29 November 2008

Speech for Hong Kong Association of Gerontology- 16th Annual Congress of Gerontology

by

Dr. C.H. Leong

The whole world is facing the challenge of an ageing population. HK is no exception. Statistics showed that we are proud that our male has a life expectancy of over 78 years, our dear old ladies, over 84. Statistics also showed that today in HK one in eight of our population is 65 or above and by 2033 some 25 years from now, one in four will be those ages. Such demographic changes however have yet another dimension. While we are getter older, we remain more active, better health and perhaps adequate financial independency, at least in the days to come relative to those of today and yesterday. In short, care of the elderly in the future would have to take on a new culture and a new direction.

IThe theme of today’s congress is “Enhancing quality care and protection for elder people”. Allow me therefore to address you on this theme not as the chairperson of the Elderly Commission but rather as an elderly myself, how I hope that care for me in the future could be enhanced, how I would like to be protected, what the society and government has done for the elderlies so far, and, what are other areas that should and could be address?

As a still fairly active elderly like many of my peers, the first item on my wish list is to enhance my image in the eyes of the public in particular the younger generation, and how perhaps the society can assist me to be able to keep up with the society, to be able to be part of the community and perhaps serve the community. In short how can we promote “Active Ageing”

On a personal basis, I am somewhat upset by the general public’s image of elderlies. The common symbol of a senior citizen is a white hair, wrinkled face person partially bald, with a much bad holding a walking stick being assisted on crossing a road. I think I do not need that yet. Elderlies are thus portraited as weak, frail, perhaps a burden, which by today’s standard they are NOT. On this basis the Elderly Commission has pioneered an Elderly Academy Project.

This is a school-based learning allowing our seniors not only a chance to really learn but also a sense of going “back to school”. Participating primary and secondary schools will be contributing their premises after regular school hours and during weekends. The students of these schools will become “teachers” teaching elders enrolled either directly or through elderly institutions and non-governmental welfare organizations. The curriculae will consist of a mandatory session on health education and healthy living. Other subjects are discussed and agreed by the ‘students” the “teachers” together. It might be a surprise to note that working with computer, and personal health care are the most commonly chosen topics. This scheme thus has achieved a few objectives.

• Ensure that our elders remain active;

• Promote their social relationship by enlarging their social circle and thus enhance their confidence and image;

• Promote cross sectional cooperation between the education sector and welfare sector

; • Induce better understanding between the old and young – in short promote intergeneration harmony, leading to appreciation of core family values.

Starting off with 32 schools in 2007, we have now 78 schools. The tertiary institutes have also showed their enthusiasm. Some 7 out of 11 local universities are involved. They provide a wide spectra of programmes ranging from specifically organized interest class to elders, to proper sub degree courses; to formally allowing the elders to sit in at regular university degree sessions. As of today, there should be over 10,000 elders in the primary and secondary schools and about 1,000 who yearn to taste university life when they were young but were deprived are now enrolled as university students.

With support from both schools and NGO’s, we hope the number of Elder Academies in primary and secondary schools can break through the 100 benchmark next year.

I am aware that the concept of the university of the 3rd Age, which is essentially a peer learning group, has been well established in many parts of the world, in particular Australia. Ours is perhaps unique in that other than offering a university life for our elders, we have also instilled a real sense of cooperation between the generations, where elder students study side by side with the younger regulars. This would no doubt promote inter-generation understanding and harmony in the long run. U3A has done a great job. I would love to see U3A joined hands with Elder Academies to make “learning” take place in a real “school”.successful ageing should includes:

