HONG KONG — Social worker Crystal Yuen Shuk-yan goes to the tenement buildings in Hong Kong’s old districts every month or so, knocking on doors to look for elderly residents needing help.

Many times, the door is slammed in her face. Undeterred, she returns on another day with gifts of rice or noodles.

Some of those who turned her away previously accept the food items and give her their personal details for follow-up. For others who remain unmoved, she leaves pamphlets about elderly services and her organisation’s contact details.

Ms Yuen, 41, who has worked with the elderly for more than 15 years at NGO Society for Community Organisation (SoCO), said it was difficult to reach out to elderly residents needing help.

Many lived alone or with only their spouse and faced mounting physical and mental health risks, but did not know about available services or were not motivated to seek help, she said.

Ms Yuen and her colleagues sometimes set up a stall outside wet markets or public hospitals in Sham Shui Po and Cheung Sha Wan to approach elderly people. After a day’s work, she manages to collect the contacts of about 30 to 40 people for follow-up action.

“Many elderly residents are ‘hidden’, lacking family or community support,” she said. “It takes time and patience to reach out to them and offer the help they need.”

SoCO has a 12-member team serving more than 700 elderly people. They make regular phone calls and home visits, hand out food and daily necessities, and organise activities and classes for them.

Rapidly ageing Hong Kong has more than 188,000 people aged 65 and above who live alone. Almost 400,000 more live with only their spouse. Among them are many “hidden elderly”, who have no family support and are not known to community networks.

Residents living alone aged 65 and over account for 13 per cent of the total elderly population, according to the 2021 by-census.

Experts and social workers have long argued that the city lacked a comprehensive policy targeting this vulnerable group, while the existing support for them and their carers was too limited.

The recent emigration of young people, who left their elderly parents behind, had worsened the situation, they said.

A string of recent tragedies, in which elderly people died alone at home, put the issue under the spotlight again, reigniting public calls for more help.

On June 13, a 75-year-old woman, bedridden with lymphoma, was found extremely weak and dehydrated by firefighters in a flat in Happy Valley. They found her younger brother and carer, aged 71, dead in the bathroom.

The pair’s social worker had alerted a security guard when no one answered the door. According to an insider, the woman had shouted for help, but no one heard her. The man might have been dead for days when the emergency team arrived.

On May 15, a skeleton believed to be that of a 69-year-old man was found in a public housing flat in Sha Tin after Housing Authority employees visited the unit. A source said police investigations showed the man lived alone and there was no sign of a break-in.

A day earlier, a 59-year-old woman and her 86-year-old father were found dead in their home after a family member called for help after nobody answered the door during a Mother’s Day visit.

“These tragedies could have been prevented,” said Emeritus Professor Cecilia Chan Lai-wan of the Department of social work and social administration at the University of Hong Kong (HKU). “Each of these cases is a clear manifestation of the failure of the existing service delivery.”

Describing the situation as a “time bomb”, she called for more resources to ensure that elderly people were not left alone to die.

‘I WAS IN PAIN WITH NO ONE BY MY SIDE’

Retired security guard Ah Wah*, 62, has lived alone in a public housing flat in Sham Shui Po since his divorce several years ago. His two daughters live with his ex-wife, and seldom contact or visit him.

He has lived with depression for years. He has high blood pressure and asthma, cataracts in both eyes, and the pain in his right knee is so severe he takes painkillers every day and relies on a crutch to walk.

Ah Wah said his ailments kept him confined at home most of the time, leaving him low-spirited and worried about what might happen if there was an emergency and nobody came to his help.

He recalled how he slipped on the street on a rainy day some years ago and fractured his right leg. A passer-by called for an ambulance and he stayed in hospital alone for about a week.

When he fell ill with Covid-19 last November, he ate instant noodles and canned food for most of the week, although his younger brother brought him dinner for a few days.

“I was in pain with no one by my side. I felt sad and helpless,” he said.

He said he felt better when social workers and volunteers called or visited him, and when he attended health talks and chatted with others with similar health issues at community centres.

