Page 199 - HA Convention 2015

Corporate Scholarship Presentations

CS1.1 Rehabilitation Services 09:00 Room 228

Inspiration of Experience in Melbourne: New Directives in Future Aged Care in Hong Kong
Ng JYT
Community Psychogeriatric Nursing Service, Shatin Hospital, Hong Kong

The presentation aims at sharing the impressive cultural support and services invested in aged care in Melbourne so as to
stimulate our thoughts on the aged care services in Hong Kong.

In Melbourne, both service consumers and staff have choices. How can one be humanistic if the staff was not being
treated with humanity. Dignity arises from having ability to earn money or to take care of one self. Under the influence of the
achievement-oriented culture of Chinese, out-pacing and disempowerment are commonly seen in the aged care in Hong
Kong. With the ageing population, we face the challenges of elderly suicide and dementia epidemic; the following may be the
directives to our future aged care:

(1) An organisational culture and commitment to facilitate recovery-oriented practice: professionals respect the living Tuesday, 19 May
experience of service consumers in planning and development of services and promotion of personal recovery in
addition to clinical recovery.

(2) A redesign of care environment and rehabilitation programme that provides choices and facilitates independence of
service consumers.

(3) “Prevention is better than cure”: A working environment should be flexible and responsive to people’s unique
circumstances and preferences, with appropriate risk management obligations.

(4) Experienced senior staff (over 60 years old) may be a group of ideal workforce in aged care.

(5) Government policy supports the employment of elderly people on part-time basis so as to combat depression especially
for those male elderly people with rigid role.

(6) Establishment of psychogeriatric nursing home(s) to accommodate the elderly people who have disturbed behavioural
and psychiatric problems so that the condition of old age homes can be improved

(7) Expansion of community and home treatment with support from professionals and government policy that facilitate
“Ageing in place” and hospice care at home.

CS1.2 Rehabilitation Services 09:00 Room 228

Hospital Avoidance — Road to Success, United Kingdom and Hong Kong Practice HOSPITAL AUTHORITY CONVENTION 2015
Ng YY
Department of Medicine, Tseung Kwan O Hospital, Hong Kong

Ageing population is common around the world with an epidemiological transition from infectious diseases to non-
communicable diseases. Unplanned and avoidable hospital admissions and readmission of elderly bring major burdens to
accident and emergency department (AED) and hospital service in Hong Kong.

Healthcare utilisation showed that people aged over 65 accounted for 50% of all patient days in Hospital Authority hospitals
in 2010, and 68% of all unplanned emergency readmission in which about 40% were avoidable.

The factors of unplanned admission and readmission for people aged 65 or above are complex. They include patient
attributes, availability of community services, access to hospital services and how hospital services are managed.

In United Kingdom, the total number of acute beds has fallen by a third in the past 25 years, from 1987 to 2009 with 7%
readmission rate (30 days). There are some hints to us in the areas of hospital admission avoidance.

During presentation, UK practice will be compared with Hong Kong practice, including AED screening, early discharge and
referral, community supports on health maintenance, monitoring and prevention of diseases, elements and barriers to the
success of hospital admission avoidance.

We believe that systems in public or private sectors should be examined when local strategy is applied, and cooperation
among primary, community and acute care should be aligned to reduce unplanned and avoidable hospital admission,
readmission and length of stay. Moreover, healthy ageing is the win-win situation in the future development of healthcare
service in Hong Kong.

Thus, how to balance the quality of care of elderly, cost effectiveness of healthcare service, the type of healthcare delivery
and financing support will be the art of healthcare service in projected ageing population in the future.

197