•

As I age more and I will, yet by that time, I would still prefer to age in this same community that I am used to, more to be able to age at home with my family. Nothing is more effective than peer inducement and peer support in this aspect. This applies particularly to the elderlies. It is on these understanding that the Elderly Commission has started pilot projects in all the districts in Hong Kong – Pilot Neighborhood Active Ageing Project. Using the neighborhood as platforms, nongovernmental organizations enter into partnership with different sectors to train up volunteers to organize activities regularly for the elderly and to pay visits to singletons elders to strengthen neighborhood support and a sense of belonging in a neighborhood setting. Today we have 19 such neighbourhood projects across the territory reaching out to every sector of the community, including private and public estates, old tenement buildings and rural areas. We have witness examples of formerly “hidden elderlies” opening up to neighbors, joining peer groups and even taking a lead to induce others to participate. The project is extended to a “Caring for Elders” concept aiming to promote care for elders and abuse prevention through neighbor support net works. Elderly abuse, of which we have no exact figures, are by no means rare, this project will tackle elder abuse through a three prong approach, namely education (through the Elder Academy Network) prevent and support (through setting up elder caring group). 18 neighbourhood projects should be up and running later this month, answering to the call of protecting the elderlies. All in all, the elders play the active role answering to the concept of “empowering” them to contribute to the society and do not “ignore” them.

For those in the audience, who belong to a more mature age, the project might bring back the nostalgia of “under the lion rock” culture where filial piety reigns supreme; where respect of the elders is a convention; where neighborhood harmony, and friendship is the norm. As a elder myself, let me say this to you, it was this culture and spirit that bound Hong Kong together to emerge a winner from the doldrums of the 50’s and the 60’s to become what we are today.

One of the problems of ageing at home would be the need for carers. The Elderly Commission is cognizant of this requirement and we are moving towards proper and formalize training for elderly carers, inducing people to realize that carers are a needed and honourable profession. We are also looking at possible ways and means of funding carers for those elders who have financial needs and wish to stay at home.

.

The time will come however some including myself that might need to be institutionalize either because of physical and mental needs. In HK there are over 700 elderly homes catering for elders with different needs. Some of them are heavily government subvented, some are run by non-government welfare organizations and many are private enterprise. Their standards and government subsidized funding varies.

The Elderly Commission has on this aspect commence a consultation study to advise on the way ahead to more prudent distribution of government funding to ensure that standard of care will be upgraded and subsidy should be spent on those who need it most. We expect the study to be completed in 2009.

No enhance care and protection of the elderly is complete without considering the provision of health care.

Elders should not only be taught that keeping healthy is their personal responsibility, they must also be provided with proper to effective medical care when they get sick. At the risk of being accused of “blowing our own trumpet” I have to proudly boast that Hong Kong has perhaps one of the best public provided health care system where “nobody will be denied of care because of lack of means”. For a mere HK$100.00 a day you are offered the state of the art investigations and cutting edge treatment. Furthermore over 60% are either totally or partially exempted from payment mostly amongst the elderlies. The confidence the elderly have on the Hong Kong public health care system makes it an impediment for those who consider venturing to spend their “golden age” north in the Mainland. Some who did are making a return.

But such social services are expensive and a strain on this public purse. As the society ages, such health care cost will increase exponentially. Elderlies have a much higher incidence of chronic illness and when they do it is invariably multipathology. Most illnesses tend to concertina in the last two years of ones life.

Figures and statistics in Hong Kong has shown that public health expenditure will increase by 3.9 times between 2004 and 2033, when GDP will only grow by 1.7 times during the same period. As a result, public health expenditure as a share of GDP will increase from 2.9% in 2004 to 5.5% in 2033. Assuming that total public expenditure will be kept below 20% of GDP, the share of public health expenditure as a share of total public expenditure will increase from 14.7% in 2004 to 27.3% in 2033. Yet such social service a vital and, Hong Kong cannot do without.

I start my address stressing “ acting ageing”, highlighting the health, the physical and mental fitness of our new generation, and cohort of elderlies, stressing how most want to learn, yearn to be part of the community and happy to serve the society. Perhaps one of the limiting factors of today is the age of retirement; though non-legally binding is peg somewhat at 60 years. Is it time then that this affluent forward-looking society of our should consider reviewing the so call retirement age. Should our business sector, our major NGO and our government not take a leader in retaining experience rather than dispose of their talent because age is a number. I am acutely aware that this is a sensitive issue but it is high time that it should be properly debated in the public domains as a factor for future sustainability.

Enhancing quality care and protection for elderly people is much more than giving, dispensing and offering to our senior. It would be more effective if we engage, empower them, and let them participate.