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Are Chinese Seniors Ready for Nursing Home Care?
 NO. 45 NOVEMBER 5, 2015



Qian Liqun, a 76-year-old retired professor at Peking University, spurred much controversy recently after he sold his apartment in downtown Beijing and moved into a nursing home in the suburbs with his wife. The nursing home charges 20,000 yuan ($3,150) for a two-bedroom apartment for the couple every month, in addition to other expenses.

Qian's decision challenges the mainstream practice of care for the elderly in China, where most senior residents live in their own homes with the support of other family members.

Some support Qian's decision, claiming nursing homes are a practical choice for the elderly. Some say Qian's way of spending his late years isn't available to ordinary people who cannot afford the cost of a high-end nursing home. Others suggest that more mid-range nursing homes should be built and relevant services improved in order to meet the challenges of an aging society.

A growing trend  

Jiang Debin ( The main reason Qian opted to move into a nursing home is because his wife reportedly has been sick and can no longer take care of housework. The establishment of his choice has complete facilities and provides good services. As a result, Qian can spend as much time on his academic projects as he used to without worrying about housework, such as cooking.

Qian is a prolific scholar, and his time is precious. If most of his time is spent on household chores like cooking and cleaning, it will be an obvious waste of time for him. Besides, as both he and his wife are too old to take on the burden of housework, a nursing home can take care of their daily lives and is the best choice for them to spend their twilight years. The public should understand and respect their decision.

Plus, as the couple doesn't have any children, they don't have to take leaving the apartment to their offspring into consideration and can sell it of their own volition.

Nevertheless, it will take time for the public to accept Qian's decision as it contradicts the traditional reliance on family-based care and support by senior Chinese residents. How the elderly are provided for should diversify as society progresses. Senior residents should be allowed to choose the best way of living for themselves based on their circumstances.

Wang Chuantao (Bohai Morning Post ): Many cannot understand why a renowned scholar like Qian should live in a nursing home and are deeply concerned about the worst-case scenarios if caregivers don't treat him well and even abuse him.

The public's questioning exemplifies their lack of trust in nursing homes, which have been mired in a string of scandals in recent years. A lot of nursing homes involved in these scandals lack sound facilities and well-trained staff, and some even abuse the elderly. In this scenario, many critics believe that sending the elderly to a nursing home is like throwing them under the bus.

Nonetheless, the trend of change in senior care models in China is irreversible. The contentious lifestyle chosen by Qian and his wife will be a choice for a growing number of senior citizens in the future. From this perspective, the couple is carrying out an experiment and exploring whether nursing homes are a viable option.

Meanwhile, nursing home services need to be greatly improved.

Additional high-caliber caregivers should be trained and appropriately rewarded. The government should invest more in public nursing homes while supporting the development of private ones. Stricter regulation of charges and standards of service should also be put in place.

In an era when most families have only one child, it's unrealistic to solely rely on filial piety to address the challenges of providing for the elderly. The only way senior residents' well-being can be guaranteed is by forming a sound system of elderly care.

The affordability issue 

Hu Yinbin (The Beijing News ): Qian's choice is a personal one without universal applicability. He can sustain the cost of the high-end nursing home while few of his peers are able to do so.

However, the heated debate triggered by related news reports reflects a widespread concern amongst the public about how to take care of themselves when they get old, an issue every person is currently facing or will face in the future.

Resources for elderly care are unevenly distributed in China. While 40 percent of beds at high-end nursing homes are vacant, nursing homes affordable to middle- and low-income earners are in short supply. According to statistics from the Ministry of Civil Affairs, there were 31,833 registered senior homes in China with 5.84 million beds at the end of March. This amounts to 27.5 beds per thousand senior residents, compared to 50 to 70 beds per thousand seniors in developed countries.

The conditions in rural areas are even worse with cheap nursing homes providing poor services.

Additional public investment should be directed toward mid-range nursing homes. Meanwhile, the government needs to supervise and manage nursing homes to ensure they serve the majority of people and have high-quality services.

Everybody needs a comfortable place to enjoy life when they become old. Finding an effective solution to this issue does not only concern the well-being of the elderly but can also advance China's social service system.

The government's role 

Zhang Song (Chongqing Times ): Rather than envying Qian for being able to spend so much on a high-end nursing home, we should explore whether current aged care services can satisfy public demands and how we can make good use of the merits of both traditional and emerging aged care practices.

Because the concept of market-based elderly care isn't widely accepted in China, the development of relevant services in the country is lagging behind. In rural areas in particular, children are regarded as impious to senior family members if they send the latter to nursing homes. Some nursing homes' poor conditions have justified this accusation.

The professional capabilities of existing elderly caregivers are also worrisome. At present, fewer than 300,000 caregivers work in senior homes across China, of whom over one half are over 40 years old and 70 percent haven't graduated from high school. Meanwhile, they have low social status and income.

The number of senior residents in China currently exceeds 200 million. It is predicted that by 2055, this group of people will account for 35 percent of the total population. However, we seem unprepared for an aging society in many aspects.

The debate around how to care for the elderly triggered by Qian's decision to receive nursing home care is a reminder to concerned government departments. The government should take on the responsibility of improving the aged care system, encourage private businesses to enter the sector and supervise nursing homes to ensure they offer quality services.

Gan Chunsong (Beijing Morning Post ): The provision of care services for the elderly is a worldwide concern. Life spans are increasing as medical care and living conditions improve. Nevertheless, the birth rate and the desire to give birth are declining. As a result, caring for the old has become a big issue facing countries around the world.

In China, most senior residents are taken care of by their offspring. Although seniors are large in number and many of them receive a rather low pension income, the country hasn't had an elderly care crisis until now.

Though market-based care for the elderly may be the best option in the future, it's worth exploring combining a contemporary elderly security system with traditional family-based support through incentive policies. For instance, financial subsidies can be provided for children who buy apartments in the same compound as their parents.

Copyedited by Jordyn Dahl

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