Hong Kong has a universal public long-term care system mainly implemented by the Social Welfare Department and various NGOs. Long-term care services cover both community and residential care for older adults with proven needs under a standardised care need assessment mechanism. Facing the ageing population, the Government aims to promote “ageing-in-place” that encourages older adults to age at home rather than being institutionalised by strengthening its provision of community care services in the recent years. However, the LTC system is being criticised for its long waiting time for subsidised services, the unbalance of resources for residential over community care, and the heavy reliance on the Government’s finance. Partly owing to the insufficient capacity of the community care, many older adults have chosen to enter residential care homes for their late life, resulting in high institutionalisation rate compared with other developed countries.

The Government of Jamaica operates 16 long-term care facilities referred to as infirmaries which provide housing, physical and mental health care to those 18 years and older who are unable to care for themselves. However, the infrastructure and staff capacity to meet the needs of all those eligible is limited. As a result, long-term care is provided primarily by the private sector through nursing homes which are governed by a regulatory body. Unfortunately, most of these homes are unregistered and, therefore, unregulated. Moreover, these residential homes or care home placement and overall long-term care, tend to be costly and are not covered by public or private insurance, thus creating barriers to accessibility. As such, care is usually provided by unpaid carers such as family members, friends and neighbours who are typically unskilled in dementia care and management.