Aging in China: Elderly care faces problems

Dhe cul-de-sac, which died out in the midday heat, leads over crumbling concrete and ends at a golden gate. “Nan Meng” is written above the archway, with a red lantern hanging to the left and right. Until 2006 the property was still an orphanage founded by the local party official. As fewer and fewer children came, the operators began to take in lonely old people. There are no more children today. “Nan Meng” became one of the largest retirement homes in the area.

Two hundred seniors live here, “average age eighty-five,” says managing director Xiao Lu. She came to the gate in slippers, wears a white T-shirt and black jogging pants. “Have you eaten yet?” She opens her office. A flat screen with video channels from the various rooms of the retirement home hangs on the wall.

In her office, Xiao Lu eats what the residents are served today: rice, chicken with scrambled eggs and pickled vegetables from the plastic tray. “We offer the relatives a good package,” she says. “Eating, cutting nails, cutting hair, we take care of everything.” It is rare that a member of the nursing home residents shows up. “Most work in the city and don’t have time.”

Even the nurses are in their 60s

China’s working-age population has been falling for ten years, and a growing army of pensioners has to be cared for. At least 190 million Chinese are older than 65 today. Their number will double by the middle of the century. State and party leader Xi Jinping has ordered the expansion of care for the elderly. China’s government promises almost five billion euros for the construction of old people’s homes. Not a large sum given the crowds of seniors, Xi maintains fiscal discipline even in times of crisis. What will become of China’s old people now?

Heim Nan Meng is located in the rural outskirts of Shijiazhuang, a metropolis of eleven million people once known for its heavy industry. Abandoned factory buildings and clinker chimneys stand out from among the bushes and trees near the old people’s home. They are relics of the plant closures and mass layoffs that followed the Communist Party’s market reforms in the 1990s. Those who could, moved on.

The old people in the country are left behind. According to the 2020 census, the proportion of Chinese over 65 was 11 percent in cities and 18 percent in rural areas. Their share is constantly increasing. “We can hardly find younger employees, even if we urgently need them,” says Xiao Lu. Some of the three dozen employees in the nursing home are already over 60 years old. She posts vacancies on social media to reach young people, but the response is mediocre.

China is being overwhelmed by the cost of care

A place in the Nan Meng home costs between 110 and 300 euros a month, depending on the degree of need. A lot of money compared to the average local salary of 250 euros. The home receives a monthly subsidy of 30 euros for each resident from the authorities. Xiao Lu says the old people’s home can hardly survive without government subsidies. This year they are even in the red. Because of the heat, they had to buy 30 air conditioners.

“China’s infrastructure for the elderly and funding for nursing homes are grossly inadequate,” says demographer and gynecologist Yi Fuxian. “We are overwhelmed by the costs.” Yi advised several Chinese governments over the years until he fell out of favor himself. Today, Yi lives in the United States. He does the math: in 2020, there were five workers for every older person in China.