Date: 24/07/2024
A survey revealed that most ethnic minority elders and carers have never used mainstream elderly centre services, with over half of carers lacking confidence in these services. According to the population census, the number of ethnic minorities aged 65 or above in Hong Kong increased by 160% from 9,910 in 2011 to 25,792 in 2021. Their needs cannot be ignored, but current mainstream services need improvement. Hong Kong Christian Service (HKCS) conducted a 'Survey on Use of Mainstream Services by Ethnic Minority (EM) Elders' from November last year to April this year, interviewing 200 South and Southeast Asian elders aged 60 or above and 50 carers. The results showed that language barriers, cultural differences, and a lack of suitable service referral channels undermine the confidence of ethnic minority elders when accessing these services.
Lack of Confidence in Mainstream Services, Language as the Main Barrier
With 10 being the highest confidence level, 54.1% of ethnic minority carers gave only 1 to 5 points to mainstream services, showing an apparent lack of confidence. Meanwhile, 87.6% of ethnic minority elders and carers have never used mainstream elderly centre services, with only 10.0% having successfully received services. Among those who have used mainstream services, 29% indicated that the language barrier was one of the problematic experiences when seeking help.
High Dependency of Elders, Need for Long-term Care Services
With limited use of mainstream services, 50.0% of the ethnic minority carers reported that the elders' dependency on them was 8 to 10 points (10 being the highest). 16.1% and 14.9% spend over six hours caring for elders on weekdays and weekends/holidays respectively. Their top three service needs are 'escort services', 'elderly sitting', and 'household cleaning service'.
Viola Tsang, Service Head, Active Ageing & Community Care Service, HKCS, stated, 'Nearly 90% of the surveyed elderly have not used elderly centre services. Consequently, they have not undergone the "Standardised Care Need Assessment Mechanism for Elderly Services" conducted by qualified staff at these mainstream service units to apply for various long-term care services. Even when ethnic minority elders attempt to apply, the relevant assessment tools are only available in Chinese. This poses significant challenges for staff and elders during the assessment process. As a result, ethnic minority elders and their carers are excluded from the mainstream service, leading to a lower usage rate of mainstream services compared to the local.'
High Demand for Bridging Services, Limited Resources
HKCS launched the 'Support to Ethnic Elderly Project' in 2016, funded by the Community Chest. Through outreach, social and recreational activities, and mutual support services, the project helps ethnic minority elders integrate into society. It also assists elders in applying for or connecting to mainstream services, mainly involving Senior Citizen Card, medical appointment and interpretation services, and joining elderly centres. In 2019, the project expanded to include carers, enhancing their caregiving abilities and increasing their awareness of community support services for the elderly. To date, the project has served nearly 1,000 people. The survey showed that 77.5% of ethnic minority elders and 82.0% of carers find the project helpful in integrating them into mainstream society.
Peggy Lau, Project Leader, 'Support to Ethnic Elderly Project', HKCS, said, 'Due to differences in language, religion, and ethnic culture, special arrangements are needed for ethnic minority elders and carers in terms of service understanding, dietary requirements, and interaction between male and female service users. Frontline staff in mainstream services may not have sufficient resources and knowledge to address these needs, making bridging services crucial.' The project currently covers Shamshuipo, Yau Tsim Mong, and Kowloon City districts, with hopes to expand to the whole of Hong Kong in the future.
Carer Forgot Medical Appointments Under Stress, Elder Only Speaking Nepali Struggles to Seek Help
Nanda is a Nepalese housewife caring for her two children and her in-laws, aged 80 and 75. Her father-in-law and mother-in-law require regular medical check-ups due to chronic illnesses. She said, 'Whenever I accompany them to their appointments, I have to ask friends to take my children to school and look after them. Sometimes, I even need to pay extra for after-school care for my 6-year-old daughter. All this adds to my burden.' 33-year-old Nanda has almost no personal time to develop her interests compared to her peers due to her caregiving responsibilities. After joining the 'Support to Ethnic Elderly Project', Nanda met other carers, shared her feelings, learned communication skills with the elderly, and gained information about social services. These experiences have helped alleviate her caregiving stress.
Another Nepalese woman, Devi, cares for her 79-year-old mother, Thapa, while also looking after her two children. About five years ago, Thapa became immobile due to illness and needed someone to accompany her to medical appointments. At that time, they didn't know about any support services and couldn't even borrow a wheelchair, feeling very helpless. Fortunately, the 'Support to Ethnic Elderly Project' referred them to a nearby elderly centre where they not only borrowed a wheelchair but also applied for home-based occupational therapy services for Thapa. With Devi's interpretation, Thapa could successfully use the occupational therapy services. Thapa said, 'My daughter and I are delighted to learn about various support services for the elderly and carers, but we still face cultural and language barriers when using these services. For example, the staff providing escort services only speak Cantonese and English, while I only speak Nepali, so we ultimately didn't apply for the needed services.'
Ameena, a Nepalese woman, not only cares for her family with three children full-time but also looks after her parents over 70. As she and her parents have chronic illnesses requiring frequent hospital visits, she is under heavy stress and sometimes forgets medical appointments. She said, 'Before joining the "Support to Ethnic Elderly Project", I didn't know about any elderly services or resources. It was only through the project that I learned about JoyYou Card, Health Care Voucher, and other elderly benefits. However, I'm still worried that my parents won't be able to adapt to mainstream elderly services due to language barriers. If problems arise during service delivery because of language issues, it will only cause me more distress.'
Recommendations
Based on the survey results, HKCS makes the following recommendations:
1. Continue to provide bridging services for ethnic minority elders
- Both ethnic minorities and mainstream service providers need comprehensive supporting measures for effectively seeking or providing the services they need. Bridging services play an important role in the transition period. On one hand, they help ethnic minorities understand more mainstream services. On the other hand, they strengthen mainstream service providers’ confidence, knowledge and skills in serving ethnic minorities.
2. Enhance mainstream social service providers' understanding of ethnic minority elders and carers
- The Social Welfare Department coordinates induction training for current elder care professionals and frontline staff. New staff must receive multicultural sensitivity training to understand the differences between different cultures and provide more tailor-made and friendly support services to ethnic minority elders.
3. Increase support measures for mainstream social service providers
- The government currently provides NGOs with additional Ethnic Minority District Ambassador (EMDA). Relevant measures should be widely implemented and regularised. Resources can also be provided to form an ethnic minority specialized team.
- Providing ongoing on-the-job training to EMDA can enable them to perform their roles more effectively.
- NGOs should flexibly use resources to recruit more ethnic minority staff to solve the difficulties that ethnic minority elders encounter in receiving services.
4. Provide diverse and multilingual public and social service information
- Some ethnic minority elders have low academic qualifications and difficulty in mastering spoken language. The government and mainstream service providers should provide information in multiple languages through different forms and channels, including audio broadcast, translate information in a simple and easy-to-understand way, etc., so that the audience can better understand and grasp it, eliminate language barriers, and obtain appropriate services.
