Published: 09:28, July 16, 2025 | Updated: 10:07, July 16, 2025
Hong Kong caregivers are falling through safety net
By Stacy Shi in Hong Kong

Hong Kong is facing a growing crisis in carer support, with a series of tragic cases exposing severe gaps in assistance for those taking care of vulnerable family members.

Among them is 72-year-old Lai, the sole carer for her 78-year-old husband Mak, who suffers from liver cirrhosis and requires round-the-clock assistance. Mak’s condition worsened with new complications including edema and unstable blood sugar levels, which pushed him to have surgery in April.

“I never learned how to care for someone, and suddenly I’m responsible for a critically ill patient. I’m terrified of making mistakes,” she said.

Lai created a detailed care log to help her cope with the unexpected responsibility, but the overwhelming stress eventually took a toll on her health, causing heart complications that required medical attention.

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On one occasion, she gave up the chance to receive emergency room treatment after a 6.5-hour wait in a hospital hallway, fearing her husband would be left unattended at home.

Such cases are not isolated. In 2023, two intellectually disabled brothers starved to death at home after their mother, who was also their carer, was hospitalized. This tragedy prompted the government to establish a cross-disciplinary database to identify high-risk caregivers for early intervention.

‘Absolutely necessary’

A pilot program began operation on Monday, aiming to prevent caregivers from slipping through social safety nets. From 9 am that day, the Hospital Authority began alerting the Social Welfare Department (SWD) upon the hospitalization of people receiving the government’s living allowance for low-income carers.

After receiving a notification, the SWD coordinates with the Caregiver Support Hotline (182 183) and other relevant welfare service units to proactively reach out to the affected families, assess the needs of people being taken care of and provide appropriate emergency assistance, such as arranging respite care and meal deliveries.

Approximately 8,000 to 9,000 carers will be included in the initial phase, with plans to gradually expand the program. The long-term vision is to extend the coverage to over 1 million elderly residents currently receiving various SWD subsidies, particularly focusing on elderly doubletons where both spouses are seniors, Secretary for Labour and Welfare Chris Sun Yuk-han said in a Sunday television program.

Sun added that all services provided to care recipients during their carer’s hospitalization will incur no additional charges, and existing allowances will not be reduced because of temporary care interruptions.

Sun also gave assurances over privacy protection, clarifying that the program will not access patients’ medical records, but only basic contact information for coordination purposes.

Replying to a China Daily inquiry, the SWD said it has received three case notifications from the HA so far. The department immediately contacted the families involved to assess their situations and evaluate service needs. None of those cases required urgent support, said the department.

Another part of the pilot program involves collaboration between the Housing Department and SWD.

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Starting in the coming one to two weeks, trials will be launched in Kwun Tong and Sha Tin, coordinating local community care teams to conduct home visits to elderly individuals living alone or to elderly doubletons residing in public rental housing.

With 1.7 million Hong Kong residents aged 65 or older — three-quarters of whom receive some form of social welfare — Sun hopes to weave “an ever-expanding safety net”.

Lai hailed the government’s new program as “absolutely necessary”, although her family falls outside its scope.

She had previously applied for a monthly HK$2,400 ($305.73), only to be rejected on the grounds that “spousal carers are ineligible” — the subsidy is only available to adult children providing care.

The couple has four children, but each has their own family commitments. With the allowance also requiring at least 80 hours of caregiving per month, Lai said: “Do they expect our children to abandon their own families just to take care of us?”

Adding to their exclusion, the couple owns their flat at Hin Tin Estate under the Tenants Purchase Scheme, a fact that disqualifies them from initiatives targeting public housing tenants.

Critical gaps

Kwun Tong district councilor Yu Siu-lun described the government’s new program as a breakthrough, but cautioned that critical gaps remain in current safety nets. Cases like Lai’s require proactive assistance from frontline community helpers, Yu said.

The councilor proposed incorporating comprehensive condition assessments into routine reviews for elderly recipients of the Old Age Living Allowance, to better identify hidden care needs. He also suggested the mobilization of community support networks to help those undetected by government-run programs.

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Emphasizing the role of technology, Yu said he has been working with colleagues to install motion sensors in elderly people’s households, with 10 in operation so far. The devices trigger exterior warning lights if no movement is detected for several consecutive hours, enabling community members to promptly check on residents.

Society for Community Organization Deputy Director Sze Lai-shan welcomed the new measure as a step forward in supporting vulnerable families but stressed that more comprehensive solutions are needed. “When caregivers are hospitalized, their dependents inevitably suffer — but many struggling families fall through the cracks even without such emergencies,” she told China Daily.

Sze said public housing estates could establish care teams for community outreach. She also called for data-driven resource redistribution and training for caseworkers to flag at-risk families.

Contact the writer at stacyshi@chinadailyhk.com