A home-based elderly care service complex in Hefei, Anhui Province. Photo: IC PHOTO

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The living arrangements of the elderly are a direct reflection of their care needs and preferences. Analyzing these arrangements in the context of rapid population aging offers valuable insights into older adults’ residential choices, family structures, and social dynamics, while also revealing underlying challenges. Such understanding is essential for improving the social care system and developing targeted services to better support the elderly. Drawing on data from the 2020 Seventh National Population Census (hereafter referred to as the “Seventh Census”), this article examines the living patterns and key characteristics of the elderly from a multidimensional perspective. 

Population census data plays a vital role in understanding the living arrangements of the elderly at a national scale. The Seventh Census provides three distinct types of data for analysis, each offering unique perspectives. First, short-form aggregated data provides an overview of elderly households nationwide, detailing their proportion of total households and internal composition, such as individuals living alone or as couples. However, it offers limited insights into co-living arrangements with children, particularly married children. Second, long-form aggregated data is valuable for its inclusion of elderly individuals in institutional care. Yet, its focus is limited to co-residents like spouses and children, without distinguishing between married and unmarried children, limiting more detailed analysis. Third, the long-form 1% sample data enables a more nuanced examination of various family household types involving elderly individuals. However, it is confined to family households, excluding institutional settings, and its findings sometimes differ from the corresponding short-form data, necessitating weighted adjustments to ensure accuracy. 

Comparison of elderly living arrangements 

Based on aggregated data, the living arrangements of the elderly can be understood from the perspective of “households.” In 2020, households with elderly members comprised over one-quarter of all households nationwide, exceeding one-third in rural areas. Among households with one elderly member, over 36% involved elderly individuals living alone. In households with two elderly members, more than 55% consisted of elderly couples living independently. 

When shifting the perspective from “households” to “individuals,” the data shows that in 2020, 16.24% of elderly individuals lived alone, while 30.30% were elderly couples living independently. Together, these groups accounted for 46.54% of the elderly population. If households with couples where only one partner is 65 years or older are included, the actual proportion of elderly individuals living independently could be even higher. 

Based on long-form aggregated data, this study explores elderly living arrangements from an individual perspective. In 2020, the overwhelming majority of elderly individuals in China resided at home, with less than 1% in institutional care. Among those living at home, less than 40% nationwide lived in households with children, with the rural proportion slightly lower at 36.15%. Nationwide, 13.35% of elderly individuals lived alone without a caregiver, and more than 56% resided in households without children. 

Based on weighted data from the 1% sample of the long-form census, this study further identifies the types of family households that include elderly individuals. In 2020, the proportion of elderly couples living in two-person households increased compared to 2010 and 2000, reaching 36.55% nationwide, making it the largest type of family household. Notably, for the first time in 2020, elderly couple households also became the most prevalent type in rural areas. Nationwide, the combined proportion of elderly couple-only households and single-person households reached 54.48%. 

All three types of census data indicate a significant increase in the proportion of elderly individuals aged 65 and above living alone or with a spouse in 2020 compared to 2000 and 2010. Moreover, the rise in elderly individuals living alone in rural areas surpassed that in urban and town areas, reflecting a trend of convergence in elderly living arrangements between urban and rural regions over the two decades. The two types of long-form data reveal that living without children has become the predominant living arrangement for the elderly in both urban and rural areas, marking a substantial shift away from the traditional arrangement co-residence with children. 

Each of the three analytical perspectives offers unique insights into elderly living arrangements. The short-form aggregated data reveals that more than 55% of elderly individuals live independently as couples when both spouses are alive, and over one-third of elderly individuals live alone. This offers a clear understanding of elderly individuals living alone within households containing one or two elderly people. The long-form aggregated data is valuable for showing that in 2020 the majority of elderly individuals opted for home-based care, with a very small proportion choosing institutional care. It also highlights that many elderly people living at home reside in childless households. The long-form 1% sample data, on the other hand, offers a more detailed and nuanced view of the diverse family household types in which elderly individuals reside. It shows that more than half of elderly individuals now live in couples’ households or single-person households, with those living with children, particularly married children, becoming a minority. 

