Listen to #Hashtag Hong Kong every Sunday morning at 8.15
Focusing on issues affecting civil society, we'll hear from representatives of NGOs, associations, statutory bodies, and non-profit groups.
(Sundays 8.15am - 8.25am)
Hello everyone. Today, I’d like to talk about something that affects far more people than we might imagine, yet often goes unnoticed— and that’s dysphagia, or difficulty swallowing.
I want to begin with a real-life story: A few years ago, I met Mrs Cheung, a devoted daughter taking care of her elderly mother. At first, her mother coughed occasionally during meals. It didn’t seem serious, and her family thought it was partly related to aging. However, everything changed during the COVID-19 pandemic. After being infected, her mother’s ability to swallow deteriorated rapidly. She could no longer handle her usual meals, not even congee.
For Mrs. Cheung, each mealtime turned into a source of anxiety. She watched her mother lose weight, strength, and happiness, while every choking incident filled the family with dread. She expressed feeling helpless, caught between the need to safeguard her mother from the dangers of eating and the pain of watching her struggle with something as basic as eating. For many caregivers, this emotional burden is as heavy as the practical challenges they face.
This is not just a story; it’s real life, and it may resonate with many people because dysphagia happens more often than we realise.
Dysphagia simply means difficulty swallowing, but behind this simple term are complex causes. Swallowing actually involves over 30 muscles and several coordinated steps—from the mouth, to the throat, to the esophagus. When any part of this system is weakened or damaged, swallowing can become unsafe.
There are many possible causes. This includes neurological conditions such as stroke, dementia, or Parkinson’s disease, head-and-neck cancers, age-related weakening of muscles, or structural issues such as narrowing of the esophagus.
Symptoms of dysphagia can vary widely. Some individuals may cough or choke during meals, while others feel as though food is “stuck” in their throats. Many silently lose weight or become dehydrated because eating becomes stressful or exhausting. If untreated, dysphagia can lead to serious complications, including pneumonia, malnutrition, and repeated hospitalizations.
Speech therapists play a vital role in both diagnosing and treating this condition. Depending on the underlying cause, therapy may include strengthening exercises, postural adjustments, or modifications to the texture of food and drinks. For many individuals, safe eating begins with simple yet essential adaptations—like opting for softer, smoother, and easier-to-swallow foods.
In Hong Kong, dysphagia is becoming increasingly prevalent. Our population is aging rapidly, with census projections indicating that one in three residents will be 65 or older by 2036. As we live longer, more people will face swallowing difficulties at some point. This issue extends beyond medical concerns; it impacts families, caregivers, and the social systems that support them.
To ensure that older adults, individuals with disabilities, and patients recovering from illnesses can thrive, we must prioritize their ability to eat well. Eating is not just about nutrition; it embodies dignity, pleasure, and connection.
This is where Care Food comes into play.
Care Food is more than just “soft food” or blended meals; it’s thoughtfully designed to meet various swallowing abilities while remaining nutritious, visually appealing, and culturally familiar. Adhering to the IDDSI international standards, Care Food clarifies how soft or thick a food item should be to ensure safety for those with dysphagia.
However, Care Food goes beyond safety. It aims to restore confidence, dignity, and the joy of sharing meals. Rather than unappealing mush, Care Food dishes can be colorful, well-presented, and resemble the original ingredients—ranging from vegetables to dim sum. For someone with dysphagia, being able to enjoy a meal with family again has a profound emotional impact.
At the Hong Kong Council of Social Service, we recognized early on that dysphagia presents a growing challenge, making community-based solutions essential. Since 2017, we’ve been leading the development of Hong Kong’s Care Food ecosystem.
We collaborate with NGOs that support older adults and individuals with disabilities, speech therapists and healthcare professionals. We also work with restaurants and food suppliers, and government departments.
We develop standards, training programs, and public education campaigns, collaborating across sectors. Over 240 restaurants now offer Care Food menus, enabling worry-free dining for families. Our community program teaches caregivers—family members and domestic helpers alike—how to prepare safe and tasty meals at home, supported by a Care Food website with free learning videos. These efforts are transforming how Hong Kong addresses swallowing difficulties, and we are dedicated to making safe and enjoyable eating accessible to everyone.
