China's elderly face a care crisis
Economic and social shifts force government to take over functions of extended family
SHANGHAI — CHEN XINYUE lies quietly in bed, thin wisps of her hair splayed on the pillow, her frail hands curled on the blanket.
Four months earlier, the 78-year-old Mrs. Chen was forced to come to the Yangpu District Home for the Aged because her six children had neither the room for her in their crowded apartments nor the time to care for her outside their busy jobs.
She has been sick for much of the time since arriving. But Yang Rendi, a daughter who was visiting one afternoon, says Chen's adapting.
``When she first arrived, she felt ill-at-ease because she didn't know what kind of institution this was,'' Ms. Yang says. ``Now she is gradually getting used to it, and her health is improving. We had to be practical. At home, she was lonely, and we had to worry about her meals and whether she would just walk out of the house.''
China faces a crisis in caring for its elderly as the government is forced to take on responsibilities performed for centuries by the family. The situation grows out of the government's stringent one-child-per-family policy and the economic reforms that triggered a major shift in social mores, Chinese analysts say.
``How to better provide and care for the aged is a big problem for China,'' says Hong Guodong, director of the China Research Center on Aging in Beijing. ``Respecting the old is a traditional value in China. However, this belief is decaying. Younger people tend to seek pleasure for themselves and care less for the old. Perhaps this is the price a nation pays for modernization.''
Within a generation, China will have the largest elderly population on earth - more than 370 million by the year 2040, almost 25 percent of its population.
Across East Asia, fast-track economies and stunning social changes are effecting in 25 years what it took the better part of a century to do in the West: As rapidly aging populations strain the region's fast growth and resources, governments are forced to develop their meager pension and social security programs to compensate for the weakened extended-family support system. Women who in the past cared for elderly family members, for example, are now too busy with jobs and raising children.
``China is now in a transformation from family care to community care,'' says Wu Linqiao, a Shanghai official dealing with aging issues. ``How can one couple care for four older people? Socialized care will become more important than family care,'' he adds.
In rural areas, the crisis is even more acute, Chinese researchers say. Now that they are free to move to the cities, many young farmers in urban areas can no longer care for aging parents in the countryside. The grandparents may also have to raise grandchildren left behind.
The Chinese press frequently carries reports on the growing incidence of divorce among older people and maltreatment of the elderly. Although Chinese law gives senior citizens the right to demand support, a growing number of rural areas are setting up old people's associations and forcing families to sign agreements of support. In some rural areas, up to 70 percent of the families have signed the agreements, Chinese researchers say.
``Before this practice started, children in rural areas didn't provide support and shirked their responsibilities,'' says Zhu Jiming, a Shanghai economist doing research on aging. ``With this migrant population, if there is an agreement, the children will feel obligated to send money back regularly.''
Shanghai, China's largest city, is at the cutting edge of the elderly-care problem. According to a 1992 census, almost 16 percent of the city's 13 million people are aged 60 or over, a figure projected to rise to 28 percent by the year 2025.
``The whole of China will become an aging society by the end of the century. Shanghai is 20 years ahead,'' says Mr. Wu, the Shanghai official. ``The aging process came suddenly, and the state isn't yet prepared to deal with these problems.''
Yet of all Chinese cities, Shanghai has the most sophisticated social-welfare system. It also has China's first old-age pension fund supported by employers and workers. The fund's assets total more than $500 million.
Still, officials say there are tens of thousands of old people unable to fend for themselves and living alone.
Seventy-five-year-old Li Tongzhou sits begging on a busy Shanghai street corner, his crutch lying nearby.
``It's not that my family refuses to support me. It's just that they can't afford to,'' says Mr. Li, whose family lost its crops to flooding last year.
A spreading network of public and private elderly homes has emerged to meet the need, although experts estimate that 3 percent of the city's elderly should be in the homes and less than 1 percent can be accommodated.
At the Yangpu home, Liu Daren, 71, says she's never been happier. Before she moved here eight years ago, she lived with a relative and felt like a burden. Now, she gets good meals, takes lessons in calligraphy and disco dancing, and has plenty of friends to chat with. ``Living with my relative was always a burden on my mind,'' she recalls. ``I was never at ease. They were always in such a haste. They would cook for you and rush out.''
But Ms. Zhu, the Shanghai researcher, says her surveys show that most elderly still feel they get better care at home.
``Many old people still wish they could stay with their families,'' she says.