H. C. J. Wong et al.
people will be taken care of by the family, 6% by community and 4% by institution [12]. This is a higher than
national standards which suggested on “9073”. However the statistical data may not reflect what kind of care
older people are actually enjoying in different categories of family, community and institutional care.
As mentioned earlier Hong Kong advocated for the Holistic Care Model of Older People. However it is li-
mited by never sufficient public resources. Service gaps are evident and many many older people, 70% accord-
ing to the Elderly Commission Report 2009, are living in privately run homes with very poor conditions. Seam-
less Care for All is now advocated by many experts in elderly care in Hong Kong.
Comparing with Hong Kong, Zhuhai, like many other mid sized cities in China, is not without its advantages
and strengths. Physically, land for facilities and space in homes are more readily. Socially, filial piety is still
upheld and family relations are more intact. In terms of work culture people are more relaxed and enjoyed a five
days working week. People will be more available to spend time with their old age parents living together, alone
or in institutions. Politically and culturally volunteer services is encouraged and young students always visit el-
derly homes.
To plan older people’s services for Zhuhai or similar cities in China, a Seamless Service Model combining
Basic and Supplementary Care is proposed. Non profit charitable organizations should play an important role in
this network taking the form of social enterprises. If the infrastructure is adopted by the authorities and sup-
ported by the local communities, Zhuhai will become the Florida of China.
Currently there are 16 public old age homes in the Zhuhai. They were designed and built as hostels for single
older people without family. It is assumed that they are still capable to take care of themselves. If physical heath
of residents deteriorates a personal worker will be hired to look after them individually. No training is required
or provided to the personal worker. Similar situations apply to other cities in Guangdong though some areas
have opened up these old age homes to older people with families with a monthly charge. In a few leading cities
simple training are offered to care workers of old age home.
For Zhuha, it is recommended that existing old age homes should be converted to provide nursing care, to ful-
fill the policy goal of 4% institutional care targeted at those older people who can no longer lived on their own
without nursing care. These old age homes should be converted into “Comprehensive Nursing Home” as stipu-
lated in the Plan.
To clarify various terms “Older People Hostel” refer to those dormitory of “Independent Living” where resi-
dents are expected to take of their own living entirely. “Older People Housing” refer to those facilities in which
residents are provided with food, laundry, simple health care and cleanliness services. It is a type of “Assisted
Livi ng”. Finally “Older People Nursing Housing” refer to facilities providing high level of nursing care to those
who partially or totally unable to take care of themselves; “Cared Living” as it may be called. A Comprehensive
Nursing Home however should provide all three Housing types and Living styles.
The Comprehensive Nursing Home will become the focal point of older people services in the district, with
its social work teams reaching out to communities and families. A Day care center with rehabilitative functions
will be incorporated in each of this comprehensive home integrating social and medical services.
On August 16, 2013, Premier Li Keqiang chairing a State Council executive meeting, instructed that Older
People care should be integrated with Healthcare services in all aspects, supported by social security provisions
as well as health insurance [13]. It is predictable that community medicine and nursing provisions will be ex-
panded and reachable for older people living under family care.
Furthermore, at the community or village level, it is suggested to set up “community kitchen” to provide die-
tary food for older people. Home help services can also be organized and supervised by resident or village
committees. Community workers now employed by resident or village committees can be trained up to form
“community social work teams” to organize meaningful activities for healthy older people in the district. Social
workers reaching out from the Comprehensive Nursing Homes can collaborate with these community social
workers and form the platform of a connected network of care. The service network bridges the gaps and form
the framework of Seamless Services.
All these services should be managed by a non-profit organization, including social work services, health ser-
vices, rehabilitation services and daily living support services such as food catering and home help (See Table
1):
To summarize, city leaders must first conceptualize the proper model of services provided to older people be-
fore we can tackle other problems like finance and manpower planning. This model will fully utilize existing