LCQ21: Supporting people with swallowing difficulties
24.5.2023

Following is a question by the Hon Tik Chi-yuen and a written reply by the Secretary for Labour and Welfare, Mr Chris Sun, in the Legislative Council today (May 24): Question: According to the Hong Kong Population Projections 2020-2069 released by the Census and Statistics Department, the number of elderly people aged 65 or above will account for more than 30 per cent of the total population in 2040 and, among them, the number of those aged 85 or above will double from about 250 000 in 2023 to over 500 000. There are views that with Hong Kong facing an ageing population and the number of people suffering from swallowing difficulties due to old age and illness gradually increasing, how to provide them with suitable meals is not only a problem for carers, but also a challenge for society. In this connection, will the Government inform this Council: (1) of the specific services the Government has put in place currently for helping people with swallowing difficulties (especially elderly people); (2) whether it knows the number of people who were assessed as having swallowing difficulties and, among them, the number of those who received the services mentioned in (1) and the expenditure involved, in each of the past five years; (3) given that the Government has provided additional resources for subsidised residential care homes for the elderly and community care service units for the elderly since October 2020 for providing soft meal service to elderly people with swallowing difficulties, of the number of elderly beneficiaries and the expenditure involved since the service was launched; whether the Government will provide more resources to enhance the service; if so, of the details; if not, the reasons for that; and (4) whether the Government will draw reference from or tie in with the studies and pilot programmes in the community on the basic dietary needs of people with swallowing difficulties, such as the Guideline of Care Food Standard jointly complied by the Hong Kong Council of Social Service, the Food Research Centre of the Chinese University of Hong Kong and the Swallowing Research Laboratory of the Faculty of Education of the University of Hong Kong; if so, of the details and the timetable; if not, the reasons for that? Reply: President, Having consulted the Health Bureau, my consolidated reply is as follows: (1) to (3) Swallowing difficulty, which is caused by degeneration or such diseases as stroke, dementia, Parkinson's disease and cancer, is a common health problem among the elderly. If swallowing difficulty is detected, healthcare professionals of the Hospital Authority (HA) will provide clinical assessment, treatment and counselling services for elderly persons with swallowing difficulty in order to prevent, reduce and overcome difficulties in swallowing, and to enhance the elderly's quality of life. HA's healthcare professionals also assess whether elderly persons have special dietary needs and provide recommendations on the appropriate modified food texture and liquid consistency. The Health Bureau and the HA do not maintain statistics on the number of persons with swallowing difficulty. To provide soft meals to elderly persons and persons with disabilities with swallowing difficulty, the Social Welfare Department (SWD) has, since October 2020 and October 2022 respectively, been providing additional resources to subsidised residential care service/community care service units for the elderly and for persons with disabilities, involving an annual recurrent expenditure of about $129 million. As at end-December 2022, about 12 700 elderly persons and about 3 600 persons with disabilities benefitted from the abovementioned soft meal services. In addition, the Government allocated $1 billion in December 2018 to set up the Innovation and Technology Fund for Application in Elderly and Rehabilitation Care (the Fund) to subsidise eligible elderly and rehabilitation service units to procure, rent or trial use technology products. Eligible service units could apply for the Fund to procure equipment, tool or technology product for the production of soft meals, e.g. puree diet system machine and cutter/mixer for soft diet. Thus far, a total of $4.2 million has been granted to 116 service units for the procurement of the above products. (4) The HA has, since the third quarter of 2021, adopted the categorisation methods suitable for dysphasic patient under the International Dysphagia Diet Standardisation Initiative (IDDSI)'s standardised dietary framework (known as the IDDSI framework) and taught carers to assist patients in consuming the appropriate foods and drinks in accordance with the guidelines. When subsidised elderly and rehabilitation service units formulate individual care plans for elderly persons and persons with disabilities, social workers and healthcare professionals will, through a multi-disciplinary approach, assess the physical conditions and care needs of service users with swallowing difficulty and provide them with soft meals and other services that suit their needs.