In accordance with the Hong Kong Population Projections 2017 by Census and Statistics Department, aging population will continue to make an impact on the overall age composition in Hong Kong for the next twenty years. In 2036, the number of elderly aged over 65 is foreseeable to surge from 1.16 million in 2016 to 2.37 million. Among this group, chronic disease sufferers of hypertension and diabetes will count up to 70%, stressing on the inevitable demand on long-term medicinal treatments. Under this circumstances, the government’s ideal of "Aging in Place" can be realized in no other way, but health and disease self-management starting from the elderly themselves.
Implementing the Home-based Chronic Disease Management Service for the Elderly (CDME) since 2014, the HKRC has devoted continuous effort on chronic disease management services for the elderly with the “case management” approach. Through health assessments by professionals and regular visits by volunteers, elders progressively acquire chronic diseases knowledge on the physical, psycological and social level, not only strengthening their disease self-management skills, but improving their living quality.
May 31, 2018 marks the big day of Madam Yip (aged 84). More than a year ago, Madam Yip was introduced by the district elderly community centre to the Red Cross' CDME Programme. After undergoing 18 months of regular home visits, Madam Yip has finally receiving her “graduation certificate” from the two volunteers, Ms. Chow and Ms. Ho. Energized and enraptured with success, the light on her face brightens shows her every day.
“She wasn’t in a good condition the first time we met her. She was quite pessimistic, and occasionally forgot things, worse of it was her medicine,” recalled Ms. Ho, one of the two volunteers who paid Madam Yip regular visits. A singleton woman living in a public housing estate in Sha Tin, Madam Yip has longed suffered from hypertension, making her a regular medicine consumer. "The worst part was taking medicine. I didn't know the difference among most pills I brought home from the hospital. Sometimes I forgot to take them, or I took too much." Not knowing the proper way to medicine, Madam Yip's hypertension did not see any positive change back then.
Knowing her difficulties, Ms. Ho thoughtfully bought her a pill box to dispense the quantity of medicine she needed for every meal. She also taught her to set alarm on phone to remind her intaking medicine. It took Madam Yip quite some time to get used to the new routine. However, after a year and a half, she now gets to monitor her medication with her own effort, largely alleviating her symptoms of hypertension.
"Ineffective medication is a common phenomenon among the elderly group. This is often caused by the elder's lack of knowledge on medicine handling, leading their health situation to further deteriorate. Regular home visiting is a solution to this problem. Not only do they receive health checks like blood pressure measuring and body weighing, most importantly, they get to learn their own progress of medication, which in turn strengthen their ability on chronic disease self-management.
Improvement on medication also brings about advancement in living quality. Used to be a fond lover of reheat meat soup, Madam Yip now understands reheat soup poses a serious burden to the body with an overdosing sodium content under continuing evaporation, which should be strictly avoided by patients with hypertension.
“She is of great discipline. She takes our advice about substituting reheat soup with fresh soup, also to observe a 'cleaner diet' by consuming more vegetables.” Apart from this, Ms. Chow, the other volunteer who also visits Madam Yip regulary, is impressed by her sensitivity on home safety. Gradually taking up the habit to clear and tidy household unwantables that come in her way, Madam Yip now knows to spare more walking space for herself to prevent home accidents.”
Madam Yip’s emotional uplift is what excites our volunteers the most. As far as Ms. Ho and Ms. Chow remeber, Madam Yip is nothing like the pessimistic woman she used to be.
“She used to worry a lot about her illness and her children. There’s a time when she was too stressed out that she quitted morning walk and all outings. Neither her health nor her memory was in a good condition by the time.” Fortunately, the bi-weekly home visits and phone chats from the two volunteers come with just the right time to offer psychological support to Madam Yip. “Elderly is emotionally fragile in the social regard. They are easily frustrated by the cold responses of others. Some of them would even choose to stay silent because of this. We therefore listen to learn their inner needs every time, reciprocating with feasible advice. Through the continuous effort in this past year, we have built love and trust with each other, leading her to a much happy and carefree life.”
This sense of belonging and trust has accompanied Madam Yip to go through her most difficult time, probably contributing to her recent cataract surgery miracle. Under tremendous pressure, her blood pressure surged up to 200, forcing the operation to come to a halt. It was through the encouragement from the two volunteers by side that she finally managed to relax and done with the surgery. “Things will eventually fall into place. I am not pushing my life anymore.” Madam Yip has taken on a positive attitude towards life, also actively involving in the elderly communities lately to embrace a more fulfilling old age. “A good thing about her is that she is very willing to change. She expresses her feelings with all her heart, and also takes in advice from others for a good cause. We’ve only been in touch for a year and a half, but feel like intimate as old friends,” expressed Ms. Ho in her contentment.
