Replies to LegCo questions
LCQ16: Medical and elderly services for frail elderly
Following is a question by the Hon Tam yiu-chung and a written reply by the Secretary for Health, Welfare and Food, Dr Yeoh Eng-kiong, in the Legislative Council today (February 12):
Question :
Regarding the provision of medical and elderly services to the frail elderly, will the Government inform this Council whether it has plans to:
(a) develop a care system based on the case management model so that the frail elderly can receive one-stop and continuous medical and elderly services,
(b) set up a central database on the medical and elderly services that have been used by each frail elderly, saving the need to conduct case review by the service institutions concerned, and
(c) enhance the training of frontline staff to promote their understanding about other professions and strengthen the co-ordination of various professional services, thereby improving the long-term care services continuously provided to the frail elderly; if it has such plans, of the details; if not, the reasons for that?
Reply :
It is the Government's aim to develop a quality and sustainable long term care (LTC) system, to provide a range of medical, nursing and personal care and supporting services to frail elders who require assistance in the provision of such services.
(a) We have taken active steps to provide tailor-made services to frail elders based on individual care needs in a holistic manner. These include the use of an internationally recognised tool to assess the care needs of elders applying for subsidised LTC services since November 2000. The tool takes into account the impairment level, carer and psychosocial support, and environmental and health factors of elders in determining their care needs. It has helped to make more precise matching of services to care needs in both the community and residential settings. The assessment results also provide the basis for individual care planning for elders receiving the services. In parallel, we have introduced the concept of Individual Care Plan (ICP) into our community and residential services. Under the ICP concept, operators are required to develop and document holistic and individualised care plans using a multi-disciplinary approach and within a defined period upon users' admission to services. The operators are also required to conduct review at regular intervals and at least once annually to adapt the ICPs in response to service users' changing care needs.
To facilitate the provision of a continuum of services in one care service/facility to meet the varied care needs of elders as their health conditions change, we will continue to build on established strategies to facilitate service integration, cross sector collaboration and service accessibility. Since April 2001, we have introduced a package of enhanced home and community care services providing home and centre based services to suit the varied needs of frail elders. Under a recent major exercise to re-engineer elderly community services, all existing Multi-service Centres for the Elderly and over 100 Social Centres for the Elderly will be upgraded into District Elderly Community Centres and Neighbourhood Elderly Centres respectively within 2003-04, providing holistic care and support to elders living in the community. At the same time, we will upgrade 138 existing Home Help Teams into Integrated Home Care Services Teams to provide a continuum of care to enable frail elders to age at home. We will also provide additional resources to provide in-situ expansion in Day Care Centers for the Elderly to meet the care needs of frail elders in an integrated manner, including those with dementia. In parallel, we will continue to pursue the concept of continuum of care in Government supplied residential care home premises put out for open tender. For example, for the three contract residential care homes which we invited tenders in July 2002 providing a total of over 280 subsidised places, about half of these places are designated for elders of nursing home frailty.
(b) We are aiming to establish a single entry point for all subsidised community and residential care services for elders. The concept is to no longer require elders to queue up for different services. Instead, there will be a central waiting list for all subsidised LTC services, and services for elders will be matched in accordance with their care needs as assessed by the standardised tool. The Social Welfare Department (SWD) is in the process of upgrading its computer system to facilitate implementation of the central waiting list. We aim to put the new system in place in the latter half of 2003.
In parallel, SWD is at an early stage of implementing Phase II of its Information Systems Strategy, which includes a Client Information System (CIS). The CIS is a case management system, which contains database on the welfare services used by all service users (including elders), their background and their needs. The CIS will be designed to comply with the interoperability framework of the Information Technology Services Department. This will facilitate future information exchange between the databases of SWD, Hospital Authority (HA) and other non-governmental organisations (NGOs).
(c) We place strong emphasis on manpower training and upgrading of the care capability of elderly service units to take care of frail elders. We are doing so by strengthening the multi-disciplinary approach in service delivery, and through equipping the professional and non-professional staff with the requisite skills and knowledge through training. We have taken steps to improve the training programmes with the dual aim of increasing staff competency and enhancing cross sector cooperation. To quote a few examples, from 2002-2003 to 2005-2006, we will provide a total of 1760 multi-skilled training places for care workers, and a total of 760 and 680 training places on care for elders with dementia respectively for care workers/home helpers and professional staff including social workers and allied health staff.
At the same time, the Department of Health (DH) is working closely with SWD to enhance training for frontline staff and to promote multi-disciplinary sharing of experience and inter-sectoral collaboration in health promotion for elders. For example, DH has recently developed a mechanism for sharing of information with SWD and its Elderly Health Services have strengthened their outreach skills training programmes for formal carers working in residential care homes to better meet the specific needs of different care homes. The Community Geriatric Assessment Teams and Psychogeriatric Teams under HA also provide training on practical skills for carers taking care of frail elders at residential care homes. DH, with the support of HA and SWD, has recently conducted a review on training for formal and informal carers with the aim of maximising the use of training resources and efforts.
End/Wednesday, February 12, 2003
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