Article by Liang Wanfu (geriatrician), Ming Pao
Hong Kong is already aging, and the proportion of the population over 65 years old is about to increase to one-third, and 40% of them are single elderly or two elderly living in the same household.
The “old” is on the way, and we need to formulate an “emergency plan.”
Sick, do we need a doctor? How to cure? Disabled, how do we arrange it? Is there a caregiver? Dementia, does anyone know? Who makes arrangements for you?
(Hong Kong News) The news that a man living alone in Shui Quan O Village, Sha Tin, Hong Kong turned into bones is a tragedy for the elderly living alone. Reading the newspapers is often discouraging. Whether it is international or local news, it is mostly negative.
So, when I’m in a bad mood, I always instinctively read the headline and just go, not wanting to dwell on the bleak details. While driving, though, I always have a habit of listening to radio news reports or “phone-in” programs discussing current events.
The theme of “Beacon” that day was a sad song about the elderly living alone. It was reported that a 69-year-old man lived alone in a unit in Shui Quan O Village. Because the unit had not used water, electricity and coal for many months, the Housing Department staff suspected that the unit had been vacant. When the officers came to collect the building, they suddenly found that the head of the household who lived alone had turned into bones at home. He believed that he had been dead for a long time, but no one knew about it.
The tragedy attracted a lot of attention and criticism. On the same day, some audience questioned: Why didn’t the Housing Department intervene in the investigation earlier? Why does Hong Kong not have a care policy for the elderly living alone? Some commentators even said: “If the government can take more care of the elderly and regularly send personnel to visit the elderly living alone, the tragedy will not happen.”
Caring for the Elderly Policy Disturbs Residents
Regularly visit the elderly living alone? Is it really possible? Hong Kong is already aging. The proportion of the population over 65 years old will increase to one-third in just a few decades, and 40% of them are single-elderly or two-elderly households, which is as high as 1 million households. Just ask, can our society really afford the responsibility of “caring”? Furthermore, at the age of 69, do you have to be cared for if you live alone? Think about it, I will be 69 years old next year. If I live alone, would I like the government to send staff to “care” me on a regular basis?
I believe that most elders do not want their lives to be monitored regularly unless necessary. Therefore, a one-size-fits-all policy of “caring” for the elderly living alone may be disturbing and unfeasible. Social resources are limited and should be used wisely. I believe that it is important to enhance everyone’s awareness and preparation for aging; secondly, it is also indispensable to help the elderly build a support network among family, neighbors and friends.
While I was meditating on this topic, a message came from Lily in the mobile group: “I flew from Chengdu to Hong Kong at 1:00 a.m. last night, and everything went well. But after returning to the residence, although there is a key to the door, I can’t think of renting a house. The floor of the building. The security guards in the building refused to let them go, and they disturbed me for a long time, and I almost called you for help. I really didn’t expect my memory to be so bad.”
Lily is the old wife’s confidant, and we have known each other for decades. Since college, she has been working and living alone in the United States. Last year, she decided to retire completely, pack her bags, and start her world travel plan after the epidemic is unblocked. She first traveled to Egypt for a month, and then returned to Hong Kong to visit relatives. After renting a house in Hong Kong, he started an in-depth tour of China and Central Asian countries. The first stop was the Silk Road. Returned to Hong Kong after roaming for two months.
Unexpectedly, Lily has rented the house for 3 months and still forgot the floor she lives in. Could it be that Lily has really degenerated? Otherwise, it is not easy for her to make an own goal. If she had the title of “Student Master” in her studies back then, Lily definitely deserved it, because she was always an excellent student, shrewd and capable, with a strong memory. My wife often said: “Among my friends, Lily is the one I admire the most. She is really smart!”
So, Lily was never a forgetful person. I immediately replied to her: “senile disease has begun. Why don’t we get together to have a cup of tea and eat a bun. Let’s discuss the countermeasures!”
Make arrangements while you are still healthy
The next day, Lily had breakfast with my old wife and me, and we met each other. As soon as she sat down, she said, “Brother Fu, don’t scare me. Although I’ve been ‘6’ for several years, I never feel old. I don’t recognize old people!”
“Oh, you don’t recognize it, you don’t recognize it, you still have to recognize it! You have already paid half the price for taking the bus or the MTR? You still say you are not an elderly person?” I said.
“Okay! Even if I’m an elder, so what? Is there a countermeasure for getting old? I’ve never been ‘old’.” Lily replied.