The CDME programme does not only benefit the elderly, but also volunteers who actively involve. Ever since the start of service in 2014, the programme has gathered more than 240 volunteers to perform home visits to singleton and hidden elderly with chronic diseases in Tsuen Wan, Sha Tin, Tuen Mun, Sham Shui Po, To Kwa Wan, Kwun Tong and other districts.
Volunteers like Ms. Ho and Ms. Chow received 18 hours of intensive training on chronic disease self-management before officially qualified as a CDME volunteer. Both as starters on volunteering, the two are very contented with the soft skills they acquire during the course. “The more elderly I come across in the programme, the more I see the importance of patience and communication in understanding their inner needs and concern. This has also helped to bring out something good in me. Now I am more willing to express my care for the senior members in my family. When words do not work sometimes, why not try out a warm hug?”
As for Ms. Chow, the volunteering experience in the CDME programme has equipped her with the basic knowledge on chronic disease and brought to her insights into proper ways to take care of her old mother. Both of them that the CDME builds a profound foundation for the realization of “Aging in Place”. “To be honest, no one wishes to spend his or her last years in elderly homes. For those who have to, either are they undergoing a really rough health condition, or they are lacking sufficient care from the family. But things can be different. If they learn to self-manage their illness earlier in time, and keeping a positive mindset, it is likely for them to lead and live their old age at home.”
No successful life comes without health of the body and the mind, as proven in Madam Yip’s case. However, even though we take care of ourselves well, we may still encounter disaters emergencies ubexpectedly, resulting in difficult level of impact and trauma.
We therefore introduce the Psychological Support Service, with an aim to reduce the emotional distress and sufferings of people who are affected by disasters and emergencies, and to provide them with instant care and psychological support. We also provide Psychological First-Aid training to the government's first responders to equip them with effective skills to cope with the impact emergency.
Everyone responds to trauma differently and it is common to feel a rang of different emotions, such as depressive mood, insecurity, loss of motivation, and helplessness. These reactions may lead to deterioration of their functioning in daily life. Timely support, care and practical assistance from volunteers can help stabilize their emotion and offering a chance for them to express tehir feelings. Recent cases like Typhoon Hato of 2017, the series of industrial and domestic tragedies in Hong Kong and the 19-death-60-injury bus accident on Tai Po Road in the beginning of this year are examples of how Psychological Support Service can reduce the impact of disasters and emergencies through immediately psychological support.
Members of Psychological Support Service Team are adult volunteers from all walks of life who have completed the psychological first aid training course taught by clinical psychologists. Mr. Lam, who has a full-time job as a secondary school teacher is one of them.
Having faces different students with emotional problem, Mr. Lam wanted to learn how to make a different for those who are in need. Therefore, he completed the HKRC’s Psychological Support Service training programme and joined as a volunteer 5 years ago. As a team member, Mr. Lam is always standing by to provide emergency psychological support in case of emergencies.
Having been volunterring for 5 years, Mr. Lam served in several cases of serious accidents. An industrial accident involving a worker fell from heights in a shipyard in 2017 being the most unforgettable one. After the incident, Mr. Lam, along with another 10 volunteers from the Psychological Support Service, participate in an emergency operation to provide psychological first aif to the workmates of the deceased. By the time he arrived, he found most of the workmates were very distressed by the incident. Some were in huge shock, some were too stressed out to say a word. "I walked to a workman whose face was crumpled with despair and remorse. The victim had lent him newspapers that morning and he interpreted the act as a sign suggesting the victim would soon pass away. He therfore blamed himself for not being able to avoid the accident." Mr. Lam understands the hardship one would have to undergo when facing different kinds of tragedies in life. Yet, he is glad that the support from his friends and family will have helped him to keep his positivity throughout his journey as a helper.
We heartfully wish that you can answer our call. Your generous donation of HK$500, HK$800 or HK$1,000 will not only allow us to afford more medical equipment like sphygmomanometer and weighing scale for supporting chronic disease patients, but also other humanitarian services reacging people like Madam Yip, as well as other singleton and hidden elders who are in need of love and comprehensive care.
Lastly, I would like to extend my heartfelt thanks to you for reading this letter. Should you have any enquiries or further thoughts to share, please do not hesitate to contact us by secretarygeneral@redcross.org.hk or 2802 0016.
Bonnie So
Secretary General