Analysis of such shift 

The study identifies a significant shift in 2020: living alone, whether in single-person or couple-only households, has become the predominant arrangement for elderly individuals. In general, for younger and middle-aged elderly individuals who remain relatively independent, living alone as couples or singles is not problematic and may even be desirable, as it enables a peaceful life with fewer household responsibilities. The primary issue with contemporary elderly living arrangements, however, is the increasing proportion of elderly individuals living alone, especially among those who are older. 

The Seventh Census data reveals a notable trend: elderly couples living independently have not only increased in number but now represent the majority. Additionally, the proportion of elderly individuals aged 80 and above living alone has surpassed 20%, the majority of whom are widows. While these individuals are generally able to care for themselves and may have even chosen this arrangement—often with nearby support from their children—living alone inherently involves significant risks. 

Data from all three perspectives show that, in 2020, rural areas had a much higher proportion of households with elderly individuals aged 65 and above compared to urban areas. Furthermore, rural areas also recorded a higher proportion of elderly individuals living alone, with 24.94% of those aged 85 and above living alone—a relatively high figure. While these elderly individuals may rely on the assistance of children living in the same village or on children taking turns to provide daily care, it must be acknowledged that they are not part of a stable, cohabiting family unit. As a result, the help they receive is less regular, and their vulnerability to risks is greater. 

Possible coping mechanisms 

In contemporary China, the aging population continues to grow while the availability of family caregivers for elderly individuals diminishes. In terms of the latter, the reality is that the first generation of only-child parents and those with fewer children are gradually entering middle and old age and will soon constitute the majority of the elderly population. 

As social transformations deepen and population migration increases, the proportion of elderly individuals living apart from their married children has risen. Influenced by both subjective preferences and objective factors, the proportion of elderly individuals living alone is expected to increase further. Under these circumstances and trends, how can we improve the quality of life for elderly individuals and reduce their risks? This is a challenge that requires collective efforts from the government, society, children of the elderly, and the elderly themselves. 

Governments should focus on enhancing social services for the elderly, particularly at the community and village levels. In communities and villages with relatively high concentrations of elderly individuals and high proportions of elderly people living alone (including both couples and single individuals), specialized staff should be assigned to establish standardized communication channels with the elderly. This will create mechanisms to promptly identify and address risks such as sudden illnesses. 

In addition, for elderly individuals who still take care of themselves but whose children are not nearby, assistance with purchasing daily necessities should be provided to extend their ability to live independently. Community and village organizations can also recruit volunteers to help address shortages in service personnel. These efforts do not require significant investment but can effectively improve the safety and quality of life for elderly individuals living at home. 

Many children of elderly individuals are currently responsible for taking care of parents who have lost their ability to live independently. The analysis in this article finds that more than 50% of elderly women, particularly widows, live with their children. It is important to note that a relatively high proportion of elderly individuals currently have multiple children, and even when living alone, many receive regular care from children living in the same area. However, for parents of only child or those with fewer children, ensuring the presence of children for caregiving in their old age becomes difficult. 

Therefore, even with improved public services in communities and villages, children should not completely “let go” due to factors such as work commitments, living separately, or other circumstances. In urban areas, children living in the same city should be encouraged to live near or with their elderly parents and share daily responsibilities. For those living in different locations, they should seek reliable caregiving alternatives for their elderly or self-care-impaired parents, such as hiring caregivers or arranging for institutional care. Ideally, for parents who can still take care of themselves but live alone, children should maintain regular interactions to alleviate feelings of loneliness. 

The Seventh Census data indicates that the proportion of elderly individuals in institutional care remains relatively low in both urban and rural areas, but it is indeed gradually increasing. Objectively, in environments with well-established community care services, where middle-aged and young children live in close proximity to elderly parents and close kinship resources are abundant, home-based care remains the optimal choice. Even when living alone, these elderly individuals can still receive support from both their community and kinship networks. This “ecological” caregiving model, where social resources and family relationships combine organically, should be encouraged whenever feasible. 

Looking ahead, however, elderly parents with fewer children or those living apart from their children will face diminishing kinship resources. Without sufficient social services, feelings of loneliness and helplessness associated with home living will intensify. If social services are inadequate, the risks they face will grow. Consequently, their willingness and likelihood to opt for institutional care may increase. In response, the government should fully anticipate this shift and proactively guide the establishment of a diverse range of elder care institutions while regulating institutional care services. 

Wang Yuesheng is a professor from the Key Research Institute of Social History of China at Nankai University.  

Edited by WANG YOURAN