I just know Lily’s character, so I want to talk to her. I briefed the news about the death of an elderly living alone in Shuiquanao Village, and told Lily: “No matter what, you need to be fully prepared when you get old. Make arrangements while you are still healthy. This is the same as buying multiple insurance policies. Illness Do we need a doctor? How? If you are disabled, how can we arrange it? Is there a caregiver? If you are demented, does anyone around you know? Do people around you have the right to arrange affairs for you?”
“Oh, I got it! In short, I will ‘travel properly’ in the future. I will also inform everyone before departure and when I return, is that okay?” Lily asked.
“That would be the best. But I would like to share a patient case,” I replied.
I have a patient, a retired principal who is single and living alone, very independent and capable of self-care. Although he is 90 years old, he can still live alone without hiring a domestic helper. She is the family business manager, deacon and mentor of her church. As an active member of the church, she has maintained a close relationship with the brothers and sisters in the church.
Sudden dementia at the age of 90
She came to my clinic for the first time 5 years ago, accompanied by fellow church members. She suffers from low back pain and has difficulty moving, so she has to have meals delivered to her home by church members. After examination, it was confirmed that there was severe osteoporosis, and one of the vertebrae was broken. However, the principal has a strong recovery ability; after more than 4 months of treatment, he can basically take care of himself. She needs regular follow-up visits.
Every time I have a follow-up visit, I always tell her that in case of dementia, it is better to make the “three treasures of old age” (that is, will, enduring power of attorney, advance medical directive) as soon as possible; and consider hiring a helper to take care of and accompany her. But her response was always: “Don’t worry, Dr. Liang. I can handle it.”
The principal is over 90 years old, but he can still live alone, take care of housework, and manage the overall income and expenditure of the family business. He really has an amazing ability to take care of himself.
I remember one day, someone shouted on the street: “Dr. Liang!” Since everyone was wearing a mask during the epidemic, I couldn’t respond immediately, but the principal had already recognized me. She was really smart and sharp. To record this happy meeting, we even took a selfie (selfie) with our mouths covered.
Unexpectedly, within half a year, a sister from the church came to tell me, “Dr. Liang, I’m sick, the principal is in poor health! What should I do?” It turned out that the principal hadn’t returned to church for many days and had no news, so the sisters went to visit. After entering, I suddenly found that the principal was in a trance, his body was thin, his blood was weak, and he seemed to be ignorant of everything. After careful questioning, it turned out that the headmaster hadn’t eaten for more than 10 days. Everyone believed that if he had been late for two days, the headmaster might have passed out.
“Wow, it’s so dangerous!” Lily said with a sigh.
Yes, if there are no sisters in the church, I am afraid it will be another tragedy of the elderly living alone. “Old” is already on the way, we really need to prepare. We have to think about it: If one day we have to face important medical decisions, but we cannot make decisions by ourselves, is there someone around us who can help? Have we authorized him/her to decide for you?
The headmaster’s story doesn’t stop there. She was diagnosed with severe cognitive impairment. She may have been infected during the epidemic without knowing it. Under the influence of the virus, her cognitive ability declined sharply. Since then, she has lost the ability to take care of herself, and she doesn’t know how to handle any affairs, go to the bank, or sign. She is disabled and demented, and is in urgent need of care, and may even have to live in a residential care home for the elderly.
Prepare contingency plans in advance
However, the problem arises from this. While everyone wanted to help, the principal did not pre-establish any “enduring power of attorney” authorizing others to handle her finances. Although she has money, she no longer understands and cannot use it. Therefore, her hospitalization expenses and future living expenses have also become problems.
“Ah, doesn’t it mean that even if you have tens of millions of wealth, you still have to be a beggar.” Lily said, “Actually, I’m not afraid of being ‘old’. I’m most afraid of troublesome people. Trouble is what I fear most.”
“Yes, if you don’t want to become a ‘trouble’ yourself, you must be prepared. In addition to the ‘old three treasures’, we should start to formulate an ’emergency’ plan. From the story of the principal and your sudden amnesia, it can be proved that the crisis is During the incubation period, dementia and disability can really appear at any time. The countermeasure is to have the habit of caring for each other, and it is best to have one or more relatives and friends who can rely on and care for each other. It is good if everyone can visit and greet each other regularly.” I said.
“It’s really not difficult. Let’s just sit down and act, and immediately set up an ‘old friend care’ group, meet regularly, greet each other, and take care of each other.”
The wife finally spoke up and actively offered suggestions. This time I really want to give her a “like”.