The Government promotes a home-based elderly care service, but community care services have been inadequate, and the successive home-saving accidents of elderly people living alone are even more distressing. As a result, many people, including members of the Legislative Council, have turned their attention to the field of technology, hoping to alleviate the plight of the elderly through gerontechnology products. However, what they advocate is only that the government subsidizes the elderly to buy more assistive equipment to adapt to technology products, ignoring that technology itself should have the basic function of ageing, otherwise it will only become a product of consumerism. In fact, what many elderly people need is not cutting-edge technology products, but that policymakers can put themselves in their shoes.

Policy Analysis Series on Members' Motions

Gerontechnology products are designed to facilitate the daily lives of the elderly. (Profile picture)

The Social Innovation Fund has set up 50 gerontechnology projects

According to the Census and Statistics Department, the proportion of elderly aged 65 and above in the total population will continue to rise from 2022.20% in 8, reaching 2039% in 31 and 2069.35% in 1. In other words, one out of every three Hong Kong people in the future will be an elder. The United Nations also predicts that Hong Kong will become the most ageing city in 100 among regions with a population of more than 2050 million. For those who govern Hong Kong, gerontechnology is a recipe for "population ageing". The Legislative Council debated and passed on Wednesday (5 May) the motion of the Election Committee Member Ng Kit Chuang and amended by the Construction and Testing Sector Tse Wai-chuen, and the Election Committee members Yan Kong, Shang Hailong, Tang Ka-biu and Ma Feng-kwok, etc., to urge the HKSAR Government to further promote the popularization of gerontechnology, enhance the quality of life of the elderly and reduce the burden on caregivers.

Gerontechnology is a combination of gerontology and technology, using big data and cloud technology to monitor the medical and health status of the elderly, and provide assistance in daily life and in times of danger, so as to improve the self-care ability of the elderly. Common gerontechnology products include wearable products such as smart watches, which are mainly used to monitor and record the health status of the elderly, such as heart rate, blood oxygen level and step count; assistive devices such as hearing aids, amplifiers and text readers make it easier for the elderly with hearing and vision loss to carry out their daily lives; Smart home devices such as smart lighting systems, smart door locks, and smart temperature control systems can make it easier for them to control various devices in their homes. In addition, there are telemedicine services, intelligent voice assistants, and more.

In recent years, the HKSAR Government has also developed gerontechnology, and the results have been mixed. The Secretary for Labour and Welfare, Ms Sui Yuk-han, said in her opening remarks on the motion that the Social Innovation and Entrepreneurship Development Fund set up by the Government has funded more than 50 projects that use technology to improve the lives of the elderly, such as a manipulator to help stroke patients enhance their home rehabilitation training and the establishment of an online soft meal ordering and delivery platform. However, during the debate on the motion, a number of MPs criticized the government's insufficient support for the application of Leji technology products. DAB Member of the South West New Territories directly elected MP Chan Heng-pan pointed out that there is a lack of co-ordination among various government departments and their practices are inconsistent; In addition, the relevant supporting policies are backward, and the application of gerontechnology cannot fully comply with the current guidelines of elderly service providers.

In recent years, the HKSAR Government has also developed gerontechnology, and the results have been mixed. The Secretary for Labour and Welfare, Ms Son Yuk-han, said that the Social Innovation and Entrepreneurship Development Fund set up by the Government has funded more than 50 projects that use technology to improve the lives of the elderly. (Photo by Ou Jiale)

Technology is widening the "digital divide" among the elderly

According to the results of the survey on gerontechnology among public housing households with elderly households released by the DAB Family Affairs Committee in January this year, 1% of the respondents said they had not heard of gerontechnology; In addition, 71% of respondents said that being too expensive was a major barrier to using gerontechnology products, 76% were worried that they would not use them after purchase, and 48% did not know how to buy them. In the face of the "information divide", many Members suggested that the Government expand the use of the Health Care Voucher and Community Care Service Voucher so that the elderly can purchase and rent gerontechnology products through the Healthcare Voucher, so as to reduce the pressure on the demand for medical services from chronic patients.

However, even if the elderly are able to purchase gerontechnology products, they may still encounter problems in practical use. Leung Mei-fan, a member of the Election Committee of the Democratic Alliance, said that some elderly people bought the whole house smart home system, but underestimated the sensitivity of smart facilities, and made a sound when they got up in the middle of the night to go to the bathroom, and the lights in the whole house were turned on. This is not an uncommon example, and it raises the question: don't gerontechnology products need to meet age-appropriate requirements? Why do they need to buy assistive facilities, improve their digital literacy and adapt to technology as much as possible?

In fact, while technology is regarded as a lifesaver for the elderly, it has also quietly widened the "digital divide" between the elderly and society. In a study, Avner Caspi, head of the Department of Education and Psychology at the Open University of Israel, asked 50 elderly people to answer how old they thought they were before and after using their tablets to book a hotel; The results showed that the average subjective age of the elderly increased from 65.48 years before using tablets to 84.16 years, and the change was more obvious for the elderly who were not familiar with the app, and their subjective age increased from an average of 62.97 years to 87.80 years.

For the elderly living alone, breaking through the digital divide under the epidemic is also a difficult problem. (Photo by Liu Mengting)

The experience of elderly needs is the core of the product

Neoliberalism tends to attribute the problem to underdevelopment and solve the problem through creation and consumption. However, rather than allowing the elderly to purchase additional assistive devices, the authorities must not ignore that ageing is the technological function of technology. If digital products are accessible, why should the elderly buy screen amplifiers or readers? Of course, not all gerontechnology products are new consumption created by insufficient technology "ageing", but we should not forget that the needs and experiences of the elderly are at the core of gerontechnology products. As Election Committee Member Tam Yue-hang pointed out during the debate, "The development of gerontechnology should be that technology is suitable for the elderly, not the other way around, and the elderly adapt to technology."

