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Gray days ahead for elderly population

By Cao Xiaofan and Quan Xiaoshu (China Daily)
Updated: 2009-01-07 11:56

When he walked out of the quiet courtyard of Fengyiyuan, a government-funded nursing home in Fenzi Hutong, in downtown Beijing's Xicheng district, Wang believed his last hope was gone.

All 30 beds in Fengyiyuan had been occupied since early 2007. It was the fourth public nursing home to turn him down in a month.

A month before, the nurse he had hired to care for his diabetic mother returned to her rural hometown to get married.

"The nurse came to my family three years ago. We paid her 1,200 yuan ($219) a month," says Wang, who works as a driver for a small private company.

An elderly woman enjoys sweet dumplings at a nursing home in Beijing. [China Daily]

"We couldn't hire a new nurse, because the cost has almost doubled by now."

With a monthly household income of no more than 4,000 yuan, including his mother's 655-yuan pension, Wang couldn't afford to take time off work to care for his mother, who suffered from a mild stroke as a complication of her diabetes. So Wang and his wife decided to find a nursing home. But every one of the four homes he visited had long waiting lists.

"Fengyiyuan has added my mother to its waiting list, but I don't know how long it will take before it will be our turn," Wang says.

A survey by the aging committee of the Beijing municipal government shows the capital is home to 2.1 million residents older than 60, accounting for 17.3 percent of its population. About 263,000 of the seniors are willing to live in nursing homes with proper care. But Beijing's 334 nursing homes can only provide 39,000 beds, enough for 1.7 percent of the city's elderly.

Experts believe the gap will expand as more baby boomers retire in two or three years.

Many among the city's graying population, like those in the rest of the country, were allowed only one child under the government's family planning policy, leaving them with few children to rely on in their later years.

However, most adult children, tied down with work and their own families, don't have the time or energy to properly care for their parents.

"Long-term care for the elderly, traditionally provided at home by adult children, is becoming less feasible in fast-paced cities like Beijing," Tsinghua University sociology professor Pei Xiaomei says.

Wang had hoped to put his mother in a private care home, where beds are available, but he couldn't afford the fees.

"Private nursing homes have better services and environments. They cost at least 3,000 yuan a month, more than triple what government-funded homes charge," Wang says.

In addition, most private homes are located on the city's outskirts, far from the big hospitals concentrated downtown.

"For people my mother's age, easy access to a hospital is important," he says.

Wang believes Fengyiyuan is the most suitable home. It costs 800 to 1,000 yuan a month, depending on the room. And it's located in a traditional courtyard-styled building, with facilities such as a sitting room with books, newspapers and mahjong tables.

Its four professional nurses and close proximity to Xicheng Elderly Hospital also contribute to Fengyiyuan's popularity.

Upon seeing disappointed applicants like Wang, 72-year-old Zhao Hongwen feels fortunate. She moved to Fengyiyuan in 2004 and feels "comfortable here".

Fengyiyuan is a cozy nursing home at Xicheng district.

"They even prepare special light meals for me," says Zhao, a strict vegetarian.

"Reading newspapers, gardening and doing needlework are part of my daily routine.

"Living here helps lighten my children's burdens and allows me to pursue my own life."

About 98 percent of Beijing's seniors live in their own homes, a 2007 study by the Municipal People's Political Consultative Conference shows. The lack of nursing homes means there's no other option.

Scholars and experts agree the government, society and families should all play a role in resolving the problem.

"The government should mainly provide public resources and regulate services in nursing homes," Pei says.

The city government has encouraged private investment in nursing homes, where 4,731 beds were added from 2000 to 2005, a 2006 civil affairs bureau report says.

"It is projected that non-governmental elderly care institutions will outnumber government-funded homes within five years," the bureau's deputy head of social welfare Wei Xiaobiao says.

The city government plans to increase the number of beds from 39,000 to 68,000, accommodating 3 percent of the elderly population, by 2010.

However, the capital is also home to a large "invisible" elderly demographic. They are the parents of children who left their hometowns to seek better educations and jobs in Beijing and moved in with their children after retirement.

No statistics are available on the group. Without registered residences, these migrant seniors are not covered by the city's insurance network and cannot apply for beds in government-funded nursing homes.

To address these problems, the city government began developing community-based elderly services centers in 2006. Usually located in or near residential quarters, the centers assist the elderly with tasks such as cleaning, cooking and shopping, in addition to delivering meals and mail, and providing basic healthcare.

This is generally believed to be the most economical and feasible way of extending public welfare to the elderly.

Deputy director of the national aging committee Yan Qingchun says the government of a city like Beijing must invest at least 150,000 yuan, mainly for land-use rights, to add a single bed to a downtown home. In addition, every bed will cost 20,000 to 30,000 yuan a year in overheads.

However, community-based care services cost an average of 2,000 yuan a year per elderly recipient.

Last April, the city government paid 100 million yuan for community care services for 140,000 ailing elderly people. Every eligible recipient receives 50 to 250 yuan a month, depending on their age, income and health.

The city government plans to cover 70 percent of residential areas with community-based care centers by 2010, but progress is slow.

"I heard about it on the TV news, but so far, my neighbors and I haven't seen any community care centers," Wang says.

"If I could find one, I wouldn't go through so much trouble searching for a nursing home."

Even the relatively affluent complain about the lack of services.

"I'm surrounded by expensive restaurants, stores and beauty salons, but I can't find healthcare nearby when I suffer from high blood pressure at midnight," 65-year-old Zhang Wen, who does not have a child, says. Zhang lives in Fuzhuo Garden, a wealthy neighborhood in Beijing's Xuanwu district.

About 90 percent of China's residential communities lack elderly service institutions, while many established centers only provide basic facilities, Pei says.

Located at the end of Chaoshou alley, the Jinrongjie Community Elderly Service Center has two rooms - a 20 sqm library with old books and magazines, and a games room with a ping-pong table.

Wang Zhizhong, 77, passes the days watching table tennis at the center.

"My eyesight has seriously worsened, so I don't read," he says.

"A canteen and a bathhouse are the things we want most. We were told the center would be refurbished early this year, but it's still the same," he adds, pointing toward the dilapidated sports facilities in the garden.

Beijing's graying population is expected to grow to 6.5 million by 2050, when one in three people will be older than 60, the aging committee estimates.

"Although the government is trying to build more institutions like nursing homes for ailing and childless elderly residents, community-based services may prove more convenient and economical for the majority," Pei says.