Hong Kong elderly killing each other in care homes: more needed to prevent fatal clashes, experts say

“The elderly have to share the living space in a care home, but they could have very different habits which are well-established, and not easy to change,” she explained.

“When they cannot come to terms with each other, for example, on which TV channel to watch, conflicts can arise.”

She added elderly people’s emotions could also be affected by medical conditions and difficulties with their families.

Lau said regular visits from family members helped to stabilise the mental state of residents.

She added, if disputes did arise, staff would separate the people involved, assess their emotional state and tried to help them reconcile. Staff members would also follow up with them from time to time.

“If necessary, we may need to separate them further by swapping beds, but we may not always have spare beds,” Lau said.

“Each elderly person also has different needs for bed locations. Some have mobility issues and need to stay close to public facilities.”

She said staff focused on risk prevention, including group activities to help residents bond with each other. Regular outings were also organised to improve their mental well-being, but Lau admitted that could stretch resources.

Concerns were raised after a 93-year-old woman in a Kwai Chung care home was arrested on suspicion of manslaughter two weeks ago. It is alleged she used her walking frame to bump into another resident, 94, knocking her over. The woman died later in hospital.

A Post survey of news stories over the past decade found at least 10 people in care homes for the elderly had died after confrontations that were later ruled to be murder or manslaughter, as well as several cases of assault.

Hongkonger, 93, arrested after woman, 94, allegedly bumped with Zimmer dies

A 75-year-old man was arrested for allegedly killing another elderly man in a fight at a care home in Tai Kok Tsui in March.

An 85-year-old bedbound man with dementia was allegedly assaulted with a pair of scissors in 2021 by a 70-year-old man, who had Parkinson’s disease and delusional disorder. The suspect was charged with murder.

An 87-year-old man with dementia attacked two bedridden residents in a Tseung Kwan O care home in 2016, leaving one dead and one with severe injuries.

The care home sector has suffered staff shortages as the percentage of the Hong Kong population classed as elderly continues to rise.

Grace Li Fai, an executive committee member of the Elderly Services Association of Hong Kong, said it was important to carry out thorough admission assessments and separate elderly people with dementia in different rooms to avoid conflict.

“But if a resident continues to harm others, despite all our efforts, the operator should persuade the family members to take them home,” she said.

Li added efforts were also needed to revamp the structure of the labour import scheme, which was launched in June and has already had more than 370 applications to bring in 2,000 care workers, less than half of which were granted approval.

“The staff are directly linked to elderly safety and quality of care,” she said. “Instead of first come, first served, those with expiring employment contracts should be given priority … otherwise, a serious manpower gap will appear.”

Li said more social workers and healthcare specialists, who had an important role in monitoring the well-being of seniors through check-ups and activity groups, were also needed.

Man, 75, arrested for allegedly killing resident, 74, at Hong Kong care home

Andrew Lau On-chun, a social service officer at the Hong Kong Chinese Christian Churches Union Kwong Yum Care Home, said one of the best methods of conflict reduction was to keep track of changes in the physical and mental condition of residents and make appropriate adjustments to care.

“But care workers may not be able to spot everything, so it’s important to build a good relationship with residents, and encourage them to open up about their feelings and needs,” he said. “And we do not take any side or make judgments … that’s how trust can be built.”

He added, however, that when all non-medical avenues had been exhausted, staff would seek help from doctors with family consent.

Dr Donald Li Kwok-tung, the chairman of the Elderly Commission, said he hoped society could reduce reliance on care homes in the future, use community resources to ease stress on carers and support “ageing at home”.

“For example, the elderly could spend their day at community centres, where they engage in social activities, and in the evening they could go home and spend time with their children … this could lessen the burden on families,” he said.

Kwok added that care homes could also make use of community resources.

“It’s easy for one to feel grumpy when stuck in the same place the whole day. The staff could take residents to places like daytime centres and district health centres, where they could take a breath, join some activities, and find social networks,” he said.

Social welfare lawmaker Tik Chi-yuen agreed more was needed to take some of the weight off carers, especially mental health support.

He said he believed more elderly people would in the future opt to “age in place” in familiar surroundings rather than institutions.

Additional reporting by Jeffie Lam and Willa Wu