Sunday, December 20, 2009

China's Coming Crisis Of Elder Care

Global Times

As China's one-child policy moves to its next generation, the "4-2-1" problem, namely four grandparents and two parents with only one adult child to look after them, has become a pressing concern for many families.

The one-child policy has severely challenged China's traditional family system. As the old Chinese saying goes, "Raise sons to provide for old age." Under the old system, the younger generation, men in particular, served as the main providers for older family members. This is the logic behind the traditional thinking of having more children, especially boys.

But the one-child policy leaves many families with little choice. Therefore, regardless of gender, the only child faces the challenge of providing for all the aged in the family when time comes. It is like an inverted pyramid – the pointed side has to support all the weight of the whole structure.

However, for many young people in the urban areas, who were born as the only child in the late 1970s or later, the time hasn't come yet. Most of their parents are either working or have social securities and personal savings to support themselves.

Their grandparents are not their problems, since their parents basically take care of the issue by sharing the responsibilities with their brothers and/or sisters and using their own resources.

China hasn't moved to the stage of "4-2-1" yet. The parents of China's first generation of one child are still the main providers now.

Mostly in their late 50s or early 60s, these people are quickly draining their lifetime savings to help their children by buying them apartments, careers, or other things. They stretch themselves to simultaneously care for their children as well as their parents.

But the situation won't last long. With China's living expenses shooting up and the increasing life span of old people, responsibility is going to shift.

Unlike Western countries, which have a developed social support system for the elderly, China is still experimenting with and reforming its public welfare system.

Not everyone in China has social insurance, especially among the rural population. When these social mechanisms fail, the last resort is their only child.

Some young people are acknowledging the challenge ahead of them. It is a daunting task even to imagine how a young couple could support four aged people or more while trying to make ends meet for their own small family.

Many of them can only cross their fingers that their parents won't have any serious illnesses that go beyond the coverage of social insurance or their own personal savings.

Even when the financial needs are not a big concern, how to take care of the other personal and emotional needs of the older generation is going to be a tricky task for these only children.

I am lucky enough to have two siblings, and even then it's hard sometimes to make sure somebody gets home for the Spring Festival with our parents. I can't imagine how bad the situation might be for those one-child families, especially given how scattered across the country many families are.

The living situation is another problem. When parents have aged to the stage where they can't take care of themselves, where to put them becomes a real headache. One can either live with the parents or send them to an old folks home.

But the latter doesn't sound like a good solution as putting parents in a nursing home is totally against Chinese beliefs.

China's elder care industry is also still in the early stage of development, as the Global Times reported yesterday.

My mother joked once that she could go there, but I could tell from her eyes that she didn't mean it.

However, with both sets of parents needing help, young families may face a very awkward situation. It is already very difficult for grown-ups to live with their parents. Living with in-laws could be even worse.

But the worst scenario is to put both sides of the parents under the same roof with the young couple, especially if there is a young grandchild around.

We can only hope that time and reform will solve everything. When the "4-2-1" crunch comes, we must already have a terrific social support system for the aged, no matter where they live or how many children they have.

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