"Ageing" is not only the basic function of technology, but also the necessity of a civilized society. Many times the elderly do not need sophisticated technology products, but only a few small changes can improve their plight, which requires putting yourself in their shoes. For example, Jiangsu Road Street, Changning District, Shanghai, once installed a smart water meter for the elderly living alone: if the meter reads below 12.0 cubic meters within 01 hours, the system will automatically issue an early warning to the neighborhood committee. The technical difficulty and cost of this smart water meter are not large, and the difficulty in achieving it only lies in whether the administrator has the idea of caring for the elderly.

Sometimes what the elderly need is not even technology, but the infrastructure of daily life. When Ho Chi-sen, a lecturer at the School of Architecture of South China University of Technology, was conducting project research in Hong Kong in the early years, he accidentally discovered an interesting phenomenon in Yau Ma Tei: there are no chairs on many roads, but there are many elderly people with mobility problems who need to find a seat to rest after walking a few minutes, and they all collect their own "chair map" of Yau Ma Tei. The map shows the location of a variety of chairs, some of which were placed in front of the door, some of which were abandoned, and some of which were not real chairs, but just objects or city amenities to sit on. Where there are really no chairs, the old people will place a chair themselves and tie it with a lock. If our cities are not yet able to provide enough chairs for the elderly, the development of gerontechnology products may sound like a rush.

The old people's Yau Ma Tei "chair map" shows the location of various chairs, some of which were placed at the door by the shopkeeper, some of which were abandoned, and some of which were not real chairs, but just objects or urban facilities that could be sit. Where there are really no chairs, the old people will place a chair themselves and tie it with a lock. (Ho Chi Sum Mapping Workshop)

Elderly care services should enable the elderly to live with dignity

How to make gerontechnology more useful is also an idea that can be improved. According to foreign media reports, the United States is also facing problems such as low income, heavy tasks, and high work pressure for elderly service practitioners, and local elderly care institutions have been in the embarrassing situation of manpower shortage for many years. The problem is still that the product is not suitable for aging. Instead of forcing the elderly to learn to apply technology directly, we might as well think about how to use technology to reduce the burden on caregivers, such as installing some intelligent systems in the work equipment of caregivers to help them free themselves from trivial matters.

According to a survey by Cambia Health, a U.S. healthcare company, more than 60 percent of caregivers surveyed said they are using at least one technology product to assist with their work, and more than 40 percent agreed that using technology products can help them connect with medical professionals for real-time help more quickly. In contrast, there is much room for improvement in the use of technology by caregivers in Hong Kong. According to a study released last year by the advisory team of the Hong Kong Polytechnic University, only 37% of carers have experience using assistive technology, although most carers see assistive technology as an effective stress reduction tool.

As Ma Fengguo said in the amendment, "The government should use the Internet to build friendly and mutual aid communities for the elderly, strengthen the flow of information and promote the spirit of helping others to help themselves, so that the elderly can live in familiar communities with dignity." The purpose of elderly care services is not simply to prolong the life of the elderly, but to enable them to live their old age with dignity, which ultimately points to humanistic care, and technology is only an auxiliary means. Liberal Party Election Committee Member Lee Chun-keung said that even if we have been very successful in promoting gerontechnology, it is only an auxiliary tool and cannot replace the love and care between people, so everyone should put themselves in the shoes of the elderly in the family and take more time to chat with them. Tam also pointed out that gerontechnology products must be supported by sustainable services for them to function, for example, some smart products have the function of health detection, but the most important thing is to get a rapid, effective and offline response when the elderly are in need.

The social enterprise "Ginkgo Pavilion" posted an online article to share a social tragedy incident, a famous uncle has rented a panel room for more than 10 years, because "at least someone here has someone to talk to me", which makes the listener sad. ("Ginkgo Hall" FB photo)

Particular attention needs to be paid to the loneliness of the elderly

So, what exactly do elders need? The social enterprise "Ginkgo Pavilion" once shared a social tragedy incident in an online post: when staff and volunteers visited the residents of the panel house in Tai Kok Tsui, they met an uncle who claimed to have been renting the panel house for more than 10 years, and he did not apply for public housing because "at least someone here can talk to me". Uncle's heartfelt words remind society of the neglect of the emotional health of the elderly, and loneliness is a problem that often accompanies them. According to a telephone survey published by City University of Hong Kong in June last year, during the fifth wave of the pandemic, the loneliness of the elderly increased significantly due to prolonged isolation and lack of community support, and the door-to-door chronic disease management programmes of social welfare institutions helped to reduce their loneliness.

According to a study by the IBM Institute for Business Value, loneliness in the elderly is almost always caused by some form of "loss", whether at the personal or social level. Not only do they "lose" their healthy bodies, but they also develop a sense of social isolation that increases with visual and hearing impairments, mobility problems, and aging of friends. The Dutch government has developed a "fight loneliness" plan for the aging population, and the Dutch supermarket chain Jumbo has launched a "chat checkout" counter, so that the slower elderly do not need to be troubled when checking out and packing things, do not have to worry about being impatiently urged by other customers at the back of the line, and can chat with the cashier for a few homely words.

I believe that such a demand is not a problem that can be solved simply by the government to strengthen the promotion of gerontechnology.