China Develops More In-Home Nursing for Aging Populations


China now has 200 million people aged 60 and older, accounting for 14% of the total population. The number of people in this age group is expected to rise to 300 million in 2025 and to 400 million in 2050. While it has the second largest economy in the world, its GDP per capita is only No. 93. Aging in China is occurring at a much earlier stage of socioeconomic development than seen in European countries and in Japan, thus the pressure of aging is heavier on its still developing economy. The shortage of nursing home is one of the most obvious problems. There are only enough beds to accommodate 2.1 percent of the aged people in China while the number in West is about 5 percent to 7 percent. One nursing home in Beijing has a waiting list of 10,000 people but only can accept about 12 every year. One solution to mitigate the pressure from aging population in China is to develop more in-home nursing facilities.

In-home nursing provider is also call “virtual nursing home”, offering similar services as brick-and-mortar nursing homes at senior’s address. The first in-home nursing facility in China opened in 2007 and there are more and more open every year. This trend is catching on because it is cheaper and can serve more customers comparing to traditional nursing homes. Many traditional nursing homes are expanding their service to serve customers at home too. So the availability of in-home nursing in China is growing faster than the sheer number of newly added in-home nursing providers, to the delight of growing aging population.

A look into the history of the demography and economic development in China reveals the reason for its rapid greying and its great need of social welfare. The one-child policy was implemented around 1980s after the high population of China caused worldwide concerns. The Total Fertility Rate (TFR), the average number of children a women would have in her lifetime, dropped to below the replacement rate in early 1990s in China and now is 1.5. The peak population of 1.45 billion to 1.5 billion will be reached around 2025 to 2030. After that, the population would start to drop and the number of older people would continue to rise. The urbanization rate was only 20% in the late 1970s but greatly accelerated by the reform started in 1980s, and today about half of the population lives in cities. If the current urbanization rate holds, it means in the next 20 years, China will add 335 million people to cities. Most of new urban residents leave their parents behind.

The Confucius culture in China considers taking care of one’s elder parents the most important virtue. Sending parents to nursing homes used to be considered as bad behavior, and only individuals who don’t want to take responsibility would do. With the time passing, the negativity associated with it has waned, as the urbanization has made it very difficult to continue the three-generation family pattern. This pattern had sustained the Confucius values throughout history, during which there was very little need for external resources like social welfare.

Now there are great need for developing social welfare to help citizens shoulder the caring for their elders. The development of in-home nursing recently in China is the right direction to help the aging population. A lot of the current nursing homes, both residential or virtual, are built by private investments, and experts advocate for strong government presence in driving the development of such facilities, providing subsidies, training staff and monitoring the qualities of the increasing numbers of facilities.

By Tina Zhang

Shanghai Daily
Science Journal

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