New elderly service model booms in aging China

[Aepsilons]

As China's population ages and the younger generation leave to find work in areas across the country, a number of elderly family members are being left behind.

Zhang Lanzhu, 84, for example, was finding it difficult to care for himself without help. His care problems were solved when he was sent to a united elderly nursing center, which has special medical staff to take care of him.

Zhang, once a farmer in northern China's Hebei province, has a son and a daughter. His wife died many years ago, while his son works in Beijing and the daughter is married, so he was left alone at home.

The Longrl elderly service center where Zhang lives and a nearby affiliated hospital were founded in July last year by Li Zhongmin, general manger of Hengshui Longrl Technology Industrial, a private lighting equipment producer.

The center and hospital solves both the nursing and medical needs of many seniors, and it is a new model being explored to help the country's huge aging population.

"The center can host 180 elders. Construction of a second phase will start in July with 140 more beds," said Li.

The population at or above 60 years of age hit 202 million in China by the end of 2013, 15% of the population. The figure is expected to exceed 300 million by 2025. Two thirds of them live with an illness, and more than 36 million of them are unable, to some extent,to take care of themselves in daily life.

By 2020, the country will have an improved system covering daily attendance, medical care, psychological counseling and emergency aid, according to the central government plan unveiled in September. The combination of healthcare and elderly services is one of the targets. Current elder services are far from meeting their demands.

"Nursing centers cannot meet the medical and nursing service demand. Few medical institutions have entered the field," said Guo Shuqin, president of the Baoding No.1 Central Hospital. "An integrated model of elderly nursing and healthcare should be explored."

The new model has gained popularity. An elderly care center affiliated to the Jinzhou Workers' Hospital in Hebei's Jinzhou city, is full and cannot meet market demand, according to Wu Dianhua, owner of the private hospital and elder center.

"I plan to purchase six hectares of land to build new hospital and care facilities with a capacity of 700," said Wu.

The new model is being promoted in other regions, including Jiangsu province and Xinjiang Uygur autonomous region.

"Hospitals and private investors should be encouraged to participate in the promotion of the new model," said Duan Huijun, vice president of the Hebei Medical University.

To prepare for the care boom, the government should provide more supporting policies in land use, taxation and financing, said Li Zhongmin, who complains about difficulty he faces in getting bank loans.

The key to promoting the combined elder service model lies in fund raising and social insurance arrangements, said Ma Xu, of the National Health and Family Planning Commission. "The government is supporting enterprises which are active in investing in the sector, but more support is needed," he said.

New elderly service model booms in aging China｜Society｜News｜WantChinaTimes.com

@TaiShang

 

[somsak]

hehehe....

I got an idea. Let's copy this business model to Thailand

I supply Thailand's place near hospital, and @Nihonjin1051 do marketing in Japan. We will open elderly services in Thailand for Japanese old people.

 

[William Hung]

This is indeed a good development.

@TaiShang posted a similar thread recently. This relates to our discussion in the other thread. As China develops, there will be alot more money to finance these much needed elderly services and nursing homes, as you argued. And it is good.

But my argument was that the elderly suicide problem cannot be completely solved by any "services." It can only be solved by the family. Because the root of the problem is a cultural issue, not a financial or medical one. And this cultural issue is unique to Confucian societies where "filial piety" is still ingrained in the national psyche but cannot be practiced in a growing ruthless capitalist/urbanised society (Like Japan, and now China).

I'll remind you again what this Chinese sociologist said in this article:

Alarming Elderly Suicides in Rural China - New Tang Dynasty Television (NTD TV)

Also, a sociological study on suicides among older people in rural China also found that suicide rates have reached an alarming level.

For example, up to 28% of the population in Rudong County, Jiangsu Province, are elderly. The majority of those who are in their 60s or 70s are still doing odd jobs and house chores. They long for the company of their children and grandchildren. But many of them are admitted to nursing homes where they are kept alive, but with no family, friends or any emotional exchange.

 

[Aepsilons]

hehehe....

I got an idea. Let's copy this business model to Thailand

I supply Thailand's place near hospital, and @Nihonjin1051 do marketing in Japan. We will open elderly services in Thailand for Japanese old people.

Sounds really good. I think the warm weather of Thailand, rich sun light (good source of melatonin, and is linked with serotonin 'feel good' effect) can greatly increase mood of the elderly, maybe even reduce depression and increase quality of care.

