Confucius described old age as a "good and pleasant thing" which
caused you to be "gently shouldered off the stage, but given a
comfortable front stall as spectator." This honorable sentiment
paints a melancholic image of how senior citizens should be
treated, given peace in their twilight years while able to freely
dispense their wisdom to younger generations.
Retirement homes are highly uncommon in rural areas where
traditional entrenchment about the nuclear family is mainstream.
"Placing your parents in retirement homes will see you labeled as
uncaring or a bad son. To abandon one's family is considered deeply
dishonorable," said Zhou Rui, a Guangxi native living in Beijing. Even in
extreme circumstances, there seems to be little deviation from this
belief. When tackling such degenerative illnesses such as
Alzheimer's disease, most families would prefer hiring a permanent
caregiver than to place their relative in a nursing home. "But
since I live in Beijing for my work, and I am an only child, my
mother has accepted to go into a home. Better to go against
tradition than leave my mother all on her own."
In Western civilizations, a disturbing trend has seen us become
increasingly uncomfortable with retirement being viewed as the end
of one's useful contribution to society. In such settings,
Confucius' words may find little hold. In China, however, taking
care of one's parents is the lot of all children?-- failure to
do so would mean a major loss of face for any family. From all
sections of society, children receive consistent reminders that
they owe everything to their parents and that they must repay this
debt in full. This responsibility and the ties it creates are never
better illustrated than in the massive human migration seen during
the Spring Festival holidays.
While this unity may seem eternal, two looming factors may
disrupt it. The first is a direct result of China's "one-child"
policy. Traditionally, parents were taken care of in old age
through having many offspring who could rely on one another. Now,
with only one child per family in towns and cities, or two in rural
areas, the social attitudes of China are rapidly changing. Already,
national media deplore the self-centered attitudes of the "xiao
huang di" (little emperors) generation who have been raised as only
children and have little respect or time for tradition, preferring
instead to focus on improving their own standing.
The second is simply that people are living longer than before.
At the end of 2005, China counted 144 million over the age of 60,
or 11 percent of its total population. Such a rise will bring
strain on both the economy and society, both of which will have to
readjust to compensate. While this issue can be seen the world
over, China must address problems all of its own. Recent efforts by
the Chinese authorities to bolster rural healthcare and establish a
better social security system have in part been motivated by a
single realization: many Chinese families are no longer able to
adequately provide for their older members.
While the average life expectancy may steadily be improving,
China finds itself lacking in related areas: expert geriatric care,
widespread knowledge of debilitating conditions such as Alzheimer's
or an understanding of the psychological conditions of the
elderly.
These harsh realities mirror a rise in the importance of nursing
homes, lone bastions of competent care for the elderly. Despite
familial reluctance at placing their parents in such institutions,
increasing evidence can be seen that these constitute a positive
environment for China's aged, where they can find companionship and
professional care.
An unlikely example of this is nestled away from the
hustle-and-bustle of Beijing, in a small gated compound near
Xizhimen. Ducking past restaurant staff enjoying their lunch-break
and the imposing inner courtyards of Maoist residential buildings,
one comes across a pleasant garden belonging to the Zhanglanlu
Community Home. Outside its entrance, five or six residents enjoy
the springtime sun, the women merrily chatting while the men mull
over a game of chess. This setting is thanks to the devotion of one
woman. Tang Xiumin, a 70-year-old former kindergarten teacher, was
asked by the local government to take over the home after her
retirement 14 years ago. Since assuming her duties, she has worked
ceaselessly to improve both the lives of the residents in her care
and the wider understanding of what a retirement home can
provide.
"Zhanglanlu Community Home was set up and is financed by the
local government itself," explains Tang. "All residents here hail
from the neighborhood, usually with their families living close
by."
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Visiting the community home, meeting its staff and seeing how
content its residents seem to be would likely dispel many fears
among Chinese families that their parents would not be well taken
care of. Although relatively small with only 20 beds, the
organization behind the nursing home is very well-structured. It is
one of three sister homes, each of which catering to old people
needing differing levels of care. Zhanglanlu was the first to be
set up and takes in relatively spry retirees who are largely able
to take care of themselves. Aside from Tang herself, two nurses,
two care assistants and one chef complete the staff roster, all of
whom seem to enjoy a very close bond with the residents.
Furthermore, the home has a partnership with the local hospital,
which offers both free monthly check-ups on site but also instant
intervention during any health emergencies.
The small size of the home when compared to the vast community
it services is striking and illustrates social stigma that must yet
be overcome. Nevertheless, it possesses a two-tiered admissions
system. The first tier is for those applicants who are childless, a
description often used by Tang with a weary shake of her head.
These are taken in completely free of charge, their entire upkeep
provided by the state. The second exists for those with families
but whose children are too busy to look after them. In this case, a
monthly fee of 650 yuan is paid directly to the local government,
offering an affordable option to leaving their parents alone all
day.
Tang is quick to point out that despite these advantages,
misconceptions about the nature of a retirement home are still
widespread with many residents very uncomfortable upon arrival.
Pangs of rejection and abandonment are common, particularly among
widowers. Although the concept of psychological care is very
limited in China as a whole, Tang and her staff have established a
mechanism which seeks to educate both potential residents and
families about life in a nursing home.
Zhao Yunhui, the home's doyen at 91 years of age, spoke of her
worries at feeling lonely or miserable, a sentiment exacerbated by
her having no children. Prior to moving in, she suffered two heart
attacks and was not thought likely to live much longer. Eight years
later, she now shares a room with two long-standing friends and,
although still very frail, appears content.
Tang has also set up an open-doors policy, allowing families to
visit at anytime, while setting up collaborations with local
schools and universities for young people to come and spend time
with the residents. Zhao's room-mate, 90-year-old Wang Xiuqing,
laughs from her bed and quips: "We even have walking races, because
none of us can run anymore."
Much as it would be wonderful to imagine the Zhanglanlu model
being copied across China, the reality is markedly different. At
the end of last year, the State Council published a white paper
entitled The Development of China's Undertakings for the Aged. It
sets a number of bold targets, including full insurance, adequate
medical care and an increase in activities for old people. The
plight of the aged in China will go hand-in-hand with that of
migrant workers, with the improvement of rural healthcare and with
the nationwide expansion of insurance coverage. These three all
represent areas into which the central government has poured funds
of late, trying to gain a foothold.
The future for China's elderly remains uncertain. As the
population continues to age and the state moves to accommodate this
trend, it is to be hoped that more local governments will take the
initiative of setting up their own homes. However, while this
solution may be relatively easy to implement in urban centers, the
countryside will require a veritable unification by all levels of
government.
(China.org.cn by staff reporter Wang Ke and Chris Dalby, April
17, 2007)