in Hong Kong –
Benefits of Comprehensive Assessment
22 September 2006, 9:30 a.m.
Jockey Club Auditorium, The Hong Kong Polytechnic University

Opening Address by Dr the Hon LEONG Che-hung, GBS, JP
Chairman of the Elderly Commission

The Reverend Lau, Prof Fries, Prof Chi, and colleagues from various sectors serving the elderly,

Good morning and welcome to the Symposium on Quality Residential Care in Hong Kong. It is my pleasure and honour to be here to open this symposium. Sheng Kung Hui Welfare Council is one of the major NGOs in Hong Kong committing to the promotion of the holistic well-being of elders in needs. In the past few years, it has proactively introduced a number of initiatives to continuously improve the quality of long term care services provided to frail elders under its care. The adoption of the Residential Assessment Instrument, or RAI 2.0 as it is known, is one of these notable innovative moves. This symposium is therefore a very valuable opportunity for the welfare sector, together with professionals, clinicians and academics, to share the successful experience of Sheng Kung Kui. In particular, we have with us today two distinguished guest speakers, Prof Fries and Prof Chi, both are world renowned leading authority on standardized assessment and individualized care planning. I am looking forward to learning more from their expertise this morning.

As we all know, population ageing is a challenge faced by all modern societies. I emphasize that it is a challenge, not a social problem. Colleagues here would agree that most of the older people are healthy and active and are able to enjoy their lives enormously. In fact, we expect that the next cohort of elders and retirees will be much more financially secure, more educated and healthier than the current generation of our parents. They will cherish very much their independence and dignity even if and when they turn frail and begin to require some assistance in managing their daily living activities. Fully acknowledging this trend, the Elderly Commission has come to the consensus that promotion of “ageing in the community” should be our first working priority. We should where possible support and facilitate elders to age in an environment they are familiar with for as long as possible. In fact, both the Government and the NGOs are doing a lot to assist these elders and their carers in this regard. But more has to be done in realizing “ageing in the community” as a genuine and viable option for elders and their families. Elders should be given sufficient information about what resources and services are available to them in the community. And these resources and services should reach the elders in need at the right time, in the right place, such that the elders and their families will be given a sense of security, knowing that with the suitable support and assistance, elders can continue to live in the community and maintain a certain degree of independence and self-reliance.

The major direction the Elderly Commission in the coming year will be working very closely with the Government and all parties concerned to make “ageing in the community” not just a vision but also a reality. Through various media, we will widely disseminate the information about the community care and support services available such that elders and their families can make informed choices when they make long term care plans. Recognizing the significant contribution of informal carers in realizing ageing in the community, we will also consider feasible initiatives to better support informal carers and enhance their care skills and know-how, and to relieve and reduce their stress where possible. Above all, I personally believe that the society as a whole should understand in greater depth the real life problems encountered by elders living in the community and their families, and how they sometimes manage to overcome these difficulties, and sometimes not. Only then will we be more sympathetic and supportive to them and begin to address their genuine needs.

Despite elders’ preference to age in the community, some of them may eventually develop long term care needs and cannot be adequately taken care of at home. Institutionalization may still be necessary at some point for some elders. But it should only be considered as a last resort. And care needs assessment is particularly important in the allocation and provision of residential care services to elders.

Since 2000, we have implemented by phases the Standardized Care Need Assessment Mechanism for Elderly Services using the locally customized, Chinese version of Minimum Data Set-Home Care, a.k.a. MDS-HC 2.0. MDS-HC is a tool internationally recognized and is well received and respected by the welfare sector here. Its application in Hong Kong has become a founding stone of our long term care system in ensuring that frail elders are matched with services according to their care needs.

Like MSD-HC, RAI belongs to the same family of assessment tools of InterRAI founded by Prof Fries. The introduction of RAI by Sheng Kung Hui in its residential care homes is instrumental in facilitating “continuum of care”, which is another guiding principle of the Government’s elderly policy. The idea is that in providing care services to elders in a residential setting, it is essential to meet the changing needs of elders, thereby minimizing the need for transfer of elders from one service provider to another as they age and become more frail. As a major step in achieving this goal, the Government has already undertaken to upgrade some 7,000 existing subsidized residential care places which do not have long term care elements to the higher level care and attention places with continuum of care. I am happy to learn that the conversion exercise has been well under way.

On the operational level, I suppose individualized care planning would be indispensable in realizing continuum of care. And comprehensive and continuous assessment would be required for integrated care management. With RAI, comprehensive assessments of residents on a continuous basis are made possible, thereby closely monitoring the conditions of the elders and hence their specific care needs. The benefits of comprehensive and continuous assessments are multi-fold. By monitoring closely elders’ health condition, their specific needs can be better attended to. Not only can this ensure better care for the elders, it also helps prevent avoidable health