Thailand may be home to more Chinese and Japanese tourists yet. Albeit, more 'silver hair' market opportunity.


7 Reasons to Retire in Thailand - US News

 

[C130]

they should house the elderly in those ghost cities along with their care givers.

 

[Aepsilons]

The new model has gained popularity. An elderly care center affiliated to the Jinzhou Workers' Hospital in Hebei's Jinzhou city, is full and cannot meet market demand, according to Wu Dianhua, owner of the private hospital and elder center.

Very sobering news, indeed. I believe that there will be a health care revolution in China in 2-5 years time. There will be a trend change where more Chinese will graduate with Nursing, Physical Therapy, Occupational Therapy, Respiratory Therapy, Nuclear Medicine, Medicine, Pharmacy, Podiatry degrees / specializations -- to meet the health care demands of the country.

This will be excellent because we will see in China a changing trend; there will be increase service-oriented economy from mere dependence on manufacturing-based economy.

There will be, definitely, opportunity in China for those who and tap into this....market trend.

This is a Multi-Billion Dollar opportunity for Geriatric Care Industries. $$$$$ !!!

 

[Arya Desa]

Wow so sad that they don't keep their parents in their home. In Indian culture if you neglect your parents by putting them in a care facility the community will shun you.

 

[Aepsilons]

Wow so sad that they don't keep their parents in their home. In Indian culture if you neglect your parents by putting them in a care facility the community will shun you.

You have to look at this at an industry perspective, buddy. By 2033, there will be about 200 million Chinese who will be over 60 years of age. Imagine the industry opportunity for Chinese start up companies , hospitals, nursing and rehabilitation facilities. This will mean an increase in demand for nurses, doctors, physical therapists, occupational therapists. This will in turn drive demand for health education programs. This in turn will lead to the graduation and employing of millions of more Chinese in the health field. This is an opportunity for all.

The elderly patient benefits with proper health care, the family benefits because they can visit their relative and at the sametime are relieved of the stress of having to physically care for the elderly. Its a mutually beneficial relationship. One that generates Billions of dollars a year.

 

[Arya Desa]

You have to look at this at an industry perspective, buddy. By 2033, there will be about 200 million Chinese who will be over 60 years of age. Imagine the industry opportunity for Chinese start up companies , hospitals, nursing and rehabilitation facilities. This will mean an increase in demand for nurses, doctors, physical therapists, occupational therapists. This will in turn drive demand for health education programs. This in turn will lead to the graduation and employing of millions of more Chinese in the health field. This is an opportunity for all.

The elderly patient benefits with proper health care, the family benefits because they can visit their relative and at the sametime are relieved of the stress of having to physically care for the elderly. Its a mutually beneficial relationship. One that generates Billions of dollars a year.

Yea but not everything is about money. Are you willing to sacrifice the most sacred parts of your culture for the sake of "development"? Why does economic growth have to be inversely correlated to social well being? Idk maybe we view our parents differently from you guys or something.

 

[Aepsilons]

Yea but not everything is about money. Are you willing to sacrifice the most sacred parts of your culture for the sake of "development"? Why does economic growth have to be inversely correlated to social well being? Idk maybe we view our parents differently from you guys or something.

Caring for the family and honoring them are all part of filial duties. This is central in my culture, in Japanese culture. This is also a trait in traditional Chinese culture. Even in Korean culture, as well. While there are going to be families that will prefer to care for their senescent relatives , there will be others who will be willing to pay for social and health care services for the elderly. Many Japanese are professional minded and do not have luxury of having servants or what not. Sometimes more often both husband and wife have to work. The benefit of these elderly care programs is that it allows a place that can care for them in the event that the parent is disaffected by more severe cognitive issues that are associated with old age; such as Alzheimer's Disease, Dementia, Parkinson's Disease; which require proper medical care vis-a-vis the professionally trained Registered Nurse who is specialized in Geriatric Medicine, and under the constant supervision of the Geriatric Medical Doctor.

Making the right choice is never the easiest, and sometimes, it is proper that a relative relegate the health care of one's aged family member to a health professional. In fact, recognizing and realizing this necessity is a form of filial piety and respect.

