China: Facing a long-term care challenge on an unprecedented scale

Abstract

Population ageing is occurring in China at a breathtaking pace and rapidly becoming a major public health issue. Due to the one-child policy, rural/urban migration and other societal changes, the family-dependent long-term care (LTC) of the past will no longer suffice. Barely existent now, both institutional and community-based services will need to expand to meet the growing need. China is still at an earlier stage in economic development and will be challenged to build these services and train staff. Furthermore, many elders are not yet covered by financial and insurance support. This massive demographic transition requires political efforts to develop integrated and sustainable national LTC systems.

The economic burden of dementia in China, 1990–2030: implications for health policy

“…Given the Chinese tradition of home care and the debate over whether formal care can ever meet all of the emotional and psychological needs of dementia cases, 36 , 37 it remains to be seen whether increasing wealth in China will have much effect on the uptake of formal care for dementia cases. However, it seems possible that China’s one-child policy, which was implemented in the late 1970s and only phased out from 2015, will leave too few adults in the 2030s to give sustainable informal care to all of the dementia cases 38 , 39 …”

Key characteristics of age-friendly cities and communities: A review

“…Where studies discussed age-friendly initiatives from the context of the developing world, similar ageing issues were reported, but with fewer resources to tackle these issues. Furthermore, it was apparent that cultural and socioeconomic influences can influence the success of age-friendly interventions in low and middle income countries (Ambigga et al, 2011;Cheng et al, 2011;Glass, Gao, & Luo, 2013;James et al, 2012;Rose, Hennis, & Hambleton, 2008). For example, a study in China by Glass et al (2013) found that family oriented long term care is no longer sustainable.…”

“…Furthermore, it was apparent that cultural and socioeconomic influences can influence the success of age-friendly interventions in low and middle income countries (Ambigga et al, 2011;Cheng et al, 2011;Glass, Gao, & Luo, 2013;James et al, 2012;Rose, Hennis, & Hambleton, 2008). For example, a study in China by Glass et al (2013) found that family oriented long term care is no longer sustainable. Changes in Chinese society such as the one child policy, rural to urban migration and the increase of female working professionals have reduced the availability of traditional family care givers.…”

“…Therefore long term care will need to be formally supplemented by formal health and social care services. However, cultural influences (most notably filial piety) will need to be considered when developing these services to ensure both the older service user and the family are supported through the process (Glass et al, 2013).…”

Long-term care protection for older persons: A review of coverage deficits in 46 countries

“…The phenomenon is also present in China, among other countries with migration between less-developed rural regions and urban centers and with very similar problems, including language barriers. Such bao-mu are literally domestic workers, often earning lower wages than other service workers and without any LTC-related training, but are mostly employed for the purpose of supporting older persons with care needs (Glass et al, 2013;Wu et al, 2012).…”