Entering the era of the first generation (those born in the 1980s) of the “one-child policy” parents, “421” has become the typical family structure and challenge for Chinese society.
Those who were born in the 1980s were once seen as the happiest generation since they were the only kids in the family and were raised and perhaps spoiled as princes and princesses in the family by parents. It was easier for these children to enter colleges than their parents’ generation since the expansion of universities across the county occurred during that time. However, these “princes” or “princesses” also felt an increasingly unprecedented pressure by the time they grew up. The universities did expand and allowed more students than before, while job openings didn’t increase accordingly by the time they graduated. In recent years, when these children started to build up their own families, they found it even more difficult to get an economical apartment, raise a kid, or support their parents who were getting old. Most of the children of the 80s thus came to call themselves “slaves to housing, kids, credit cards, and elderly parents.” This was due to the national situation as well, as housing is extremely expensive in the most populous cities such as Shanghai or Beijing. Education for kids is costly. When the “grandparents” would get old enough, the “parents” would have to be ready to take care of the elderly both financially and in terms of physical and mental health — due to the Chinese culture, as well as limited pension funds from the government.
Elderly homes are not welcomed by the elderly in China. One of the main reasons for this is due to their unsatisfying service and high prices. In addition, according to the traditional Chinese culture (bringing up children for the purpose of being looked after in old age), being delivered to the elderly home has made the elderly people feel they are left out or ditched by the family. On the other hand, the “empty nest elderly” has reached over 30% on average in big cities, or even more than 50% in some individual cities.
As the most populous country in the world, the number of elderly people has reached over 141 million, which makes it the country with the most elderly people in the world as well. It accounts for ⅕th of the global elderly population, and half of the Asian elderly population. Generally, the reasons of the trend of elderly society are: the extension of life expectancy, the decrease of the birth rate, and the decrease of the mortality rate. However, for China, the three main causes are happening all together and on extreme levels. The “one child policy” since 1978 was a sudden change for China after the populous number of births during Mao’s era. Together with the decrease of mortality which was brought by the development of the economy, it took only 18 years for China to change into an “elderly country” from an “adult country,” which was an extremely fast transition when compared with high-income countries. China is facing a severe challenge with the aging society.
In most high-income countries, urbanization and industrialization come together with the aging situation. When the seniors (people aged over 60) reached 10% of the total population, their GDP per capita generally reached 10,000 USD or more. They became rich before they grew old. Unfortunately, for China, it is the other way around.
As recognized in international standards, an aging society is defined as the following: over 7% of the total population having reached the age of 65, or over 10% of the total population having reached the age of 60. In this case, China has become an aging society since 2000. However, there are only around 40,000 elderly homes with 1.6 million beds, which means there are only less than 9 beds for every 1,000 elderly people who are aged 60 or above.
As for the support from the next generation, as mentioned earlier, there will be a very long time for the country to move forward when “two young people are taking care of four old people.” In addition to young people’s pressure to survive, and the family separation in different cities or countries due to urbanization, traditional family support would be very difficult to implement.
The change of the economic level, population structure, and the traditional concept of family support or traditional elderly life have brought people to start thinking. Nowadays topics like the methods of generating or expending the pension, the extension of the retirement age, etc. were hotly debated in China. People are all aware of the changes. But how much can they accept the changes, especially for the elderly people? Can they be emotionally independent enough from their kids like the westerners? Even if they can, would the society be able to provide the facilities or benefits for the elderly after they’ve contributed to the society for several decades?
Of course, effort from only one side would never be enough for a country like China especially when it comes to such a big change. In the “421” family, the “2” are still trying to support the “4” in every way they can while taking care of the “1.” The “4” are also doing best they can for themselves to be independent and to try to accept all the changes they never thought would happen. There are some 50-60 people initiating online that they could build up a small elderly home to live together and take care of each other. From the society, there are also proposals that “flexible retirement” might work instead of compulsory early/late retirement. People or companies could choose the best for themselves, since each industry is different after all. There is no rule that applies to all.
In China, the population over age 60 has reached 180 million. It is predicted that the number will be increasing every year by 5-8 million. Beijing, for example, has the number of elderly people accounting for more than 15% of the city population. In the meantime, due to birth control (one child policy) starting in 1978 – together with the fact that more and more young people are going abroad for work or studies – the number of households with only elderly people is increasing. Senior citizens living alone have become the main characteristic of the aging situation in cities such as Beijing and Shanghai.
The retirement age normally is 50 (for women) or 55 (for men) in China, which is relatively young comparing to the western countries. What do they do after they retire? Most elderly have to provide day care for their grandchildren since maternal leave is only 3-4 months, while kids could only start going to day care at the age of three. In fact, the elderly are taking care of their grandchildren day and night during working days and the kids only stay with their parents during weekends. So when the elderly are enjoying the company of grandchildren, they have to make efforts to take care of them too.
The neighborhood community plays a key role in daily life for the elderly, especially in urban areas. The community center is an ideal place for elderly living in the same neighborhood to gather together and play chess, exercise, etc. Recently, these communities would also be responsible for the day care services (i.e. meal delivery) for the elderly who lose self-care abilities and ensure health checkups of the elderly in the neighborhood.
Transportation is a dilemma, as it is both easy and hard for the elderly. Starting with Shanghai, several other regions such as Sichuan, Lanzhou, Hangzhou, etc. allow elderly people aged above 70 to take public transportation for free. However, if they wish to take a flight, a health certificate is required by most aviation companies.
Monthly pension is normally 1000-2000 CNY (157-315 USD). However, elderly people feel insecure due to low coverage of public medical insurance (from the government). So Chinese people generally save for retirement, meanwhile support from the family is also expected especially when they are sick in the hospital – since usually medical insurance is not enough to cover the costs. Furthermore, nursing service is normally expected from family members due to Chinese tradition and unsatisfying nursing services provided by public hospitals/nursing homes.
Nursing homes are more acceptable by the elderly now than they used to be. In the past, elderly going to nursing homes has been looked down upon, since normally only solitary aged individuals would have to go there and the service from nursing homes was poor. However, due to the trend of an oncoming inverted pyramid within the population – and the improvement of service – going to nursing homes is more acceptable by the elderly nowadays. By interviewing one private nursing home owner, it was observed that compensation on the nursing homes for the elderly requires several criteria. Non-profit nursing homes are either hard to get in or equipped with poor service – with 6-8 beds in one room and one nurse for 15-20 people, while private nursing homes would have rooms with single bed available. There are also newly built public nursing homes these years with better conditions, but it could take the elderly years in the queue system to get a spot. Another issue mentioned by the interviewee was the labor system. Running nursing homes needs employees take night shifts. However, the nursing home labor system doesn’t share the same one as the hospital’s, which has made the management of employees difficult.
The Fifth Social Welfare Institute is one of the best nursing homes in Beijing. It has 230 beds in total and the normal price is 1800 CNY per month per bed. It is equipped with designated medical care (which could be reimbursed), as well as different kinds of activity rooms for dancing, playing pingpong, calligraphy, reading, etc. The reasonable price and complete setting of the nursing home attracts lots of elderly people, however, the waiting time to get in could be years.
In short, after early retirement, the elderly in China rely on pension for the expenses on daily life. While when they get sick or more senior, support from the family will be needed. They enjoy having fun with the people at the same age in the neighborhood or in nursing homes. The number of nursing homes in China is far from enough due to the rapid aging population. Though, the bed occupancy rate might be low in private nursing homes. More affordable nursing homes with upgraded and reimbursable medical services are definitely required for the elderly population in China.