 

[William Hung]

Caring for the family and honoring them are all part of filial duties. This is central in my culture, in Japanese culture. This is also a trait in traditional Chinese culture. Even in Korean culture, as well. While there are going to be families that will prefer to care for their senescent relatives , there will be others who will be willing to pay for social and health care services for the elderly. Many Japanese are professional minded and do not have luxury of having servants or what not. Sometimes more often both husband and wife have to work. The benefit of these elderly care programs is that it allows a place that can care for them in the event that the parent is disaffected by more severe cognitive issues that are associated with old age; such as Alzheimer's Disease, Dementia, Parkinson's Disease; which require proper medical care vis-a-vis the professionally trained Registered Nurse who is specialized in Geriatric Medicine, and under the constant supervision of the Geriatric Medical Doctor.

Making the right choice is never the easiest, and sometimes, it is proper that a relative relegate the health care of one's aged family member to a health professional. In fact, recognizing and realizing this necessity is a form of filial piety and respect.

1. Yes, the Confucian principle of filial piety is still ingrained in the national psyche of countries/cities such as Japan, SK, HK and China. But why did you ignore my other source that quote a survey made by WHO to show that elderly suicide rates in these Confucian countries are actually higher than average, even higher than other western developed countries. There seems to be a variable that is emerging: Capitalist countries that still hang on to its Confucian root.

2. You keep arguing that with increase in wealth, there will be alot more finance available to fund these elderly services, which will solve this elderly suicide problem. But again, that WHO survey shows that even in rich and developed countries like SK and Japan, elderly suicide rates are still high, higher than even poorer countries. You mentioned that Japan and HK has great mental health services for the elderly, but the survey still show that their suicide rates are high.

3. Another argument that wealth won't solve the elderly suicide problem: My PRC source I previously linked said that elderly suicide rates has significantly increased since the last two decades. The elderly suicide rates China had when it was poorer is actually lower than it is today. This is why that PRC sociologist said it is a paradox: growing wealth should mean more money to assist and care for the elderly. Instead, their suicide rate shot up.

4. The PRC has an ageing demographic.
As time goes by, the young working population will be burdened by the disproportionate number of the retired elderly. This mean that they will have to import a large number of migrant care givers to look after these elders. However these migrant care giver will be foreign to the elders. Thus, the elders will still feel lonely and neglected by their children/fellow countrymen. Like what that Chinese sociologist say, they will be kept alive in these nursing homes, but they will still miss out on true companionship.

 

[Aepsilons]

1. Yes, the Confucian principle of filial piety is still ingrained in the national psyche of countries/cities such as Japan, SK, HK and China. But why did you ignore my other source that quote a survey made by WHO to show that elderly suicide rates in these Confucian countries are actually higher than average, even higher than other western developed countries. There seems to be a variable that is emerging: Capitalist countries that still hang on to its Confucian root.

An unfortunate consequence of severe depressive episodes , which is common in elderly is loss of social affect, and in severe cases, suicidal thought and suicidal behavior. But from statistical data, suicidal rates in Japan is not as high as say in Russia, Estonia and other OEC countries. I am in the position that with increased mental health care service awareness , and forray into public perception, individuals with severe clinical depression can avail of these behavioral therapy services.

Please refer to graph 1,

​

2. You keep arguing that with increase in wealth, there will be alot more finance available to fund these elderly services, which will solve this elderly suicide problem. But again, that WHO survey shows that even in rich and developed countries like SK and Japan, elderly suicide rates are still high, higher than even poorer countries. You mentioned that Japan and HK has great mental health services for the elderly, but the survey still show that their suicide rates are high.

Of course, classical economic theory supports this and illustrates how this manifests in micro and macrosystems.

​

3. Another argument that wealth won't solve the elderly suicide problem: My PRC source I previously linked said that elderly suicide rates has significantly increased since the last two decades. The elderly suicide rates China had when it was poorer is actually lower than it is today. This is why that PRC sociologist said it is a paradox: growing wealth should mean more money to assist and care for the elderly. Instead, their suicide rate shot up.

Your article doesn't take into consideration that China, currently, is in the verge of health care reform. With time, as China develops economically and as the Government (CPC) pours more fiscal investments in geriatric care services, these deficiencies that you point out will be alleviated.

