The Perception of Older and Other Stakeholders on Long-Term Care Services with Higher Individual Autonomy: A Qualitative Study in Hong Kong and Analysis of Official Data During 2004-2016
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AbstractIntroduction/Objective
The modern long-term care system is facing a growing demand for better tailored and more responsive care; choice and flexibility of care users has become one of major goals of the system. There is a trend that public-funded long-term care systems in the OECD countries opted for providing entitlements to service users in form of cash or other forms of personal budgets for them to choose and purchase the care services that suit their needs. The Hong Kong government is also providing vouchers for older adults to choose community and residential care services. This study aims to find out how Hong Kong older adults feel about higher autonomy in choosing care services and the barriers of implementing such care models perceived by stakeholders.

Design/Methodology
Focus group discussion was conducted among community-dwelling older adults (2 groups), informal carers (2 groups), and social care professionals (2 groups) to gather views on autonomy and flexibility of choice in care services. Official data records of needs assessment of older adults who were eligible for public-funded long-term care services during 2004-2016 (N=171,201) were obtained in order to verify part of the findings from the focus groups.

Results
Older adults’ perception on higher autonomy varied from persons to person, while carers did not consider individual autonomy as a crucial issue in long-term care. The care professionals did support the idea that autonomy of older adults is important in caring and also suggested that their decision or demand should be assessed by the care team. Insufficient care resources, information asymmetry, insufficient decision-making capacity and agency problems can be found as barriers from the focus group and supplementary data analysis.

Conclusion/Discussion
Not every older person in Hong Kong wants higher autonomy in their long-term care services, and carers and care professionals believe collective decision making is important. Due to the nature of their perceptions and above-mentioned barriers, routine communications between professionals and older adults should be established and enhanced with multiple ways to ensure information is accessible and guidance is sufficient. The private sector should also be promoted to introduce more care options to long-term care in Hong Kong.

Disclosures
This research project (2017.A4.039.17C) is funded by the Public Policy Research Funding Scheme from Policy Innovation and Co-ordination Office of the HKSAR Government. The work is also supported by Research Grant Committee Theme-based Research Grant (T32-102/14-N). Other sponsor: The Graduate School of The Chinese University of Hong Kong.
Acceptance Date01/03/2019
All Author(s) ListWang K, Wong A, Wong EL, Cheung A, Yeoh E
Journal nameJournal of the American Medical Directors Association
Year2019
Volume Number20
Issue Number3
PublisherElsevier
PagesB34 - B34
ISSN1525-8610
LanguagesEnglish-United States

Last updated on 2020-27-03 at 01:40