The challenges of dementia care in rural China

Abstract

Many countries face policy challenges related to the well-being of their aging populations, and China, with the world's largest aging population, is no different. Over the past 40 years, China has experienced demographic transition toward an “aging society.” According to the National Bureau of Statistics in China (NBSC), the number of people aged 60 years and older in China has risen to 185 million, with rural areas aging more rapidly during China's demographic transition (National Bureau of Statistics of China, 2013). In 1982, the proportion of population aged 60 years and older was 7.8% in rural China and 7.1% in urban China. However, by 2011 these proportions had risen to 12.6% and 15.4%, respectively, with a national average of 13.26% (National Bureau of Statistics of China, 2013). Difference between rural and urban areas in the proportion of the population aged 65 years and older in China has shown a similar trend over time. Rapid economic reforms since the 1980s, associated with increased rural-to-urban migration, especially the outflow of rural young population, have resulted in a larger proportion of elderly adults in rural areas (Cai et al., 2012; National Bureau of Statistics of China, 2013). These same social forces have resulted in relatively fewer people available to take care of the growing population of older adults as well. The “elderly dependency ratio” (the ratio of older adults in China to those in the population of working age) has increased from 8.0% in 1982 to 12.7% in 2012 (National Bureau of Statistics of China, 2013). The economic and social impact on caregiving will be profound.

Perspectives of dementia from Asian communities living in New Zealand: A focus group of Asian health care professionals

“…Dementia‐related stigma is pervasive across the globe and may be affecting ethnic or immigrant minorities to a greater extent . Chen et al reported that culturally there is stigma in China where people with dementia face ridicule, misunderstanding, isolation, discrimination, and even abuse . The theme of stigma (towards the person people living with dementia and family, and health care) found in our study is not unique.…”

“…20 Chen et al reported that culturally there is stigma in China where people with dementia face ridicule, misunderstanding, isolation, discrimination, and even abuse. 21 The theme of stigma (towards the person people living with dementia and family, and health care) found in our study is not unique. For example, a recent review that included western and non-western studies classified stigma towards dementia as public stigma (members of the community), professional and structural stigma (institutions, public policy, health care professionals, etc.…”

The impact of dementia on women internationally: An integrative review

“…As family structures are changing, particularly with migration from rural to urban areas in LMICs, the number of people living alone or with a partner rather than in extended family structure is increasing (Chen et al, 2014). Very little research emerged on women with dementia without family caregivers, or the impact of migration of younger family members on care provision for the older family members remaining behind.…”

Identifying support needs to improve rural dementia services for people with dementia and their carers: A consultation study in Victoria, Australia

“…25 Our participants also raised the issue of stigma in rural communities as a barrier to seeking support and as a contributor to social isolation. Another study described the significant problems faced by China in caring for rural older people with dementia, specifically the very large number of older people experiencing dementia, the erosion of the traditional model of families providing elder care, the lack of services in rural areas and the substantial stigma that is attached to dementia.…”