Wang Hong, a nearly 70-year-old woman living in Beijing, has chosen to age in place rather than move to a nursing home. She has never married, and her parents passed away a few years ago. “A few years ago, I managed quite well. I would go out to buy groceries in the morning, cook, clean, and take my dog for walks in the evening. But now, I can’t do that anymore,” she shared. Two years ago, a serious illness left her reliant on a walker and unable to fully care for herself.
Mr. Liu, a community worker in Wang’s neighborhood, explained to a reporter from Legal Daily that she is often unable to leave her home, and relies on community staff to deliver her essentials. He mentioned that there are several other elderly individuals in similar situations within the community—people who are elderly, single, and disabled.
“Elderly individuals who are single, childless, and unable to care for themselves face significant challenges,” Mr. Liu said. According to a recent survey, about 35 million elderly people in China are disabled, and that number is projected to rise to 46 million by 2035. With the demographic trend indicating a steep increase in aging individuals, the issue of how to care for these elderly individuals is a pressing societal concern, not just a personal one.
In Rizhao, Shandong Province, 90-year-old Zhao Lin has been living with mild disabilities for over a year. Due to the high cost of professional caregivers, she often relies on neighbors who can only provide limited support, such as helping her walk or picking up groceries. “As she gets older, she has become more sensitive and vulnerable. During traditional holidays, she often asks if I’ll come visit her and needs reassurance,” said one of her neighbors, acknowledging the difficulty in providing consistent care due to their own family responsibilities.
In Ankang, Shaanxi Province, 68-year-old Cao Jun has faced a similarly challenging situation. After being diagnosed with diabetes six years ago, he could not afford insulin and subsequently lost his eyesight. With no family support, he spends his days waiting for volunteers or neighbors to deliver food, leading to feelings of increasing depression. “While I know there are nursing facilities with professional caregivers and companionship, I don’t want to spend my last days in a nursing home. I wish to be at home,” he explained.
Experts have noted that there is a significant divide between urban and rural elderly care support systems. For many elderly individuals, especially in rural areas, the social safety net falls short. A recent report highlighted that the bed occupancy rate in rural nursing homes is only 42%, with a lack of trained personnel for those with more complex care needs.
Professor Mu Guangzong from Peking University pointed out that the lack of family and social support places many elderly individuals in precarious living situations, with little oversight or care. Moreover, he emphasized the need for innovative grassroots governance to address the care needs of vulnerable elderly populations. To better serve these individuals, he suggested a comprehensive social assistance system, a tiered and categorized eldercare service model, and an innovative multi-department management approach.
Many observers, including He Fan from the China Welfare Institute, agree that while the concept of home-based eldercare is deeply rooted in Chinese culture, the realities many elderly face often make such arrangements difficult. They advocate for strengthening the support systems and public resources available, especially in rural areas where access to quality care remains limited.
Collectively, these voices emphasize an urgent need for policy reform to create a more inclusive and supportive environment for the aging population, ensuring they can age with dignity and support, whether at home or in dedicated care facilities.
