The people of Hong Kong have been widely recognized for their longevity. In 2020, the life expectancy for males was 82.9 years, and for females it was 88 years. With 1.3 million older adults in a population of 7 million, there was a need for long-term planning to support older adults to age in place, as so many wish to do.
In 1990, the Hospital Authority took charge of all levels of healthcare. A team of community care nurses was established to care for patients discharged from the hospital and who were referred by their doctors for home care. Due to budget tightening, hospitals are forced to discharge patients prematurely without much consideration of their support in the community. In 2009, the Elderly Commission was convened under the Social Welfare department and consisted of 75 teams of Integrated Home Care Services and 34 teams of Enhanced Home and Community with a mix of social workers, care and social assistants. In 2017, there were only 482 community nurses doing 867,226 home visits, with each nurse taking care of 27 to 29 patients at any one time. In view of the tremendous demand with 1.6 million discharges from the public hospitals annually, it is understandable that only a very small percent of discharged patients who needed short-term follow-up could be accommodated.
Ageing in Place became only a fad slogan, unacceptable to the families of the older people who were unable to complete their care responsibilities due to being too busy, lacking skill, or who had no place in their homes to accommodate the elderly. This is a key reason for a high rate of institutionalization of aged people in Hong Kong.
Last year, I together with a team of retired nurses, established the first of its kind Florence Nightingale Home Health Nursing (FNHHN), aimed to illustrate to the government a home nursing model that truly supports ageing in place. The mission of this self-financed, not-for-profit social enterprise corporation is: "Our professional case nurses and their care teams of medical and allied professionals, rehabilitation therapists and care support workers will support the care of our clients and their family at home in providing the most relevant care tailored after their assessment in an intelligent manner."
The following are our dedicated values using the acronym FNHHN:
Finance Sustainable Care Model
Need Focussed
Holistic Caring Approach
Health the Destiny
Nursing Led
On this International Florence Nightingale Day 2022, we, the team of home nurses are so proud that we have taken our nursing careers beyond hospitals as our life goal, and the following message from Florence Nightingale will always be remembered as our caring motto:
"Hospitals are only an intermediate stage of civilization, never intended... to take in the whole sick population. May we hope that the day will come...when every poor sick person will have the opportunity of a share in a district sick-nurse at home."