Caregiver Policy and Practice in Hong Kong: Past, Present, and Future

Hong Kong’s ageing population, with over 20% of residents aged 65 and older by 2024, has intensified the demand for robust caregiver support policies and services to sustain “ageing in place”. This policy review examines the evolution of informal caregiver policies and practices for frail older adults in Hong Kong, analyzing historical, current, and future dimensions through Bronfenbrenner’s (1983) ecological systems theory. Pre-2020 services were fragmented across microsystem (family strain), mesosystem (service gaps), and macrosystem (residual funding) levels, rooted in filial piety norms with limited accessibility. Post-2020 reforms, informed by the 2022 Consultancy Study, have solidified support through regularized caregiver allowances, expanded respite services and community care vouchers, with social workers fostering stakeholder collaboration and bridging ecological levels. The review reveals Hong Kong’s first systematic ecological analysis of policy evolution, identifying cross-level causal pathways (e.g., pre-2020 macrosystem funding failures due to mesosystem deficits) and international LTC financing gaps (Japan, Germany, Singapore). Future directions propose integrated strategies: assistive technologies, caregiver-friendly workplaces, longitudinal research databases, workforce upskilling, and medical-health-social data platforms. By highlighting social work’s pivotal role in bridging micro-, meso-, and macro-level systems, this review offers insights for policymakers and practitioners a roadmap for a sustainable, equitable caregiving aligned with Hong Kong’s ageing society.