Following is a question by the Hon Pan Pey-chyou and a written reply by the Secretary for Labour and Welfare, Mr Matthew Cheung Kin-chung, in the Legislative Council today (May 19):

Question:

I have received complaints from quite a number of elderly groups and family members of elderly people that fundings currently provided by the Government for care services for elderly people suffering from dementia and support for these elderly people are far from adequate.  In this connection, will the Government inform this Council, with respect to each year from 2004 to 2008:

(a) of the number of elderly people suffering from dementia in Hong Kong; whether it knows among them, the number of attendances at hospitals or clinics under the Hospital Authority and the Department of Health, as well as the number of elderly people who were waiting for places in subvented care and attention homes or infirmaries through the Standardised Care Need Assessment Mechanism for Elderly Services of the Social Welfare Department (set out in the table below);

                                           
(b) whether it knows the respective numbers of elderly people suffering from dementia who are residing in various residential care homes for the elderly, receiving home care services in day care centres and receiving home-based community care services (set out in the table below); and

(c) of the amount of designated funding provided by the Government for care services for elderly people suffering from dementia, as well as the number of beneficiary organisations of such services, whether it knows the average enrolment rate, average waiting time and number of beneficiaries (set out in the table below)?

Reply:

President,

Like other developed economies, Hong Kong is facing the challenges of an ageing population.  Hence, the Government has been allocating additional resources in recent years to enhance the care services for elders, including the support for demented elders and their carers.

My reply to Dr Hon Pan Pey-chyou's questions is as follows:

(a) According to the study conducted jointly by the Department of Health (DH) and the Department of Psychiatry of the Chinese University of Hong Kong in 2006, around 9.3% of elders aged 70 or above living in the community suffered from dementia.  Based on the elderly population (aged 70 or above) of about 678,000 in mid-2009, it is estimated that there are some 63,000 demented elders living in the community at present.

The Elderly Health Centres (EHCs) of DH provide clinic service of health assessment, counselling, curative treatment and health education, etc. to enrolled elderly members, including those suffering from dementia.  The number of demented elders served by EHCs from 2004 to 2008 is as follows:

         
As regards the Hospital Authority (HA), as elders may have more than one disease at a time (e.g. elders with chronic diseases may also be diagnosed with dementia), HA would arrange for doctors of different specialties to follow up their cases, having regard to the eldersˇ¦ different clinical needs and conditions, so as to provide them with appropriate care.  In individual circumstances, patients with dementia may be provided with services by more than one specialty, including internal medicine, geriatrics and psychiatric departments.  The number of dementia patients referred to the psychiatric department for follow-up is as follows:

Note: the above figures do not include demented elders followed up by other specialties.

The Standardised Care Need Assessment Mechanism for Elderly Services (SCNAM) of the Social Welfare Department (SWD) adopts an internationally recognised assessment tool to assess eldersˇ¦ abilities in looking after themselves, their physical functioning, memory, communication skills, behaviour and emotion, health conditions, living environment and abilities in coping with their daily activities, etc., in order to recommend and match appropriate care services for elders in need.  Since the assessment is not designed for the purpose of medical treatment, its focus is on elders' capability in respect of the above-mentioned areas, and not on ascertaining whether they are suffering from any particular disease.  SWD has no separate record of the number of demented elders being matched with services through SCNAM.

(b) At present, there is no requirement for elders receiving various kinds of elderly care services to go through an assessment on dementia.  Hence, we do not have precise information on the number of demented elders using our services.

Nevertheless, SWD has been providing a "dementia supplement" (DS) to all subvented residential care homes for the elderly (RCHEs) in the territory since the 1998-99 financial year, enabling RCHEs to employ additional professional staff to provide care services and arrange training activities for demented elders.  The allocation of DS has been further extended to cover all private RCHEs participating in the Enhanced Bought Place Scheme (EBPS) since 2009-10.  RCHEs applying for DS have to report to SWD the number of residing elders suffering from dementia (i.e. the number of elders confirmed to be suffering from dementia by the psychogeriatric team of HA).  Based on the information collected from this channel, the number of demented elders residing in the RCHEs receiving DS from 2004-05 to 2009-10 is as follows ˇV

Since the DS arrangement is not applicable to subsidised day care services, home care services or private RCHEs not participating in EBPS, SWD does not have the relevant figures in respect of these services.

(c) Regarding elderly care services, as mentioned above, all subvented RCHEs and private RCHEs participating in EBPS have been receiving DS.  The DS allocation from 2004-2005 to 2009-10, the number of beneficiary organisations and beneficiaries are as follows:

In addition, the Government allocated an extra $17.12 million to 188 subsidised RCHEs and day care centres in 2008-09 so that they could improve their facilities (such as installing anti-wandering systems and multi-sensory facilities, etc.) for serving demented elders.

Like other elders, demented elders are provided with appropriate care services according to the results of SCNAM.  We have not compiled separate statistics on their service enrolment rate and average waiting time.

Apart from the above, the psychiatric department and memory clinics of the internal medicine specialty of HA provide assessment, treatment and rehabilitation services to patients with dementia.  HAˇ¦s various community outreach services for elderly patients, such as psychogeriatric outreach services, community geriatric assessment team outreach services and community nursing services, also serve patients with dementia.

Besides, the Elderly Health Service (EHS) under DH actively promotes elderly health and carer skills.  Dementia is part of it.  Since these health promotion activities and the clinic services as mentioned in part (a) of the reply constitute only part of the overall work under EHS, we are not able to provide a breakdown on the funding designated for dementia services.  Health promotion on dementia covers all elders and their carers in Hong Kong, and the clinic services are part of the services provided by EHCs.  There is no additional waiting time for demented EHC members.  Please see part (a) of the reply for the number of beneficiaries.