By Zhang Bingzi

Research Report Vol.20 No.5, 2018

Due to, among other factors, the accelerating process of population aging, the increase of ill and incapacitated people, and the falling capacity of family care, the demand for elderly care in China will grow rapidly. In China, people aged 65 and older increased from 25 million in 1953 to 135 million in 2015, an increase of 110 million in a span of over 60 years. The 20 years to come will see rapid growth in Chinese elderly population, which by 2035 will double to reach nearly 300 million. In the meanwhile, the proportion of incapacitated or semi-incapacitated elderly people will increase faster with the increase of the aged. Moreover, the decreasing fertility rates, the migration of population and the change in lifestyle will work to continuously reduce the capacity of family care. All these put heavy pressure on the issue of eldercare in the future, and will create many jobs in this sector.

I. The Supply of Eldercare Workers Falls short Both in Quality and Quantity

Elderly care workers are the main suppliers of elderly care services. The problem at present of inadequate supply of elderly care workers, as is in the case of housekeepers, is quite remarkable, with elderly care facilities finding it rather difficult to recruit and retain care workers. Future demand for elderly care workers is related to the increase in the elderly and the change in their needs, and also to in what model and for what objectives the entire elderly care service system will operate. To reflect more fully future demand for elderly care workers in different scenarios, the author adopts the following two forecast methods.

Method 1: The demand for elderly care workers as estimated by development objectives in respect of elderly care beds

By 2020, according to the 13th Five-Year Plan for the Development of Civil Affairs, there will be 35-40 elderly care beds for every 1,000 elderly people in China. The National Plan for Elderly Care Services and System Building during the 13th Five-Year Plan Period, on the other hand, requires that the percentage of nursing beds for elderly care be not less than 30%. If a standard of 35 elderly care beds for every 1,000 elderly people is maintained in 30 years to come, 70% of elderly care beds are non-nursing beds for elderly people who are able to take care of themselves, and 30% are nursing beds for incapacitated and semi-incapacitated elderly people - a percentage that is in keeping with the proportion of elderly people incapacitated and semi-incapacitated a year[]①. Moreover, according to the Standard on Care Services in Elderly Care Facilities, “An elderly care facility should be staffed with elderly care workers as needed for elderly care services, with the ratio of elderly care workers to elderly people who are able to take care of themselves, to partially nursed elderly people and to fully nursed elderly people desirably not below 1:20, 1:10, and 1:4 respectively; that is to say”, the ratio of elderly care workers to non-nursing beds, semi-nursing beds and full-nursing beds is 1:20, 1:10, and 1:4.

According to estimates shown in Figure 1, China’s demand by 2020 for elderly care workers will be about 640,000, including 110,000 for full-nursing beds, 220,000 for semi-nursing beds, and 310,000 for non-nursing beds. And by 2050, the figure will double to reach about 1.24 million: 260,000 elderly care workers for full-nursing beds, 400,000 for semi-nursing beds, and 580,000 for non-nursing beds; of all elderly care workers, the proportion of those for incapacitated and partially incapacitated elderly people will rise from 51% in 2020 to 53%.

Method 2: The demand for elderly care workers as estimated based on health conditions of the elderly

Method 2 estimates the demand for elderly care workers based on measured numbers of urban and rural elderly people incapacitated and partially incapacitated. It uses the numbers of incapacitated and partially incapacitated elderly people in different years to estimate the demand for elderly care workers based on the foregoing ratios of elderly care workers to non-nursing semi-nursing and full-nursing beds. Elderly people who are able to take care of themselves are assumed to not need care by others or to only need general care, and so don’t need elderly care workers.

According to the estimates shown in Figure 2, China will need about 5.2 million elderly care workers by 2020, including 1.8 million for incapacitated elderly people and 3.4 million for partially incapacitated ones. The figure by 2050 will rise to about 13.14 million, roughly 2.5 times that of 2020, including 5.14 million for incapacitated elderly people and 8 million for partially incapacitated ones.

Obviously, Method 2 forecasts a bigger demand for elderly care workers. This is mainly because Method 2 takes into consideration all elderly people with impaired ability to take care of themselves, regardless of the form of elderly care, be it home care, community-based care or family care, and regardless whether or not they receive care from nursing facilities, community service workers, housekeepers, family members, or friends. Method 2 estimates elderly care workers in the broad sense, including both paid and unpaid elderly care workers. It should be noted also that the ratios used herein of elderly care workers to elderly people are minimum requirements on nursing facilities nationwide and so more elderly care workers will be needed to provide better care services for the elderly. For instance, the Classification of Nursing Facilities which Shandong Province issued in 2015 requires that the ratio of elderly care workers to elderly people able to take care of themselves, to partially incapacitated elderly people and to incapacitated elderly people is 1:8-10, 1:4-6, and 1:1-3, respectively, which are obviously higher than the foregoing standards. The staffing of medium- to high-end elderly care facilities is also generally above the foregoing standards.

II. New Technologies Bring Hope to easing the Shortage of Eldercare Workers

With the growing demand for elderly care workers, according to the above estimates, the supply-demand conflict will become more outstanding. And it is rather difficult to increase the supply of elderly care workers substantially. This is one the one hand because China’s working-age population has been in decline, with the proportion of people aged 15-59 down from 70% in 2011 to 66% in 2017, a decrease in the age group from 940 million to 915 million during the period. On the other hand, among other factors, low income, low social status, poor benefits, and limited career prospects also make the elderly care sector less appealing.

The application of new technologies such as assistive and intelligent devices can improve the quality of life of elderly people effectively, reduce the workload and cost of elderly care, and ease the pressure on the short supply of elderly care workers. The reasonable use of assistive devices helps elderly people in eating, dressing, taking baths and using the toilet, and even allows them to do some housework and travel independently, thus mitigating inconvenience caused by incapacitation. Some assistive devices may protect against the deterioration of incapacitation. Intelligent devices mainly refer to products built with such new-generation information technologies as the Internet of Things (IoT), cloud computing, big data and intelligent hardware, used in various fields like disease and health management and domestic care. At present, many products have proved quite effective in such elderly care fields as GPS, remote nursing, intelligent behavioral analysis, fall detection, chronic disease management, catering and entertainment. The application of these new technologies, while improving the independence in life of elderly people, lowers their safety risks, mitigates the burden of persons who look after them, and reduces the demand for manpower.

...

If you need the full text, please leave a message on the website.