Now, returning to the real-life story of Mrs. Cheung’s mother - after transitioning to Care Food under the guidance of her speech therapist, her mother’s appetite gradually returned. Meals became safer, more calming, and enjoyable. She regained strength and, most importantly, could again sit at the table and share meals with her family.
For Mrs. Cheung, this was a turning point. “Care Food gave us our mealtime back,” she said. “It restored my mother’s dignity, and it gives us hope.”
If you or a loved one is facing chewing or swallowing difficulties, know that you are not alone and support is available. Speak to a speech therapist or visit the HKCSS Care Food website to learn more about dysphagia and how Care Food can assist you.
Good morning everyone. Recently, I was referred to a case involving an 8-year-old girl whose father had tragically passed away in an industrial accident. Her mother was concerned about her daughter’s excessive internet use, spending over five hours per night watching Chinese dramas. Her exam result was poor and stopped talking to her mother.
When I first met her, she kept silent, avoiding eye contact and mumbling as if she felt guilty. Gradually as we built mutual trust, she began sharing dramas she watched with me, which mostly focused on family topics. These dramas were actually helping her to cope with the loss of her father and the absence of the father and daughter relationship.
Expressive art therapy was applied to her case. By drawing and painting, she found ways to express her emotions and dealt with the memories she wished she could have shared with her father. She even drew herself holding hands with her father at a park, a memory she cherished deeply. As she released her repressed grief, she became less rely on the internet and began developing healthier coping mechanisms.
While tools like time limits and internet restrictions help manage screen time, they are addressing behaviours but not the root cause. The root causes, such as unresolved grief or emotional struggles, must be identified and addressed. For this girl, her internet use was a way to cope with shattering loss.
This case indeed reflects a broader issue in Hong Kong. A recent study on Internet Gaming Disorder (IGD) revealed that 11.8% of around 4,300 students surveyed showed signs of IGD, with 27.7% spending four or more hours daily on online games. Excessive internet use can lead to negative consequences such as poor eyesight, abnormal bone development, obesity, memory loss, and difficulty concentrating. However, one of the most alarming effects is the strain it placed on family relationships, which often leads to conflicts and communication breakdowns.
Parents often worry about their children’s gaming habits, citing deterioration in academic performance, loss of interest in hobbies, and an inability to disconnect from their devices, even during meals. While "time-limiting" tools and device monitoring help regulate behaviour, these solutions cannot address the deeper needs driving excessive gaming. According to Glasser’s theory, all humans have five basic needs which are survival, power, love and belonging, freedom, and fun. For Hong Kong students, academic success or sports performance often fulfills the need for power and satisfaction. However, the city's competitive and high-pressure studying environment make it difficult for students to meet these needs. As a result, they would rather turn to video games, where effort is rewarded with rankings, badges, and achievements, providing a sense of power and satisfaction.
Furthermore, gaming offers a sense of belonging. Many students team up with classmates or online friends to play games, forming communities where they feel accepted and included. These emotional needs—such as love, belonging, and accomplishment—are often missing in the real life, thus they turn to gaming in order to escape from the real life.
Before addressing gaming addiction, it is crucial to understand the underlying needs and tackle the root causes. Family plays a key role in the intervening process. Establishing clear rules and boundaries early on, negotiating screen time, and ensuring children balance their time between studying, resting, and family interactions are essential steps. Encouraging diverse interests like sports, arts, and social activities can also help students build a support system and reduce their reliance on gaming. Fostering open communication in the family, where children feel that their feeling is being heard and understood, is of equal importance.
Schools can also contribute by boosting awareness and understanding of online gaming addiction. Educational programs on internet safety and gaming risks can equip students with knowledge and self-management skills to prevent addiction.
While the challenges of managing excessive internet use and gaming addiction may seem daunting, they are not unconquerable. By addressing the emotional and developmental needs behind these behaviours, families, schools, and the community can work together to help children build a healthier habit. These efforts take time, patience, and understanding, but they pave ways to a brighter future where children feel supported, balanced, and emotionally fulfilled.
Our service, “Net” Education and Counselling Service of Hong Kong Family Welfare Society provides a WhatsApp messaging and hotline for enquiring any concerns like Internet addiction, online dating and so on, feel free to contact us at 5592 7474.