China’s Healthcare Reform: How Far Has It Come? | China Business Review

WPRO | Health sector reform in China

Healthcare and Insurance Among the Elderly in China: Evidence from the CHARLS Pilot - Aging in Asia - NCBI Bookshelf

http://gas.sagepub.com/content/17/2/209.short

http://ije.oxfordjournals.org/content/31/4/772.short

As time goes by, the young working population will be burdened by the disproportionate number of the retired elderly. This mean that they will have to import a large number of migrant care givers to look after these elders. However these migrant care giver will be foreign to the elders. Thus, the elders will still feel lonely and neglected by their children/fellow countrymen. Like what that Chinese sociologist say, they will be kept alive in these nursing homes, but they will still miss out on true companionship.

I don't think China will have to worry about worker deficiency, they are the most populous nation in the earth, with very high efficient work force. Importation of foreign workers may not manifest in China, given their abundance in man power, and growing skilled labor market.

 

[William Hung]

An unfortunate consequence of severe depressive episodes , which is common in elderly is loss of social affect, and in severe cases, suicidal thought and suicidal behavior. But from statistical data, suicidal rates in Japan is not as high as say in Russia, Estonia and other OEC countries. I am in the position that with increased mental health care service awareness , and forray into public perception, individuals with severe clinical depression can avail of these behavioral therapy services.

Please refer to graph 1,

​

Your first graph doesnt indicate what age group they are looking at. We are only concerned with the elderly group here.

The second graph support the claim that the "confucian" countries has noticeably higher elderly suicide rates than the rest of the OECD (and higher than less developed countries). I'm surprised that the SK rate is so high!

Of course, classical economic theory supports this and illustrates how this manifests in micro and macrosystems.

​

Your article doesn't take into consideration that China, currently, is in the verge of health care reform. With time, as China develops economically and as the Government (CPC) pours more fiscal investments in geriatric care services, these deficiencies that you point out will be alleviated.

China’s Healthcare Reform: How Far Has It Come? | China Business Review

WPRO | Health sector reform in China

Healthcare and Insurance Among the Elderly in China: Evidence from the CHARLS Pilot - Aging in Asia - NCBI Bookshelf

http://gas.sagepub.com/content/17/2/209.short

http://ije.oxfordjournals.org/content/31/4/772.short

Yes, I didnt take that into consideration. I do not know for sure whether these health reform will make a impact or not. And neither can you, we both have to wait and see. My argument was that, even in wealthier countries with a much more developed health care sector (like Japan, HK and SK), the elderly suicide rates still remain higher than average.

I don't think China will have to worry about worker deficiency, they are the most populous nation in the earth, with very high efficient work force. Importation of foreign workers may not manifest in China, given their abundance in man power, and growing skilled labor market.

I think you're mistaken about the ageing population issue. It's not about the size of the working population, but the proportion between the working population and the retired population.

Unless, the working population becomes extremely efficient and can multi-tasks (or hope that an automation revolution takes place), which I doubt they can, the need to import migrant workers is likely within the next 15-30 years.

 

[Aepsilons]

Your first graph doesnt indicate what age group they are looking at. We are only concerned with the elderly group here.

Its a comprehensive data, in regards to the 1st graph. That's why I provided the 2nd graph, which delineates the trends in varying age groups. Its also juxtaposed to other nations, for ease of comparative analysis.

I'm surprised that the SK rate is so high!

Yes. One should be compelled to study the various social factors; service deficiency, social dynamic et al and their implication for this. But I would conjecture that the issue is based on limited elderly care , limited behavioral therapy services readily available as compared to western counterparts.

Yes, I didnt take that into consideration. I do not know for sure whether these health reform will make a impact or not. And neither can you, we both have to wait and see. My argument was that, even in wealthier countries with a much more developed health care sector (like Japan, HK and SK), the elderly suicide rates still remain higher than average.

I addressed this in my above response ^

I think you're mistaken about the ageing population issue. It's not about the size of the working population, but the proportion between the working population and the retired population.

You're failing to understand the Allied health complex. In nursing and rehabilitation centers, let's say in a medium sized rehabilitation center (300 bed facility). At any given time there will be about 30 to 40 Registered Nurses on the floor because there are usually 1 RN or LPN for ever 8 to 10 patient. In support of the RN (Registered Nurse) or LPN (Licensed Practical Nurse) is the CNA (Certified Nursing Assistant). Then there are the Medical Social Workers, Clinical Psychologists who do their hourly roundings and provide mental health services.

