The Development of a Transformative Practice Model in Hong Kong: A Case Study on Engagement, Empowerment and Sustainable Community Change

Purpose: As society ages, the proportion of unengaged old people increases. Over 10% of the old people in Hong Kong have disengaged themselves from the community.  It is therefore not surprising to find old people died at home without being noticed.  Unengagement means total withdrawal from the community.  More often than not, unengaged people are depressed, malnourished, vulnerable and suspicious.  Their health is deteriorating faster than normal and they are frequently escorted by their family members or neighbours to the emergency room.  Many local NGOs and government agencies have attempted to address the problem. 

Methods: This paper reports an initiative that was designed and implemented by a local university to locate, engage and empower the unengaged old people and transform the practices in the community to assist this vulnerable group. The initiative initially covered two districts and has gradually expanded to four more districts where a higher percentage of unengaged old people (>20%) lived. The research team worked closely with an enthusiastic NGO, sharing skills so that they could provide the service autonomously.  The team then moved on to a new district.  As every district is different, the team adopted an action research approach to ensure the strengths and weakness of their potential clients and the community were identified, and training in the intervention provided according to need.

Results: At present, an NGO in one district has taken over the initiative from the team and begun to work independently with its local clients but in another district, the community partner did not have the resources to do so.  Evaluation is ongoing and analysis from these two districts suggests that external factors like staff turn-over, funding and manpower strength could account for the difference.  

Conclusion: The findings show the importance of nurses working knowingly to enable communities to transform their practices.