Elderly facing nursing home dilemma

CHINA.ORG.CN – JESSICA ZHANG December 27, 2010

As the winter sun rises, the streets in the Beijing suburbs around Fragrant Mountain begin to bustle with commuter traffic. But in a local nursing home for the elderly, the atmosphere remains quiet and peaceful.

Li Fengqing’s 83-year-old wife sits quietly on a bench in the Aimujia Nursing Home, holding her walking stick in her frail hand. Briefly animated, she recalls her wartime experiences working in the shipbuilding and munitions industries in the southern city of Guangzhou, but these days she mostly sits quietly with her memories.

Li and his wife exemplify China’s rapidly aging population. In 2009, the number of over-60s in China reached 167 million, accounting for 12.5 percent of the country’s population, and one fifth of the world’s elderly. China is now the only country with more than 100 million old people. And until 2035 at the earliest, most elderly couples will have to rely on a single child to provide for their old age. The rapid increase in the elderly population poses serious problems for China’s creaking social insurance system.

Old people face a dilemma. There are not enough places in government-owned nursing homes to meet the growing demand, and private nursing homes are simply too expensive for most people.

Private nursing homes beyond reach

Aimujia Nursing Home is a large-scale private home set up two years ago. It resembles a holiday villa more than a nursing home. A standard room has two single beds, a desk with a telephone, an emergency call system, a flat screen television, air conditioning, and a small porch.

The room costs 5,000 yuan (US $ 754) per month, excluding meals. But for this, the elderly also receive care from two doctors and a nurse who attend to their medical needs and perform regular checkups of their blood pressure and so on.

Mr. Li says he is very satisfied with the environment and the level of care he and his wife receive. “But the price is very high,” he added.

Mr. Li was born in northern Hebei Province but headed south to Guangzhou before 1949, where he taught for decades in a primary school. His wife is a former senior engineer in the Ministry of Industry. When they retired, they returned to Beijing because they were both born in the north and wanted to spend their old age in familiar surroundings.

The couple have four daughters, two in Guangzhou, one in Australia and one in Beijing. When they first returned to Beijing, they lived with their daughter’s family, but later moved out to a villa their son-in-law bought for them, because they did not want to disturb their grandson who practices piano every day.

But they often feel lonely in the villa. “There is no-one to play Mahjong with. And my wife is losing her memory, and needs people to talk to,” Li said. So they moved temporarily into the nursing home, and will stay there until Spring Festival.

The secretary of Aimujia Nursing Home said that they only accept relatively fit elderly people who can take care of themselves, and added that the prices they charge are only slightly above average and by no means top of the range in Beijing.

Waiting lists for public nursing homes

Xiangshan Mountain Apartments for the Aged is a publicly-owned rest home for the elderly. The environment and infrastructure cannot match that of the Aimujia, but the price is lower at 3,000 yuan (US$452) per month. But beds are limited and there is a waiting list to get in. “Some people on the list will have to wait until 2012,” one of the residents, Liu Tianqing, a retired professor from Peking University, said.

Liu didn’t want to go to the United States to live with his son, so he first went to live in a nursing home at Qijiahuozi. “But when I moved in I was very disappointed. One of the meals I ate there gave me diarrhea for a fortnight,” he said angrily.

There are just 40,000 beds in Beijing’s nursing homes, enough to accommodate just 1.8 percent of the city’s elderly population. By comparison, other countries usually have places available for between 5 and 7 percent of their old people.

Care in the community: a solution with Chinese characteristics?

Chinese people are very keen on keeping the family together and are usually reluctant to send their elderly parents to live in nursing homes.

But for young couples, the support of four elderly parents is a huge burden that saps their physical and financial resources. More and more are seeking a way out of their dilemma. “I can’t send my parents to a nursing home. It’s better for family members to look after them than nursing staff,” said Qi Yang, a white-collar worker in Beijing.

As a compromise, “Living in the Community” may be the best solution to the problems of an aging society. This kind of arrangement means old people can be cared for by their families while also receiving support in the form of services provided by the local communities.

The authorities of Beijing’s Haidian District say it is no longer realistic to rely entirely on the government to support the elderly, and the private sector has to share the responsibility.

The problem is that private nursing homes are focused on making a profit, while government-owned homes seem to be in a long-term decline. Some experts say the only solution is care in the community, supported by China’s emerging voluntary sector.

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