More than 80 per cent of caregivers who look after the elderly in Hong Kong indicated signs of depression during the fifth and deadliest wave of Covid-19 in the city to date, a survey has found.

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An elderly and her caretaker photographed outside the Prince of Wales Hospital in Sha Tin. File photo: Hillary Leung/HKFP.

Hong Kong Christian Service on Tuesday announced the findings of an online questionnaire conducted between April 11 and 22. They asked people who looked after seniors to indicate the state of their mental health as the city’s daily Covid-19 caseload and related deaths declined after peaking in March.

Among the 287 valid responses collected, 85.1 per cent said they had mild to serious symptoms of depression. Close to 10 per cent of the respondents said they thought they “would be better off dead,” or had considered self-harm.

The organisation used the government’s Patient Health Questionnaire in the study, a list of nine questions that screen for depression.

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Caritas Medical Centre in Sham Shui Po, Hong Kong during the fifth-wave Covid-19 outbreak. Photo: Kyle Lam/HKFP.

Hong Kong registered tens of thousands of daily Covid-19 infections between late February to late March it struggled to curb the spread of the virus. As of Monday, 9,148 Covid-19 patients died in the fifth wave. Among them, close to 70 per cent were unvaccinated individuals aged 60 or above.

Among the caregivers surveyed, 76 per cent had to look after one elderly person, while 24 per cent had to care for two to four seniors. Asked to list out the challenges they faced during the pandemic, more than half said they had “inadequate knowledge” about the quarantine arrangement, followed by 45.6 per cent indicating they lacked the “correct medical information.”

Made with Flourish

The closure of some daytime care homes and the suspension of certain caregiving services failed to alleviate the burden on these carers, the Hong Kong Christian Service said. Social distancing measures imposed on specific premises also “reduced the personal time” of caregivers, who were under “immense stress,” the group added.

Around 21 per cent of the respondents were aged 65 or above, which represented the case of “elderly people taking care of elderly,” the organisation said. Close to half of the people surveyed had a full time job and around 12 per cent worked part-time. The rest were retirees or full-time caretakers.

The group cited the case of a woman surnamed Mak, 86, who was responsible for taking care of her 96-year-old husband with visual impairment. The caretaker said she was “very helpless” when her husband came down with Covid-19 in late February, as the health authorities did not follow up on his positive rapid test result.

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Government staff hand out supplies to residents under lockdown. Photo: GovHK.

She suffered from insomnia and was worried that she would become infected as well, Mak recalled. The family eventually received anti-epidemic supplies from various social welfare organisations.

Another case involved Mr Chan, 79, who cared for his wife of the same age with dementia. Both of them tested positive for Covid-19 in mid-March, and Chan had concerns over using traditional Chinese medicine together with his wife’s dementia medication.

The temporary shutdown of daytime elderly carehomes also meant Chan’s wife had to spend long hours at home, with Chan tending to her around-the-clock.

“Sometimes my wife doesn’t even recognise me and she would drive me away. She also refuses to sleep sometimes, then I can’t sleep too,” Chan said.

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Elderly people photographed in a park in Hong Kong. File photo: GovHK.

The NGO urged the government to coordinate district groups including community service units and housing estate offices to distribute anti-epidemic supplies and daily necessities to those infected.

The authorities should improve the central hotline system to cater to enquiries from social welfare groups, the NGO said, while priority should be given to the elderly and sick when making medical treatment and isolation arrangement.

The group also reminded carers to be aware of their mental health, saying the panic and unease they experienced during the fifth wave may “produce different extents of psychological stress.”

“The government can consider setting aside more resources to establish or subsidise some post-pandemic emotional support services, to rebuild the mental health of the citizens,” Bonnie Cheung, coordinator of the NGO’s Active Ageing and Community Care Service, said.

If you are experiencing negative feelings, please call: The Samaritans 2896 0000 (24-hour, multilingual), Suicide Prevention Centre 2382 0000 or the Social Welfare Department 2343 2255. The Hong Kong Society of Counselling and Psychology provides a WhatsApp hotline in English and Chinese: 6218 1084.

See also: HKFP’s comprehensive guide to mental health services in Hong Kong

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Ho Long Sze Kelly is a Hong Kong-based journalist covering politics, criminal justice, human rights, social welfare and education. As a Senior Reporter at Hong Kong Free Press, she has covered the aftermath of the 2019 extradition bill protests and the Covid-19 pandemic extensively, as well as documented the transformation of her home city under the Beijing-imposed national security law.

Kelly has a bachelor's degree in Journalism from the University of Hong Kong, with a second major in Politics and Public Administration. Prior to joining HKFP in 2020, she was on the frontlines covering the 2019 citywide unrest for South China Morning Post’s Young Post. She also covered sports and youth-related issues.