This is the reason why the United States is able to provide quality nursing and skilled care to elderly population. At any given time due to these said organized skilled care processes. If Japan, South Korea and China follow the American standard , there would be alleviation of elderly comorbidities.

 

[William Hung]

Its a comprehensive data, in regards to the 1st graph. That's why I provided the 2nd graph, which delineates the trends in varying age groups. Its also juxtaposed to other nations, for ease of comparative analysis.

And the 2nd graph show that the elderly suicide rates in the "confucian" countries are noticeably higher than everybody else (on that graph).

Yes. One should be compelled to study the various social factors; service deficiency, social dynamic et al and their implication for this.

And here lies our biggest differences in this debate. You want to focus on the treatment that you conject would solve this suicide problem. I'm not denying that the treatment and therapy can help. What I want to focus on is the causes of this social problem. So I want to examine and isolate the factors that causes this problem.

My hypothesis was that it was the tension between the Confucian idea of filial piety still being embedded in the national psyche and the ruthless lifestyle and changing ethos of the younger generation in these "confucian" industrialised countries. I was saying that this was the main factor that contributed to the rising level of elderly depression and suicide.

Not sure if you know it or not, but there was a couple of bus incidents last month involving some elderly people in China. The behaviour of the Chinese youth involved was appalling, but more shocking was the responses made online by young chinese netizens. It became clear (to me atleast) that the chinese ethos of the younger generation has changed and filial piety is slowly disappearing.

This incident was also the reason why I created that "Euthanasia and Asian ageing population" thread last month. To me, your knowledge of Asia and Asian people are only academic book-knowledge, not street-knowledge. You are not aware of the reality of Asian youths on the street level and can only repeat textbook idea about "Confucian Filial Duty" and how Asian people will always look after their elders.

My argument was that this is slowly no longer the case and it is for this reason that elderly depression and suicide are high in Confucian countries.

But I would conjecture that the issue is based on limited elderly care , limited behavioral therapy services readily available as compared to western counterparts.

This is only a conjecture. One reason why I won't bite into it yet is because you said it yourself in the other thread that these services are readily available in Hong Kong and Japan, both of which still has higher than average elderly suicide rates.

You're failing to understand the Allied health complex. In nursing and rehabilitation centers, let's say in a medium sized rehabilitation center (300 bed facility). At any given time there will be about 30 to 40 Registered Nurses on the floor because there are usually 1 RN or LPN for ever 8 to 10 patient. In support of the RN (Registered Nurse) or LPN (Licensed Practical Nurse) is the CNA (Certified Nursing Assistant). Then there are the Medical Social Workers, Clinical Psychologists who do their hourly roundings and provide mental health services.

^ How does this paragraph address your misunderstanding of the ageing demographic issue where the size of the working population is not the problem but the disproportionate ratio between the working and retired population.

This is the reason why the United States is able to provide quality nursing and skilled care to elderly population. At any given time due to these said organized skilled care processes. If Japan , South Korea and China follow the American standard , there would be alleviation of elderly comorbidities.

You contradict yourself with what you said in the other thread where you asserted that Japan (and HK) has already adopted this American standard and services.

Here's what you said in the suicide thread:

Cognitive Behavioral Therapy, Psychoanalytic Psychotherapy and other therapeutic modules are proven to be effective long term...These services don't exist in many rural areas of China right now. But these services are readily available in the urban areas such as Hong Kong, Shanghai, Guangzhou. Nanjing, Beijing, Chongqing.

This same situation happened in the United States; where there was lack of geriatric care and awareness in the past 50 years, but recently, through the auspice of ANA (American Nurse's Association), APA (American Psychological Association), and AMA (American Medical Association), geriatric care, geriatric rights and awareness of such issues have permeated the entire medical establishment. So much that it is even addressed by the United States HIPAA Law that was passed in '96.
Now, in the present, there is a focused geriatric care in the US. The same also in Japan. I believe it will be observed also in China.

I'll say this again, I'm not trying to deny that these mental health services can improve the condition of a depressed patient. I'm hypothesising that it is the tension between the Confucian ideals still embedded in the hearts of these elders and the reality of a urbanized society that are making them depressed and suicidal.