To get a sense of China’s elder care challenge, begin with this figure: 230 million.
That’s the number of people in China who are 60 years of age or older today, Professor Du Peng of Renmin University told an audience at the McCormack Graduate School of the University of Massachusetts Boston on March 15. For the first time, those elders are equal in number to the country’s population age 15 and younger.
Like other countries around the world, China is in the midst of more dramatic demographic shifts that will increase the sheer number its older citizens and make them a bigger part of nation’s population.
China expects the 60-and-older population to grow to 500 million people by the year 2050 and make up 34 percent of the population, said Professor Du, an international leader in aging studies who serves as Director of the Institute for Gerontology at Renmin in Beijing. Without the effect of China’s recent shift to a two-child policy, the elder share of the population in 2050 would be expected to become even higher—36.5 percent.
Some countries around the world expect even higher percentages of elder citizens among their populations in the future. But no other nation forecasts more senior citizens than China in the years ahead.
Caring for an aging population has become an important priority for China’s government, Professor Du said, but the country faces many challenges that may sound familiar to elder service providers and policymakers elsewhere around the world.
Among those challenges: Managing contributions from many different government agencies responsible for public health, welfare and labor. All have a role in providing services to the older population but their work and funding streams are not well integrated.
Rapid development of care services has created new resources but many unmet needs remain. There are now seven million nursing home beds in China, a huge increase over the past 10 years. But only half are occupied.
Traditionally, Chinese nursing homes have provided custodial care, covering services such as meals, shelter and assistance with activities of daily living. But almost none of the homes offer dementia care and those private facilities that do charge as much as $3,000 per month. As the country’s elder population swells, a policy question has come up for consideration: Who should nursing homes serve and what kinds of care should they emphasize?
Meanwhile, China also faces problems of geography when it tries to help senior citizens. Younger people may move to cities for jobs and other opportunities, but half of the country’s elders live in rural areas where services are more difficult to provide and access.
Across the country, Professor Du said, China is considering different ways to pay for long-term care. One province is experimenting with a long-term care insurance model that covers everything other than hospital care. In Beijing, seniors receive government financial support in form of coupons they can use to pay for social services. But the costs of those services are greater when paid for with the coupons.
In other areas, funds are pooled and used only for people who require long-term care. Professor Du recommends such a model, though he noted some natural resistance. Elders who don’t need care but receive a government stipend, as some do in Beijing, are reluctant to give up the benefit.
The future of long-term care in China is a topic that will bring Professor Du back to the United States this summer. At the International Association of Gerontology and Geriatrics World Congress in San Francisco, he will participate in a program called “East meets West,” focusing on long-term care in China and the U.S.