Hong Kong’s elderly need housing options beyond care homes and living with family

This article appeared originally in South China Morning Post on 14 Oct, 2023.
Authors : Ryan Ip, Vice President cum Co-Head of Research, Maira Qamar, researcher and Ingrid Li, Internship at Our Hong Kong Foundation

Have you ever thought about where you would live in your old age? Some might picture themselves moving in with family or living in residential care homes for the elderly.

But what if these options are not your first choice, no longer feasible or you simply want to maintain your independence? In such instances, what alternatives are available to you? Emerging trends, including changes in family support owing to low fertility rates and the exodus of young families, suggest that living with family might no longer be as common as we once thought.

Additionally, the overwhelming demand for care homes has resulted in average wait times of about two years, with some elderly people dying while still in the queue. There is also a view of residential care services as a last resort, with people avoiding them because of their poor reputation and inherent restrictions.

The options for living in one’s golden years should be abundant. There could be exclusive senior housing with basic in-house medical and support services, enhanced support services in existing flats or even intergenerational housing. By providing alternative options, seniors can delay or even avoid institutionalisation in care homes.

Hong Kong’s government has long advocated for “ ageing in place” as the cornerstone of its elderly policy, aiming to enable elderly to live in a familiar place for as long as possible. However, there is a significant disconnect between policy objectives and current practices.

Spending on residential care services has consistently exceeded spending on community care services in the past decade, with the latest budget estimating a difference of nearly 2.5 times. So far, Hong Kong government’s actions speak differently from its vision of ageing in place.

One potential solution lies in the expansion of the senior housing market. Currently, the market lacks the critical mass required to transform it from a niche market to a credible option the broader elderly population can consider. For example, senior housing projects, such as continuing care retirement communities, offer all-inclusive services that can come with a hefty price tag.

While the Hong Kong Housing Society has made tremendous efforts in recent years to introduce progressive housing, such as Tanner Hill and projects under the Senior Citizen Residence Scheme, the market has limited players.

To lower entry barriers, policymakers could consider implementing land use policies that are favourable towards the development of senior housing. Successful implementations of similar approaches in places such as New South Wales in Australia have included incentives such as bonus floor space for senior housing projects.

Another overlooked option is to enhance services in regular housing. Simple strategies such as home modifications can help elderly retain their independence. For example, the Community Ageing in Place – Advancing Better Living for Elders programme in the United States integrates occupational therapists, nurses and handymen to carry out home fixes and empower the elderly.

Studies have shown significant returns on investment, with tenfold savings in healthcare costs, and improvement in overall health conditions. In Hong Kong, such cost-saving measures are not only feasible but highly relevant given the government’s large expenditure on elderly services. Levelling up the home modification industry in Hong Kong is a small but powerful start.

Only the Housing Society and Housing Authority offer similar programmes for rental units, with no such services available in the private sector. To make home modification services more accessible, it is crucial to raise awareness of the benefits, provide user-friendly guidelines to the public and train workers accordingly.

Can Hong Kong's elderly afford quality lifetime rental flats?

Besides home modifications, Hong Kong can nurture a sense of community among the elderly. Consider Singapore’s Community Care Apartments, a senior housing initiative in the public sector where an on-site community manager offers elderly an array of services and prioritise admission to nearby nursing homes, if required.

Similarly, by scaling up the concept of “community service manager” to other housing estates and senior housing models, community managers or the like can help establish connections with elderly people and

provide support services such as assisting with home fixes, liaising with family and referring residents to relevant district services.

It is time Hong Kong shifts towards adaptation, explores ways to expand senior living options to address the diverse needs of the elderly population and encourages a wider participation of players to fulfil the promise of ageing in place.