What eldercare duties can a domestic helper perform in Hong Kong?

Overview

Many Hong Kong households employ a domestic helper specifically to assist with an elderly parent or grandparent who needs daily support. The Standard Employment Contract (ID407) covers "domestic duties" broadly — it does not exhaustively list every task. This creates a practical question for employers: what can you reasonably ask a helper to do for an elderly person, and where does domestic care end and medical or nursing care begin?

What a Domestic Helper Can Do — Eldercare Tasks Within Scope

The following tasks are generally within the scope of domestic helper duties, provided the helper is comfortable performing them and they have been discussed at the time of hire:

Personal hygiene and daily care:

• Bathing, showering, or sponge-bathing
• Dressing and undressing, including managing buttons, zippers, or compression stockings
• Oral hygiene (brushing teeth, denture care)
• Hair washing and grooming
• Incontinence management — changing adult diapers and maintaining hygiene
• Skin care — applying moisturiser, monitoring for pressure sores (though treatment of sores requires medical involvement)

Mobility and physical support:

• Assisting with transfers (from bed to chair, chair to toilet) using proper technique
• Accompanying to the bathroom and monitoring safety
• Light exercise or walking support as directed by a physiotherapist
• Wheelchair assistance

Nutrition and medication:

• Preparing meals suited to dietary or swallowing requirements
• Feeding assistance for those who cannot eat independently
• Medication reminders — reminding the elder to take prescribed medication at the right time
• Handing medication — taking pre-dispensed medication from a pill organiser and giving it to the elder
• Monitoring fluid intake

Companionship and cognitive support:

• Conversation and companionship
• Reading aloud, playing simple games, accompanying on walks
• Orientating a person with mild dementia (reminding them of the date, place, routine)

Medical appointments and community access:

• Accompanying to doctors, clinics, or hospitals
• Helping with wheelchair or mobility equipment in transit
• Collecting prescriptions (with appropriate authorisation)

What a Domestic Helper Cannot Do — Tasks Requiring Clinical Training

A domestic helper is not a registered nurse or healthcare professional. The following tasks fall outside the scope of domestic helper duties and should be performed by qualified medical or care professionals:

• Wound care requiring sterile technique — dressing wounds with risk of infection, debriding wounds, managing surgical sites
• Catheter management — inserting, repositioning, or irrigating urinary catheters
• Injections and IV management — administering injections (including insulin injections) or managing intravenous lines
• Tube feeding management — inserting or managing nasogastric or PEG tubes
• Suctioning — airway suctioning for patients with respiratory conditions
• Complex medication management — splitting or crushing medications without pharmacist guidance, managing complex multi-drug regimens

Employers should not ask helpers to perform clinical tasks. If such care is needed, a district nurse, home care nurse, or day care centre arrangement should be put in place alongside the helper.

Setting Expectations Before Hiring

Eldercare requirements are among the most important areas to discuss before a contract begins. Helpers have varying levels of experience and comfort with eldercare tasks. At interview and at hire:

• Describe the elder's condition and daily care needs in specific terms
• Confirm what personal care tasks the helper has performed before
• Discuss any tasks that may be emotionally or physically demanding (incontinence care, dementia-related behaviour, transfers for a heavy patient)
• Reach a clear mutual understanding — the contract covers "domestic duties," but both parties should know what that means in your household

See what to ask when interviewing a domestic helper for a full interview framework including eldercare-specific questions.

When the Care Needs Change Mid-Contract

Care needs for an elderly person often increase over time. If the employer's parent progresses from needing light companionship to requiring intensive physical care — for example, following a stroke or hip fracture — this represents a significant change in the helper's duties.

A helper who agreed to light eldercare at hire is not automatically obligated to perform heavy personal care that was not contemplated when the contract started. Employers should discuss changed needs openly, provide any relevant training, and consider whether additional professional home care support is appropriate.

If the care needs change so significantly that the helper cannot manage them alone, or refuses tasks she was not hired for, that is a matter for discussion and adjustment — not grounds for dismissal without following the proper termination process. See serious illness obligations for how medical developments during a contract affect the employer-helper relationship.

What This Means for You

• A domestic helper can perform a wide range of eldercare tasks as part of household duties — personal hygiene, mobility assistance, medication reminders, meal preparation, and companionship are all within scope
• Clinical tasks — wound care requiring sterile technique, catheter management, injections, tube feeding — are outside the scope of domestic helper duties and require qualified professionals
• Set out eldercare expectations clearly at interview and at hire — see interview checklist for eldercare-specific questions to ask
• If an elder's care needs increase significantly during the contract, discuss changes openly and consider supplementing with professional home care — do not simply add tasks without discussion
• The Standard Employment Contract (ID407) covers "domestic duties" broadly; specific eldercare expectations should be clearly understood by both parties before the contract begins

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