Buccheri’s concern echoes that of Cai Qingyang, pioneer of the model and Qiantun’s village chief.
“Old people with critical illnesses need more than the very basic care provided here, and we will have to think of other ways to care for them,” said Cai, a 61-year-old former soldier as he watched several old villagers dancing in the yard.
“But this really is the only feasible way given the local elder care situation. The village and the government simply can’t afford proper institutional care for every aged rural resident,” Cai said.
In 2008, Cai sought to do something about the lack of care for rural elderly left behind as young adults sought better paying work in cities. He turned an abandoned brick house into an old-age home, where 25 elderly villagers moved into 11 rooms, keeping each other company, sharing meals, as well as farming and doing housework.
His innovation has thrived under state support and more than a dozen other provinces have replicated the model.
What separates China’s aging pattern from that in other Asian societies such as Japan, South Korea and Singapore is that the country is still relatively poor on a per capita basis. The phrase “getting old before rich” reflects the fact that even though China’s economic growth remains robust, its demographics work against it.
Those in the emerging middle class have more options among at-home care providers, and public as well as private senior homes, and are more likely to find them affordable.
The rural elderly have fewer resources and fewer choices, while youth migration patterns unstitch the traditional family safety net. And despite years of efforts by China’s leaders, the income gap between urban and rural residents has increased. A report published by the World Bank last year said the rural elderly have “remained consistently poorer than the urban elderly over time.”
Nor is that likely to change. Two-thirds of elderly Chinese currently live in rural areas, and although migration patterns cloud demographic estimates, many demographers believe the majority of China’s elderly will remain in the countryside.
To meet the challenge, China must make its urbanization an equalizer of basic social services for urban and rural residents, Wang said.
To do that, it must reform the household registration system that ties social services to people’s registered home to facilitate family migration to cities and receive care there, he added.
However, in the short term, rural areas such as Qiantun, which has three times as many elderly residents as young adults, can only make do with the resources they have. The government provides 600 yuan a year in subsidies for each of the 30 elderly Qiantun villagers at the center. Their average age is 75.
By contrast, offering professional care at an old-age care institution would cost a minimum of 10 times as much, 6,000 yuan a year, according to government estimates, offset by a mere 120 yuan annual subsidy from the government.
At the Qiantun Villager center, “old” Zhang, as he is known, talks about the future as he brings a bowl of dumplings and medicine to the bedside of his charge, bedridden by a broken thigh bone.