According to government statistics, life expectancy in Hong Kong has continued to increase over the years, with men now expecting to live an average 81 years from birth while women 87 years, the longest among all developed economies.
However, the increasing life expectancy of Hong Kong citizens has also given rise to a wide range of issues, including the fact that more and more senior citizens are suffering from cognitive-communication and swallowing disorders, mainly as a result of dementia, Alzheimer’s disease, Parkinson’s disease and stroke.
Unfortunately, in many cases, their condition is often overlooked by caretakers. In particular, many elderly people who have difficulty in swallowing (dysphagia) because of their inability to coordinate their muscle movements suffer from poor nutrition, dehydration or even chronic pneumonia because they often choke on their food and cannot eat and drink properly.
Many elderly Parkinson’s and Alzheimer’s patients also suffer from speech impairments due to poor muscle control and coordination.
But their condition can actually be substantially improved and their pain eased if they are given proper therapy by professional speech-language pathologists (SLPs).
Unfortunately, many senior citizens suffering from dysphagia and speech impairment barely have any access to such therapy because of the acute shortage of SLPs in Hong Kong.
In 2014, there were only 641 qualified SLPs across the city, official figures show. Among them, 82 worked under the Hospital Authority (HA), while 259 were employed by government-subsidized organizations and 227 by private institutions such as private hospitals and nursing homes.
Earlier, a private organization carried out an extensive study on how common dysphagia is among nursing home residents in Hong Kong, and the findings are alarming.
According to the study, as many as 28 percent of the elderly people cannot swallow solid food properly, and 9 percent have to be tube-fed on a daily basis.
Among the nursing homes that are taking care of elderly dysphagia patients, half of them don’t have any speech therapy service available, while 40 percent have to rely on public hospitals and clinics for such service. Only a very handful of them have their own SLPs.
Among those nursing homes that don’t have their own SLPs, 45 percent say they believe speech-language therapy service is necessary.
As we can see, there is indeed a huge and urgent demand for speech therapy among elderly patients suffering from dysphagia and speech impairment. However, their demand is hardly met since there are simply not enough SLPs in Hong Kong.
As such, in order to help elderly dysphagia patients overcome their difficulties in swallowing and communicating, I strongly urge the government and the HA to drastically review the existing policy on providing speech therapy, and above all, to increase the number of qualified SLPs in the city.
The government can also draw lessons from other advanced countries on how to formulate a long-term manpower policy regarding the provision of speech therapy in our hospitals and nursing homes.
Currently, there is no government regulation of both the practice and qualifications of SLPs. I, along with other concerned members of the health sector, have repeatedly called on the government to establish a proper regulatory regime for SLPs to make sure they are all well-trained and qualified.
Our calls finally got answered in 2016, when the government launched an accredited registers pilot scheme for SLPs. While the scheme is still underway, I believe the government should put more resources into the scheme so that it will remain effective and sustainable, and help safeguard the health and welfare of our senior citizens.
This article appeared in the Hong Kong Economic Journal on Oct. 9
Translation by Alan Lee
[Chinese version 中文版]
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