Macau facing an increasing shortage of care facilities for the elderly

The SAR is facing an increasing shortfall of elderly care spaces, despite government plans to expand capacity in the coming years.

Government data indicates that as of 2021, there were 2,510 residential care beds in the city. This number had remained unchanged for several years, likely due to the impact of the Covid-19 pandemic.

To address the growing demand, the government has announced plans to add 200 beds in the short term and an additional 900 beds in Zone A by 2028, bringing the total number of beds to 3,600.

However, projections based on past studies suggest this may not be sufficient to meet Macau’s needs, according to an interpellation made by lawmaker Lo Choi In.

Previous research reports and government data have referenced an unofficial standard of 3.4%—meaning that for every 1,000 residents, 3.4 residential care beds should be available. Based on this benchmark, academics estimate that the city would require approximately 4,000 beds by 2026. Yet, even with the planned increase, the city is expected to face a shortfall of nearly 400 beds by 2028.

According to data from the Organization for Economic Co-operation and Development and the World Health Organization (WHO), the median standard for residential care beds in developed nations is 4.4% of the total population.

“If Macau were to align with this standard, it would need approximately 5,200 beds by 2026, far exceeding the government’s current expansion plans,” said Lo.

The 2021 Population Census conducted by the government further underscores the urgency of the situation, revealing that 5,226 elderly residents aged 65 and above are unable to care for themselves.

Challenges in expanding elderly care services

Many care homes in the SAR rely heavily on imported labor due to the strenuous nature of elderly care work. However, Lo warned that wage constraints and rising salary levels in mainland China are making it increasingly difficult to attract and retain foreign workers.

“Most care homes struggle to offer competitive salaries,” said Lo.

“This makes it hard to maintain a stable workforce, leading to high turnover rates and potential declines in service quality.”

Additionally, the government imposes limits on the ratio of foreign workers to local employees in care homes.

Lo explained that when local staff leave and cannot be quickly replaced, care facilities may struggle to maintain their workforce, creating a vicious cycle of understaffing and declining service quality.

Therefore, Lo urged the government to reassess its elderly care policies. Some have called for an expansion of private sector involvement in elderly care services.

“Neighboring regions have successfully leveraged private care facilities to complement public services, reducing government burdens while creating jobs,” said the lawmaker.

“Macau should consider optimizing land use and offering incentives to develop its private elderly care sector,” she added.

The lawmaker is also advocating for increased financial support for care homes.

She argued that given rising operational costs and inflation, the government should review and adjust the subsidies provided to residential care facilities to help them maintain quality services.