New research conducted by students and faculty in the School of Economics at Nanjing University of Finance has revealed that 49 percent of elderly people wish to live out their days in a nursing home.
There can be few other areas that are such a metaphor for westernisation in China. In the good old days, children were irrevocably tied to their parents out of filial piety. Now, the pressure is on to make ends meet. That means longer hours working more jobs, and as a consequence, less time looking after China’s old age pensioners.
Considered a last resort that was almost taboo for many years, now it is the elderly themselves who are requesting residential care outside the family home. Of the 620 people surveyed, twice as many under the age of 70 preferred the nursing home option to those over 70. A student who worked on the survey attributed the difference to changes in Chinese society as regards perceptions of ideological progress and economic independence.
Good news for the liberals then; not so for the government. The most recent census of 2014 put the proportion of people who are 65 or over at 9.6 percent. Projections for the future claim China’s pensioners could account for one third of the population by 2050, approximately 500 million people. Left unchecked, the huge numbers of Chinese people growing older present a potential and insurmountable economic drain, to say nothing of social instability.
The shift in the public consciousness was noted by Gu Yuqing, owner of Ai Wan Qing, a nursing home in Shanghai when she spoke with the UK’s Telegraph newspaper; We have been open for more than a decade, but we always struggled to fill our 60 beds…. That all changed two years ago. And in the past two months we have been getting constant calls. We are full to bursting”.
As of 2015, the average basic monthly pension for retired workers in Nanjing was ¥2,659, putting it on a par with the average costs for a basic nursing home, including bed and meals.
In order as to not price themselves out of the market, the majority of nursing homes have entry point options. At the lower end, Nanjing Gulou District Social Welfare Institute, a district-level public nursing home, offers a rock bottom price of ¥1,448 per month, including meals, for those on a budget.
Others have greater means. Tianfu Yao and her husband also stay at the Nanjing Gulou District Social Welfare Institute. She is very happy with her living conditions, pointing around the room at all her furniture. “Some nursing homes have just a bed and a nightstand. They feel like a ward,” she told a reporter for the Modern Express newspaper. Little luxuries have their price; including nursing fees, the old couple together spend a total of ¥8,700 on their residential care each month.
Larger luxuries come with larger price tags. Nanjing Pukou Social Welfare shall be Taiwan’s first municipal “public pension agency”, and one that includes a nursing home. Inside, in addition to barrier-free facilities, walkways and toilets fitted out with safety handrails, each room is equipped with telephone and Internet, while on hand are also a variety of facilities such as a gym, auditorium, painting rooms and, believe it or not, jacuzzis. Prices are again dependent upon the level of care required and selected facilities; by way of example, a sixty square metre room for a couple, complete with kitchenette, shower room and fully automatic washing machine, costs ¥140 yuan a day, bed only. Care costs and meals are extra.
At present there are a mere 292 nursing homes in Nanjing. Not a lot for a city of 8 million people, but perhaps a prettier picture than that elsewhere; in Beijing, urban legend has it the waiting list for a bed in the city’s No. 1 Social Welfare Home is literally a lifetime.
With the worrisome population projections and such a massive supply-demand mismatch, the gap in the market is gargantuan. Yet, is is just the start of the government nightmare. For private operators, there is the understandable focus on the high end of the market; luxury nursing homes for the parents of the newly minted, whereas what the authorities need is an abundant supply of mid to low end residential care. Since 2005, government policy has been to offer property developers a mix of land incentives, tax rebates and fast track approvals on the one hand, while continuing their preference to reimburse for in-home care versus residential-based care on the other.
Foreign companies are also sitting up and taking notice. April this year saw a groundbreaking ceremony for the Nanjing Nightingale Nursing College, a collaborative partnership agreed between King’s College London’s Florence Nightingale Faculty of Nursing and Midwifery and the Nanjing Health School China. Whether or not it includes plans for nursing homes has not been made apparent. No matter, with Nanjing’s increasing numbers of middle class pensioners banging on the doors, there will be plenty more coming in their footsteps.
