Hong Kong Christian Service

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Issue 009
2015 September

Untimely elderly home manpower policy
Government should amend accordingly

While the abuse case of Cambridge Nursing Home Limited is coming to a close, problems of private homes surfaced, have yet to be solved. It is not simply a matter of monitoring, but also the untimely legislation, constant shortage of manpower. In addition, there is no mandatory manpower ratio for private homes which breeds a lot of problems, we therefore urge the government to take the necessary review to prevent worsening of the situation.

Generally speaking those who stay in elderly homes are in need of care with moderate or high level of frailty, and over half of them need assistance to travelling; some of them cannot communicate properly and requires a lot of patience from staff to communicate to understand their needs.

However, under the present manpower establishment, one health worker has to take care of several frail residents at a time. With such a line production work model, it is almost impossible for workers to provide better service to the elders, cater to their specific needs and develop a trusting relationship.

Untimely manpower policy

It was stipulated that the ratio of health workers to residents of moderate impairment level or above in a care and attention home is 1:20 from 7 am to 3 pm; and 1:40 from 3 pm to 10 pm and 1:60 from 10 pm to 7 am of the next day. This acute shortage of manpower ratio is far from satisfactory.

Take a routine day time operation for example, a health worker has to feed individual resident one by one, that will be over 1/6 of the residents, and at the same time, over 60% of residents need assistance for shower while others require assistance for personal care and daily living activities such as going to toilet or walking around. How can such a manpower ratio satisfy the huge demand?

Let’s take a look at the operation at night. The requirement of Social Welfare Department (SWD) is 1:60 for moderate level frailty, lack of self-care ability and higher level of care. However, the problem is that there are over half of the residents have incontinence and need frequent change of diapers at night, roll them over every now and then to prevent pressure sores which need at least 2 health workers. Under such shortage of manpower, health workers have to attend to these needs, not to mention regular checking of sleeping quality of residents, handling issues arising from dementia and rushing them to hospital in case of emergency.

Private homes are unwilling to strengthen manpower so as to save costs

From a commercial point of view, all private homes need to fulfil the requirement of Licensing Officer of Residential Care Homes for the Elderly of SWD. Additional manpower would reduce their profits. Furthermore, the long standing shortage of frontline health workers has increased capital costs of manpower which makes private homes more reluctant to increase manpower as this is linked to profit.

Can this kind of manpower policy provide a dignified life for the elders? Is this amount of workload reasonable for health workers who are taking care of large number of elders requiring higher level of care? The existing policy has been in place since 1996. After 20 years’ of rapid service development, clientele needs and rise of demented elders, the existing policy has become unrealistic and cannot catch up with service demand. The government must speed up its pace to review the elderly manpower policy and amend accordingly to provide a reasonable environment for the elders, their families and health workers in elderly home.

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