China is growing old fast. National demographic statistics show that in 2015 people aged over 60 accounted for 16.1 percent of the population and it is likely to more than double to 35 percent by 2050.
"The growth rate of per capita GDP in China can hardly catch up that of its aging population," said Mi Hong, professor of Demography at Zhejiang University. "And the number of the elderly who suffer from dementia or chronic illness is rising quickly."
The central government has been combining senior care with medical services. In Hangzhou, a community integrated senior care center opened in October last year. The senior care center is located in Caihe community of Jianggan District. It is one of the oldest residential communities in Hangzhou and has a larger proportion of elderly people.
Spanning more than 300 square meters in total, the center is split into three parts, the rehab building is linked with an 11-bed residential area, while the canteen, which is also used as a recreation center, is around 200 meters away.
There is one nurse assigned to the center, who is in charge of medication administration and basic training for nursing skills. Three caregivers work on shift to ensure that it is 24-hour monitored.
The caregivers work full time and they are responsible for regular checks, serving the elderly's daily routines and also taking them to rehab exercises and recreational activities, such as craftwork or gardening.
The center has also signed an agreement with the local community hospital, and there will be a weekly visit by a doctor and guidance from nurses at the hospital.
"Our center is aimed to offer respite services for family caregivers who need breaks on a week day, holidays or those without the skills for looking after people following surgery," said Mei Chen, director of operation at the Ai Zhao Hu Co, a senior care company introduced by the local district government to manage the center.
Taking care of the elderly has always been considered a duty of the offspring in China, as filial piety is a commonly held belief. But the one child policy has meant that the traditional way of getting old, in an extended family, where several siblings look after seniors is no longer possible.
A community-based senior care center is a good alternative for shifting some of the responsibilities to a specialized organization.
The 96-year-old Zhou Xuemei applied to live in the center several months ago. Her son-in-law, Mi Mi, who is already retired, told Shanghai Daily he chose the center because it was close and convenient for them to visit her regularly.
"We live in the nearby neighborhood. And we come to see her every afternoon, together with my granddaughter," Mi said. "Also the caring service they offered is better than some of the other nursing homes we have inspected before.
"For me the caregiving service is far more important than facilities."
Mei told Shanghai Daily that the average occupancy rate at the center is 80 percent with the longest stay at three months and the shortest one-week. The average age of the elderly living in is 85. However those who suffer from severe chronic illness or immobility are excluded.
"We intend to cover a broader age group, including those aged between 60 and 75, who are comparatively healthy and active," added Mei.
These community-based senior care centers are also expected to take even more responsibilities in the future.
"We actually encourage residents to buy in-home services from these senior care centers," said Shen Jianping, chief of Jianggan District Bureau of Civil Affairs. "We hope that in the future people who age in their own homes will be able to rent a caring bed and related services from these centers when they need them."
Like state-run retirement homes, these senior care centers are heavily subsidized by the local government. In the case of the Caihe community center, the venues are offered free and the company who runs the center is subsidized with more than 100,000 yuan (US,131) each year in operation.
Qiao Xiaochun, professor of Demography at Peking University, believes we need more specialized social organizations and companies in the senior care industry, and introduce a long-term care insurance.
"The main problem now is that we don't have a cross departmental design for that," said Qiao. "The Ministry of Civil Affairs is in charge of senior care, while medical services are offered by hospitals which fall into the administration of another department. But the needs of a person are all encompassing and cannot be divided like that."
Shen of Jianggan District revealed that the city government of Hangzhou is already going to launch its own long-term care insurance next year.