Remember ME - You Me and Dementia

Saturday, January 12, 2008

Aging City Leads Way : We need to learn from China how to care for Elderly

People often mistake 49-year-old Liu Yuling for the daughter of 93-year-old Cui Yuhai as Liu supports Cui during his twice-a-day stroll in the community garden. Liu spends over ten hours in Cui's 40-square-meter apartment every day. Since Cui's wife died two years ago, Liu has been the first person the elderly man sees when he wakes up in the morning and the person who says good night to him at his bedside. She cooks meals, washes his clothing, shops for his favorite snack food, keeps diaries on his health care and expenditure and listens to his stories. To better communicate with the elderly man, Liu even learned to master Cui's dialect.

"I wish I could have such a good daughter as her," Cui tells anyone who asks whether Liu is his daughter. "She treats me just like a good daughter would."
On a monthly salary of 400 yuan ($54) per month, Liu started to take care of Cui and his wife in 2004 as a housekeeper for the elderly, a system invented in the coastal city of Dalian of Liaoning Province in 2002.

Like Liu, who was laid off from a wool product factory in 2002, all housekeepers are unemployed workers who were retrained by the government. All of these housekeepers are registered and managed by government agencies. Their services are priced at a low level so that they are affordable to elderly citizens. Meanwhile, the government has ensured that their income from working as a housekeeper for the elderly won't affect their unemployment allowance. For elderly citizens who have no children and no income, the government pays for part or all of their home nurse services.

Up to last May, over 2,600 households in Dalian had enjoyed the services of a housekeeper, whose services are evaluated by their patrons. They can get a pay rise if they are promoted to a three-star or five-star housekeeper based on their service quality.

"This system of supporting the elderly has comforted the two groups of disadvantageous people, the elderly and the unemployed," said Han Yumin, a top civil affairs official of Shahekou District of Dalian, which employs over 726 housekeepers for the elderly.

As one of China's fastest aging cities, Dalian has 965,300 elderly citizens of 60 years old and above, accounting for 16.85 percent of total population. This is far above China's national average of 12.26 percent. It is estimated that by 2025 one in four of Dalian's citizens will be elderly.

"This fact of being an aging society since 1987 has propelled Dalian to lead other Chinese cities to explore new methods to satisfy the demands of the elderly," said Yang Fubin, Director of the social welfare department of Dalian Civil Affairs Bureau.

Yang told Beijing Review that the development of social welfare for the elderly in Dalian in the last five years has exhibited three characteristics. First is the exploration of new models to satisfy the different demands of elderly citizens of different age groups and economic capacities. Second is to increase the proportion of elderly people enjoying government living subsidies. Third is to learn from nursing homes in Japan. One reason for this is that Dalian is geographically close to Japan. Another is that as the most rapidly aging country in the world, Japan has accumulated a wealth of experience in providing social services for the elderly. During the 2005 Aichi Expo, Dalian Civil Affairs Bureau sent a delegation to attract investment and technical cooperation from Japanese companies involved in elderly care. This made Dalian the first city to promote foreign investment in caring for the elderly.

"In the past, government welfare for the elderly has been mainly confined to taking care of elderly people without children and income at government-run homes for the elderly. Now the government's increased financial strength and people-oriented governance guidelines will enable a larger proportion of elderly people to enjoy social benefits," said Yang.

New services

In 2004, Minister of Civil Affairs Li Xueju called upon civil affairs agencies of different levels to learn from Dalian's diversified models.

One new model is that the government issues bills to elderly citizens who have financial difficulty but don't want to move into government homes for the aged. The bills, printed with different face values, can be used to pay for the employment of government-trained housekeepers and lunches at a discounted price at government-run elderly citizens leisure centers.

Several agencies to care for the elderly have been set up in Dalian. By calling the hotline number of these agencies, elderly citizens can get help in choosing a nursing home that suits their demands, booking home delivery of heavy consumer goods such as flour and edible oil, free psychological and health consultation, and book accommodation at resort communities for the elderly when they want to travel to other cities in China. The government offers tax exemption incentives to these companies so that their services can be free or priced very low.

Since homes for the elderly cannot provide enough beds to meet the growing demand in Dalian, the city government has also started to offer economic incentives to private homes for the elderly so that more private investment can be injected into this area.

Yang said in Dalian elderly people in financial difficulty can either enjoy government-subsidized housekeeper services or live in homes for the elderly where the government pays part or all of their expenses; well-off elderly people can live in resort communities for the elderly in Dalian or other cities; the elderly who like the atmosphere of a big family can choose a home according to their financial capacity; and the elderly who don't want to leave home can go to nearby leisure centers to do exercise, dance, play cards or chat with other elderly people.

"We really cannot afford to waste any time in improving social welfare for the elderly. Since China started to implement its family-planning policies in late 1970s, the first generation of parents with a single child will turn senior citizens in a few years. Elderly people in an extended family may need more than their children can provide," said Yang.


Source: http://www.globalaging.org/health/world/2008/aging.htm

Forget yourself for others, and others will never forget you.

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