Two years short of 70, Zhang Guosheng spends his days caring for an 81-year-old fellow villager — washing his clothes, bringing meals to his bed and keeping him company — a routine he will keep up until he himself needs the type of care he is now giving.
“Living here is better than staying at home alone. We help each other and have a common language,” said the spritely Zhang, an enthusiastic dancer. “We are very happy here.”
With younger villagers who would traditionally have looked after their parents and grandparents flocking to the booming cities to seek work as part of Beijing’s urbanization drive, Qiantun Village in China’s Hebei Province has had to pioneer a new model — the old looking after the even older.
Surrounded by green wheat fields that stretch across a flat plain, Qiantun is unremarkable among countless rural Chinese communities, but its old-age care model is now a prototype cited by central government as a solution to the daunting challenge of caring for a vast and rapidly graying rural population.
One of every four Chinese will be older than 60 by 2030, according to the Chinese Ministry of Civil Affairs.
Massive rural-to-urban migration will further strain the rural areas’ ability to provide care for the elderly, as personal savings and family support remain the primary pillars of old-age care.
“Migrants to urban areas are mainly young adults, leaving mostly the elderly in villages with children,” said Wang Dewen (王德文), an expert with the World Bank’s Beijing office. “The formal eldercare system in rural areas is very weak, and basically a blank spot in many places.”
As a result, the gap between the number of elderly in rural and urban areas is expected to balloon over the next 15 years, to 11 percentage points from today’s 1.24 percentage points, the ministry projects.
The costs of caring for China’s rapidly expanding elderly population are likely to be too heavy a burden for the government, forcing Beijing to find cost-effective and creative ways to provide care in myriad localities. The self-help model practiced among the 1,500 residents of Qiantun offers a cheaper and streamlined alternative to a state-run system.
More than 95 percent of China’s rural elderly still adhere to the traditional practice of seeking old-age care within their families, Wang said. However, families are no longer able to cope, with youth and even middle-aged people heading to cities to find work, leaving the elderly behind to fend for themselves.
In their search for affordable eldercare models, Beijing’s leaders have turned their attention 450km to the south in Hebei’s Feixiang County, where Qiantun lies. The practice of old people taking care of each other posed a simple and attractive solution.
Labeled “mutual assist eldercare,” the Feixiang model is set to be expanded to the rest of rural China, with 3 billion yuan (US$490 million) set aside by the central government to get it started over the coming three years.
“The light of Feixiang will shine across China,” Chinese Minister of Civil Affairs Li Liguo (李立國) declared enthusiastically during a trip to Feixiang in 2011. “Feixiang has set an example for the whole country.”
However, not everyone is as optimistic about the model.
“As people get older, they don’t tend to get healthier. So if you have somebody in their 60s caring for somebody in their 90s, are they going to be able, and trained and strong enough themselves to care for somebody who has chronic conditions?” said Tony Buccheri, a manager with Right at Home International, a US-based senior home care provider that offers services in China through a partner.