Xu Fengqin, a Puleyuan resident, eats lunch while being watched by her son, who pays regular visits.(Zou Hong/China Daily)
Necessity, not choice
Yan Shuai, head of the Pule-yuan nursing home in south Beijing, said the matter is not one of choice, but necessity, and caring for disabled seniors is demanding and costly. "The monthly fee, from 5,500 to 8,000 yuan at Puleyuan, is a big burden on the elderly and their families," Yan said, adding that the fee for other patients is about half that for disabled seniors.
Demand is uncompromising and high. At present, disabled patients account for 30 percent of all Puleyuan's residents, and their illnesses range from dementia, cerebral hemorrhages, strokes and spinal injuries, according to Yan. "As long as people are bedridden, they are classified as disabled," he said.
Wang Lingfang, 68, is one such resident. She cannot swallow or speak and exists on a liquid diet administered via a feeding tube.
Wang has been bedridden for eight years, and Xi Xiulan, her long-term caregiver, said her meager pension of 2,600 yuan doesn't cover the monthly fee, so Wang is partly supported by her son, Liu Liangcai, a bus driver.
"I have my own family and child to support as well. We are struggling to make ends meet," said Liu, who earns about 5,000 yuan a month.
Yan, the nursing home head, said the pressure on people such as Liu could be alleviated by the introduction of long-term care insurance designed to cover a certain proportion of the cost of care.
Li Zhong, spokesman for the Ministry of Human Resources and Social Security, said the provision of care insurance is a matter of social development and stability.
The number of seniors is projected to rise to 400 million by 2035, and the proportion of disabled elderly is expected to rise substantially, Li said at a media briefing in February.
Yuan Xin, an expert in population studies at Nankai University in Tianjin, said the family has long shouldered the burden of caring for disabled seniors in China, but the continuous reduction of family size in the past three decades has made that model unsustainable.
The National Health and Family Planning Commission says the average 1950s household had 5.3 people, compared with 3.3 last year.
Trials underway
Li, the ministry spokesman, said the country's top decision-makers have recognized the challenge, and last year began considering the introduction of long-term care insurance nationwide. Trials are underway in selected regions, including Qingdao, East China's Shandong province, Shanghai, and Beijing.
In the Haidian district of Beijing, a trial program is open to all locals ages 18 and older. The premium rises with age, but for people ages 18 to 39, the monthly payment is 114 yuan, 20 percent of which is paid by the local government.
After 15 years of payments, disabled seniors are eligible for care worth 900 to 1,900 yuan a month.
Meanwhile, the government of Beijing's Fengtai district has been trialing the use of a government-funded program to purchase services for disabled elderly people who live at home.
Wu Dongning, head of Lehu, a company that supplies nursing services for the program, said nurses are sent to help with things such as post-stroke rehabilitation, injections and catheterization, and suggested the insurance should cover items such as these.
Sun Jie, deputy director of the School of Insurance and Economics at the University of International Business and Economics in Beijing, said the types and levels of long-term care services should be studied and defined at State level to facilitate the policy nationwide.
The approach was pioneered in the 1960s in countries with rapidly aging populations, such as Germany, Japan and the Netherlands, and has proved effective in addressing the long-term care demands of disabled seniors, she said.
