As societies continue to age, there is an increasing focus on the quality of life for older adults. This paper explores Adult Foster Care (AFC) as a viable alternative to residential or institutional care. It emphasizes active ageing and ageing in place by enabling older adults to live in a home-like environment. A case example from Finland illustrates the practice of the AFC. Adaptation of AFC to Hong Kong is discussed in the cultural and societal context.
Understanding Adult Foster Care
Adult Foster Care provides a home-like environment for older adults who require assistance but do not need intensive medical care. Care is typically provided by trained caregivers, not necessarily health care professionals, or family members within a residential home setting. This can be the carers’ home, the older person(s)’ home, or a specially established home where carers and older people live as a family. It offers an alternative for individuals who may require assistance with daily activities but do not need continuous medical care. (Leinonen and Kuukkanen,2020.) It promotes the ageing-in-place philosophy, allowing older adults to maintain independence and autonomy in a familiar living environment. The concept of healthy ageing underscores the importance of physical, mental, and social well-being, while active ageing focuses on optimizing opportunities for health and participation. AFC facilitates and supports healthy and active ageing and ageing in place naturally and organically. (Leinonen. 2020).
Adult Foster Care homes are suited for individuals who can manage daily activities but require some assistance. The Finnish model emphasizes strong family networks, training for caregivers, and established guidelines to ensure quality care.
Adult foster care provides individualized attention tailored to the specific needs and preferences of each resident. This personalized approach allows caregivers to build strong relationships with older adults, enhancing their emotional well-being.
The home-like environment engages the residents in normal daily activities depending on their abilities. It facilitates communication and collaboration between the carers and residents. They typically include a mix of caregivers and family members, fostering intergenerational living dynamics and interactions.
The Need for Adult Foster Care
The demand for and cost of care for older people is rapidly rising globally due to the growing population of older adults. This demographic shift increases the demand for various care options, including adult foster care. Many older adults prefer to live in a home-like environment rather than institutional settings. AFC arises from the desire to support older adults living full lives within the family environment. This model is characterized by small residential settings, typically housing 1-5 residents, where caregivers provide around-the-clock support. Such environments foster close relationships and social integration, thereby enhancing mental well-being and reducing feelings of loneliness.
Comparison with Other Care Models
Adult Foster Care differs significantly from assisted living and nursing homes. Assisted living facilities accommodate more residents and may lack the homelike atmosphere, and nursing homes focus on skilled nursing and medical care, resembling hospital settings. In contrast, AFC allows older adults to live in single-family homes, creating a more personal and nurturing environment.
| ASF | Assisted Living | Nursing/care home |
| – Offer some assistance with daily living needs – Residential, homelike – Limited to 1-5 residents. – Caregivers available 24/7 – Caregivers are residents living in the home – Consistency, stability | – Offer some assistance with daily living needs – A larger number of residents. – Caregivers available 24/7 – Caregivers awake on duty, do not live in the home | – Provide skilled nursing and medical care – More like a hospital – Professionals in 24/7 shift duty – Constant change |
Characteristics of Adult Foster Care Homes
Adult Foster Care homes are suited for individuals who can manage daily activities but require some assistance. They typically include a mix of caregivers and family members, fostering intergenerational living dynamics. The Finnish model emphasizes strong family networks, training for caregivers, and established guidelines to ensure quality care.
Adult foster care provides individualized attention tailored to the specific needs and preferences of each resident. This personalized approach allows caregivers to build strong relationships with older adults, enhancing their emotional well-being.
This model not only saves financial resources but also promotes a healthier, happier lifestyle for older adults who remain active participants in family life.
Challenges and Adaptation
Despite its advantages, Adult Foster Care faces challenges, including the recruitment and retention of caregivers and ensuring financial sustainability. Cultural considerations and economic factors also play a critical role in adapting this model to different contexts, such as Hong Kong. Policymakers must consider local values and family dynamics when implementing AFC.
| Finland | Hong Kong | |
| Population | 5.5 million | 7.5 million |
| Older Population (65+) | 1.5 million (27%) | 1.3 million (17%) |
| Land Size | 338,455 km² | 1,106 km² |
| Population Density (people/km²) | 16.25 | 6,775.43 |
AFC Adaptation to Hong Kong
Cultural Considerations: Understanding local values and family dynamics.
Economic Factors: Financial viability in a densely populated city with small-size and expensive housing.
Policy Framework: Aligning AFC with existing healthcare policies in Hong Kong.
The Hong Kong Chief Executive (President/ Prime Minister) in his 2023 Policy address set a task “The Government will continue to strengthen elderly services according to the principle of ”ageing in place as the core, with institutional care as back-up”. (The HK Chief Executive’s Policy Address 2023).
Policy Recommendations
– Advocating for pilot programs in collaboration with the Greater Bay Area
– Engaging stakeholders in discussions about best practices.
– Housing policies
Research Needs
– Further studies to evaluate the efficacy of AFC in Hong Kong and other cultures and economics.
Key Takeaway
– AFC can enhance the quality of life for older adults.
– Importance of community and social integration.
– Policies must reflect local cultural and economic realities.
– Essential to consider innovative care models.
– AFC in Finland may offer valuable insights for Hong Kong.
– A more inclusive and supportive environment for aging populations.
– Engage with local communities and policymakers to explore AFC adoption.
Conclusion
In conclusion, Adult Foster Care presents a promising approach to enhancing the quality of life for older adults. The Finnish experience provides valuable insights for other regions, including Hong Kong, where innovative care models are essential. By fostering community engagement and understanding local needs, Adult Foster Care can facilitate active and healthy aging in place.
Author:
Raija Kuisma, professor, Saint Francis University Hong Kong (formerly Principal Lecturer, Karelia University of Applied Sciences).
References:
Leinonen E. Time to care? Temporal variations of agency of the Finnish adult foster carers. 2020. J Aging Stud. Mar;52:100830. doi: 10.1016/j.jaging.2019.100830. Epub 2019 Dec 26. PMID: 32178800.
Leinonen, R. and Kuukkanen, M. (2020) Adult foster care of older people, International Journal of Care and Caring, 4(3): 441–446, DOI: 10.1332/239788220X15864994310333