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May 2020   |   Volume 21 No. 2

Cover Story

Embracing an Active Old Age

People can have active, productive and meaningful lives in their senior years, especially with the right systems and support in place.

Hong Kong is getting old. By 2024, the city will officially be a ‘super-aged society’, meaning more than 21 per cent of people are aged over 65. By 2034, we will be ultra-aged, like Japan, with more than 28 per cent over 65. 

“These numbers mean both challenges and opportunities,” said Dr Vivian Lou Weiqun, Director of HKU’s Sau Po Centre on Ageing, “particularly as they imply a significant change in demographics that challenge our existing infrastructure.” 

Dr Lou has been investigating active ageing and how to empower people to better enjoy their senior years, and recently received more than HK$12 million from The Hong Kong Jockey Club Charities Trust to bring her strands of research under one umbrella, The Jockey Club Golden Age Journey Project. 

“Our aim is to promote active ageing and make the process better, healthier and more meaningful. We want to empower older adults through a focus on balancing employment and caregiving, volunteering, and learning. If older adults can become more engaged, this will have positive impacts on individuals, families, communities and society as a whole,” she said. 

This empowerment is happening at a time when the traditional Chinese model of families looking after their elderly parents has become unsustainable because the nuclear family now dominates and adult children have work and other obligations. As a result, caregiving is a growing concern. 

“We also don’t have enough professionals to deliver care to the rapidly growing number of elderly,” she said. “Instead, we need to think about a model in which families, community services, volunteers and the healthcare system collaborate and share caregiving for the elderly.”

Filling in the blanks 

The first step is to understand how many people are engaged in caregiving and who they are, including age, gender, relationship with the elder person, labour force participation and other information. The government has not collected this data but following a 2018 study of the problem led by Dr Lou, it is changing tack: a subset of questions about caregivers will be included in the 2021 census. “Without data, evidence-based policy and planning is impossible,” she said.

The costs of caregiving must also be understood. A study she conducted jointly with HSBC and The Women’s Foundation in 2019 estimated the direct and indirect costs of caregiving (such as reduced labour force participation by unpaid caregivers) will more than triple by 2040 to HK$126 billion (against HK$38.8 billion in 2018). 

Moreover, there is a need to understand the emotional cost on caregivers who have paid work and fear revealing their caregiving obligation will cause employers or work colleagues to look at them in a negative way. “We need to pool multiple stakeholders, including the commercial sector to look at this very serious challenge,” Dr Lou said. 

One solution is to train volunteers to share the caregiving load. Dr Lou has developed capacity-building programmes for the ‘young-old’ – retired people in their 60s or early 70s who are healthy and resourceful and who are sent to visit socially-isolated people with mild cognitive impairment. She and her team have also produced guidebooks, websites, apps and videos for both trained volunteers and those families who are taking care of stroke patients recently discharged from hospital or engaged in end-of-life care for loved ones. 

“We have standardised evidence-based volunteer empowerment by studying who are the most vulnerable groups and training volunteers to help them. My dream is to have specialised volunteers providing partnered care and support for community-dwelling older adults in every neighbourhood in Hong Kong,” she said.

Breaking down barriers 

An added benefit is that volunteering can help the young-old lead more meaningful lives, especially as Hong Kong employers are still reluctant to recruit, retain and retrain them. “Fewer than 10 per cent of those aged over 65 do paid work. Internationally, this figure is not desirable. If we want older adults to have healthier, more meaningful lives, work should be an option,” Dr Lou said. 

To break down some of the boundaries for the aged, the Sau Po Centre on Ageing launched the Campus Ageing Mix Project for University Students (CAMPUS) last year with support from the ZeShan (HK) Foundation to bring together groups of senior citizens and students in the Faculties of Law, Engineering, Medicine, and Architecture to discuss topics of shared interest and increase the students’ ageing literacy. For example, law students met with seniors to discuss wills and power of attorney, while medical students learned about the daily challenges and experiences of ageing. Dr Lou has also worked with HKU Libraries and the Common Core Team on an inter-generational participatory co-design project supported by a Teaching Development Grant. 

All these efforts are working towards one goal. “Through our innovative inter-sector, interdisciplinary and international collaborations, we strive to continue our leadership in promoting quality of life in the face of new demographic realities and technological advancements,” she said.

The Campus Ageing Mix Project for University Students (CAMPUS) brings together groups of senior citizens and students in different faculties to discuss topics of shared interest.

HKU students and community members collaborate in inter-generational projects to design innovations for an ageing society.

We need to think about a model in which families, community services, volunteers and the healthcare system collaborate and share caregiving for the elderly.