Current Status of the Long-term Care Security System for Older Adults in China

Abstract

In response to the increasing care demand of older adults and their families, the construction of the long-term care (LTC) security system has been widely recognized by the government, society and families. This article discusses the socio-demographic background, current situation, achievements and issues of this system. The LTC security system in China has achieved considerable progress in enriched service provision and expanded social insurance system pilot programs. However, the issues of unbalanced service provision and the explorative design of the insurance system still need to be resolved. Our recommendations for the development of the LTC security system include comprehensively reviewing the integrated care service system in terms of placing “old adults at the center,” addressing the long-standing divisions between urban and rural areas in service provision and insurance design, advancing research and discussion concerning pilot experiences and improving the unified evaluation and financial planning systems.

Caregiver burden and its associated factors among family caregivers of persons with dementia in Shanghai, China: a cross-sectional study

“…Informal care from family members is the primary source of care for PWDs in China. However, due to the rapid socioeconomic shifts and changing demographic structure, reliance on the care provided by families has become untenable 23. Formal care in most high-income countries has evolved into the home-and community-based care 23.…”

“…Second, the level of caregiver burden in our study was relatively high compared with western countries, which can be attributed to the different social environments, cultures, healthcare policies, ethnicity and age of caregivers. 23 42 43 Caregiver burden was defined as ‘a multidimensional response to physical, psychological, emotional, social and financial stressors associated with the caregiving experience’. 44 Caregiver burden derived from the perceived stressors is influenced by psychosocial factors like social, environmental and cultural.…”

“…However, due to the rapid socioeconomic shifts and changing demographic structure, reliance on the care provided by families has become untenable. 23 Formal care in most high-income countries has evolved into the home-and community-based care. 23 The situation might be responsible for more caregiver burden in our study compared with other countries.…”

“…China’s pilot long-term care (LTC) insurance policy was implemented in 15 cities since 2016. However, the supply and demand of LTC services are unmatched and unbalanced 23. Formal care service is difficult to access at home.…”

“…However, the supply and demand of LTC services are unmatched and unbalanced. 23 Formal care service is difficult to access at home. Support to family dementia caregivers is limited in most areas of China, 24 which is insufficient to reduce the caregiver burden.…”