The silver bullet

HK's rapidly graying population has spawned a profession catering to the particular needs of the elderly. The emergence of medical escorts is in line with the SAR government's push to develop the silver economy to help residents in their sunset years. Li Xiaoyun reports from Hong Kong.

Ho Wai-kuen, in her 50s, relishes her role as a medical escort, having accompanied three patients each week on average to medical appointments, as Hong Kong's aging population fuels growth of the silver economy.

Accompanying patients to hospitals, helping them to make payments, collecting medicines and test reports, and escorting them home are the core of what a medical escort does. More importantly, the escorts often go beyond their medical responsibilities - they offer clients emotional support and serve as their long-term companions.

The services of medical escorts are beneficial to people over 50 who live alone and have health issues, especially in Hong Kong, which has one of the world's oldest populations. According to the city's Census and Statistics Department, there were 1.45 million elderly people aged 65 and above in 2021, accounting for 20.5 percent of the city's population.

Aging poses critical challenges to the community in providing sound care for the elderly. According to the department, for every 20 people employed in the city, nine children and elderly people were supported on average in 2021, and the number of dependents is projected to climb to 15 by 2046.

Demographic changes have led to rising demand for medical and healthcare services in Hong Kong, creating more opportunities for various professions in the industry, such as medical escorts.

Most of Ho's clients are seniors, who often doubt the value of life due to their advanced age and deteriorating health. Aggravated by the agony and stress of living alone and having to rely on foreign domestic workers who can hardly speak Cantonese, they often struggle to overcome loneliness and emotional distress. Ho says an essential part of her role is being a good listener for the elderly and providing them encouragement.

Ho recalls that, on one occasion, after accompanying an elderly woman to see her doctor, the client insisted on having lunch with Ho to allow them to continue their conversation.

Besides the passion for and dedication to the job, medical escorts need professional qualifications although the entry requirements are much lower than those required for doctors and nurses.

"Those who are untrained shouldn't be medical escorts," advises Ho, saying that professional training is necessary. While working as an occupational therapy assistant and medical escort in 2021, she found that the swelling on an elderly man's foot had worsened when she went to his home. She then made an assessment of the client's physical and mental state before proceeding with the planned therapy.

The man subsequently suffered a fall in the restroom and was unable to get up despite attempts by Ho and his wife to help. Ho prioritized a test of the client's vital signs including temperature and blood pressure to rule out any signs of a stroke or other acute diseases, while reporting the emergency to her company.

With the patient's wife at a loss and his son out of touch, Ho made the decision to call an ambulance based on her medical knowledge, and accompanied the aged couple in the hospital's emergency room for more than four hours until 9 pm when the patient was finally admitted to a ward.

Call to set standards

Although Ho possesses a basic understanding of nursing after having worked as a nurse in a clinic, she completed a 116-hour training course at an authorized training institution appointed by the Employees Retraining Board, and received the Foundation Certificate in Escort Service for Out-patient Visit Training issued by the organization.

Ho says the government should regularize training programs for medical escorts, ensuring they're kept up to date with developments in the industry, such as the latest techniques used in elderly care, and the implementation of smart healthcare solutions in hospitals.

Cissy Yu, founder and CEO of Supreme Care - a nursing and rehabilitation service provider in Hong Kong - says to qualify as a medical escort, one must acquire basic nursing knowledge and medical literacy, including skills like measuring blood pressure and blood oxygen, interpreting health indicators, and helping bedridden elderly people onto wheelchairs. They're also required to learn how to care for seniors who have suffered a stroke, or have cognitive impairment or diabetes.

"The 116-hour training isn't long, given the extensive knowledge medical escorts need to become proficient in their role," says Yu, who's also a fellow of the Hong Kong Academy of Medicine. Good medical escorts should also speak slowly, face the elderly within an arm's length and use simple language in communicating with the elderly.

However, the profession remains largely unregulated. Besides the ERB, there are private entities offering training programs for medical escorts, but their standards are difficult to ascertain. Yu wants a collaborative approach by all stakeholders to set standards for such services, and develop a structured career pathway for professional medical escorts.

A medical escort's average hourly wage is between HK$90 ($11.50) and HK$100, with the rate going up to HK$110 in emergency cases, according to Yu. Most medical escorts find the pay scale satisfactory as their decision to join the profession is motivated by their passion and interest in making a difference to the lives of senior citizens, coupled with the job's flexibility that enables them to strike a balance between work and family.

"They love to be caring, and they love to look after people. When you empower them with the skills and knowledge, they blossom, and will get a lot of satisfaction in getting the job done properly," says Yu.

Yu's company employs about 800 part-time medical escorts, and the number is expected to grow as the demand from an aging population increases.

Amid the graying demographic landscape, Chief Executive John Lee Ka-chiu's second Policy Address in October proposed tapping into the business potential of the silver economy, and setting up an advisory panel next year. The aim is to cater to the needs of senior citizens for products and services in medical and healthcare, as well as home and personal care.

Besides government involvement, more work needs to be done.

Cheuk Wing-hing, deputy chief secretary for administration, says private service providers must join the campaign to give the elderly a better deal by offering them self-financed community care services and high-quality residential care homes.

Contact the writer at irisli@chinadailyhk.com