HKU’s Prof Chan said elderly people living alone or with only a spouse faced mounting health risks as well as social isolation.

“It is physically impossible for a frail elderly person to look after another elderly person,” she said.

But community care services such as home cleaning and assistance attending hospital were too limited to help all of them, while those who opted to move into the government’s subsidised care homes had to undergo strict assessment and wait around three years because of the severe shortage of places, she said.

HELPLINE CALLERS ‘OVERWHELMED BY LONELINESS’

The Senior Citizen Home Safety Association provides elderly support services and has about 70,000 users, the majority being those who live alone or with only their spouse.

Its 24-hour emergency hotline, Care-on-Call, received 46,904 calls in May alone, up from 44,304 in April and 39,933 in March.

Some callers do not have children or explain their family members live elsewhere. Many ask for an ambulance or someone to accompany them on hospital visits, while others need help with their daily life.

Some callers who are suicidal or need emotional support are referred to social workers.

Vincent Ng Chi-kwan, executive director of Suicide Prevention Services, said elderly people living alone or with only their partner were at higher risk of developing emotional problems or becoming suicidal if they had long-term illnesses and were in physical pain, or had strained relations with family members or had been left behind by children who emigrated.

The charity’s 24-hour hotline received about 200 calls a month from people aged 60 and above, accounting for about 3 per cent of total calls.

Its home visit service helped about 300 elderly people with suicidal thoughts or emotional problems a year, mostly those living alone or with just their spouse.

“They are overwhelmed by a sense of loneliness,” Mr Ng said. “When they call, what they need most is to have someone who will listen to, care for and understand them.”

‘MORE WORK HAS TO BE DONE’

Chief Executive John Lee Ka-chiu on Sunday (July 2) said that authorities would target elderly people living alone, or with only their spouse, in poverty alleviation measures.

The government has provided a range of community support services such as counselling, referral and emotional support at its subsidised elderly community centres, and organises activities including seminars, carer training courses and outreach activities.

Support teams attached to the centres conduct home visits and call elderly residents to identify those who are vulnerable, and provide emotional support and referral services to those living alone or with only an elderly spouse, according to the Social Welfare Department.

There are about 75,000 places at residential care homes for the elderly, with about 35,000 subsidised by the government.

Mr Lee announced in his policy address last October that the target was to provide an additional 6,200 places by the end of 2027.

He also said the government would set up district services and community care teams across the 18 districts to organise care activities including visits to those in need.

So far, the teams have been established in Tsuen Wan and Southern districts earlier this year, with more to come in phases.

The Home Affairs Department said these teams would visit elderly people at home to tell them about available support services and also refer those who needed professional help for follow-up. The department was also working with welfare authorities to explore offering more help to the elderly and their carers.

Experts and social workers called for more and better community and residential care services.

But they stressed that the government had to first locate the city’s most vulnerable elderly residents, including those living alone or with just their spouse, and those with financial difficulties and without family support.

HKU’s Prof Chan suggested that management companies of private buildings compile a list of elderly residents so that district care teams could follow up and offer support.

She said the Housing Society had teams of social workers running activities for elderly residents in its public flats, and suggested that the city’s largest public housing provider, the Housing Authority, did the same.

Dr Donald Li Kwok-tung, chairman of the Elderly Commission, said that apart from those who were underprivileged, well-off residents who had no close family members also needed attention and support.

He urged elderly residents to make use of the proposed district health centres, where they could interact with their peers and have their health monitored, while the government could also establish a database.

Social welfare lawmaker Tik Chi-yuen called on the government to set up a community support centre in each district to provide services for ageing residents such as health and emotional counselling as well as referral to other professional service providers.

He also suggested assigning social workers and nurses as case managers for long-term follow-up.

SoCO’s Ms Yuen suggested the authorities mobilise NGOs in every district to recruit residents interested in helping the elderly and train them to provide care services such as meal delivery and home cleaning to make up for the shortage of such services.

“The work is challenging, but it has to be done, not only by an individual organisation, but by the authorities and the whole society,” she said. SOUTH CHINA MORNING POST

*Name changed at interviewee’s request