Heavy load [By Jiao Haiyang/China.org.cn]

A recent report on the shortage of nursing home beds for the elderly in China is a prime example of how the country's rapidly ageing population has become a major financial and social issue.

When I first came to Beijing in 1990, I was highly impressed by the way the city's senior citizens were encouraged to remain active members of society, and not shut away in a grim "old people's home," as is the norm in my native home of England.

One could see large groups of senior citizens dancing, practicing qigong, sword play, playing chess, bringing their songbirds out for a walk in the park and enjoying quality time with their children and grandchildren. I'd hate to see this tradition abate in the face of fiscal austerity, yet economic realities seem to be eroding China's image as a "paradise for the old."

A report delivered to last month's annual session of the Chinese People's Political Consultative Conference (CPPCC) said the country is now facing the biggest and most rapid age shift in world history. This is due to improvements in life expectancy and a declining birth rate. China only has 3.15 million nursing home beds, representing less than two percent of the nation's retirees.

This would not necessarily be a problem if most senior citizens were healthy enough to look after themselves or have family to take on the responsibility once the debilitating effects of old age manifest. However, one can no longer make this assumption.

In my opinion, the best approach is epitomized by Beijing City's 12th Five-Year Plan, setting a target of 90 percent of the elderly receiving care at home through improved social services by 2020; six percent staying with community centers supported by the government; and four percent in nursing homes where their condition demands more intensive care.

As I age I want to stay clear of institutionalized care at any cost. At the same time, I am anxious about the prospects of loneliness if I am cut off from regular contact with society in my own home. Yet, whether one stays at home or moves into a "home," there's a question of cost. Private homes for the elderly do exist in China, but they're prohibitively expensive. That's also the experience in Britain, where much of the care is in private hands, is nothing other than a profit-seeking business like any other.

I have personal experience with private nursing homes, beginning some years ago when my late father suffered his first stroke. There is great demand for hospital beds, and after doctors determined they were unable to do anything further for him medically, my mother reluctantly agreed to move him into a private nursing home.

The owner of the nursing home painted a glowing picture of the loving care he would receive, but the opposite was true. Inmates were stuck in a single room all day, with nothing to do but stare at the television screen and sleep. The neglect was so complete that two hours past before anyone noticed one man was not dozing but was dead! Poor George – his children had placed him in the home but never came to visit him, handling everything regarding administrative matters such as payments to the home through their lawyer! We moved my father out the next day.

Staying at home can be no better. A UK charity reported: "Thousands of elderly people die alone in their homes every year without being noticed, and increasing numbers spend their final years in abject isolation. Britain's ageing population is "losing the will to live" through a lack of personal contact with friends or visitors."

A study of the social isolation of senior citizens in New York stated: "More than three million people in the United States need help from another person in order to remain living 'independently' in their own homes. Without this help, many of these elderly and disabled individuals face going hungry, falling, or experiencing other problems that could increase the risk of institutionalization and death."

Regular reading of the Chinese media shows that such problems also occur in this country, and may become worse with the break-up of the "nuclear family" and development of the "empty nest" phenomenon. This subsequent urban renewal results in the elderly being forced to move to remote new suburbs far from their "roots."

China long nursed the concept of filial piety and respect for the aged through Confucianism. Today, studies show that instead of retirees being able to rely on support from their children, they often have to supply it – whether in monetary terms or babysitting duties.

Hopefully the country can keep alive old traditions as the ageing population expands. But it's going to be terribly expensive – in providing home care facilities, subsidizing families willing but financially unable to provide support, community programs for social integration, medical care and – as a final resort – state-financed or subsidized nursing homes.

The author is a columnist with China.org.cn. For more information please visit: http://www.h5a3.com/opinion/geoffreymurray.htm

Opinion articles reflect the views of their authors, not necessarily those of China.org.cn.