In lieu of an abstract, here is a brief excerpt of the content:

2฀ Long-term Care in Hong Kong: The Myth of Social Support and Integration Raymond Ngan and Edward Leung D Introduction: Rationalization of Community Care into Long-term Care as the Policy Objective Community care has been the major policy objective in developing services for the elderly in Hong Kong since its adoption in 197 7 (Hong Kong governmen t 1977). Not only has the notion of family care been commonly practised amon g the elderly Chinese , but it has also been accepted within th e community a s a family's responsibility to do so (Hong Kong government 1990) . As community care seems to have been accepted as a culture-relevant policy for the aged, since it fits the concept of filial piety and family duty, the Working Group on Care of the Elderly recommended i n 199 4 that a policy of long-term care become key to the existing philosophy of providing services for elderly people in Hong Kong (Hong Kong government 1994) . This policy of long-term care goes beyond th e conventional community-car e approac h with the following new initiatives: 1. appropriat e suppor t shoul d b e provide d fo r olde r person s an d thei r families t o allo w elderl y peopl e t o gro w ol d i n thei r hom e environmen t with minima l disruption . Th e concep t o f 'agein g i n place' , otherwis e known a s car e i n th e community , ha s serve d u s wel l i n th e pas t (a s described i n Hong Kon g government 1994 , p. viii); 2. a continuum of residential care and integration of services for those elderly whose familie s ar e not abl e to tak e car e of them ; 18฀RAYMOND ฀NGAN฀AND฀EDWARD฀LEUNG฀ 3. people-base d approach and partnership among the public, subvented an d private sectors; in Hong Kon g government 1994 , it was emphasized tha t the contribution o f the subvented and private sectors must be encourage d and recognized. It seems that the Hong Kong government is following th e developing tren d toward s 'th e mixe d econom y o f car e provide d b y th e public, subvented an d private sectors' along that of the United Kingdom . It seems clear that in Hong Kong , the hitherto polic y of community car e which ha s bee n accepte d a s th e conventiona l wisdo m approac h t o promot e family car e o f th e elderly , i s no w bein g furthe r rationalize d int o a policy o f long-term car e t o cate r fo r differen t carin g need s o f th e elderl y Chinese . However, thi s chapte r argue s tha t th e policy o f long-term car e is still largel y a practising myth i n Hong Kon g as empirical experience s hav e shown that : 1. home-base d support measures and programmes for family care-givers have not develope d far , i t being acknowledged onl y comparatively recentl y i n Hong Kon g government 1994 ; 2. a t present, th e continuu m o f residentia l car e an d integratio n o f service s are stil l largel y fragmentar y an d piecemea l i n nature ; ther e exist s a 'no care ' zon e (Este s an d Swa n 1993 ) fo r thos e acute-illnes s patient s wh o are discharged earl y from hospital s — family care-giver s usually lack th e basic nursin g car e technique s t o handle thei r chroni c bu t acut e medica l conditions, such as in the care of stroke patients. In the United Kingdom , stroke patient s ca n normall y sta y a relativel y longe r tim e i n hospital s than in Hong Kong. As hospital beds in Hong Kong are in tighter demand , patients ar e usuall y discharge d earl y onc e thei r healt h condition s hav e only stabilized . Whe n famil y care-giver s canno t cop e wit h thei r deteriorating conditions , suc h a s a secon d o r thir...

Share