An elderly woman was watering her garden in Fuzhou, Fujian Province Photo: Weng Rong/CSST

The phenomenon of “aging before preparation” is an important characteristic of the aging population in China, while the social elderly care service system is relatively lagging behind the demand for such services. Going forward, it is essential to thoroughly investigate and research this phenomenon in the local context, and summarize new ideas and methods for building an elderly care service system.

Providing practical experience

Since 2018, our research team has been conducting ongoing tracking research on the elderly care service status in Beilun District, Ningbo City, Zhejiang Province. The Beilun District has collaborated with the team, jointly developing reform plans for an integrated elderly care service system. Beilun District has accumulated a series of practical experiences.

Beilun has actively introduced well-established elderly care institutions to leverage professional support, so as to improve the overall level of elderly care services in the district.  

The district has advocated for small-scale applicability, promoting the integration of elderly care institutions into the community. These small-scale institutions primarily offer two types of services. The first type encompasses health services, such as health management and chronic disease management. The second type includes social services, such as daily care and encouraging the active participation of the elderly in society.

Furthermore, Beilun has prioritized harmony within its elderly care institutions by ensuring equal treatment for both impoverished and self-funded individuals. In certain subdistricts, the subsidies for impoverished elderly people even surpass the fees for self-funded elderly individuals.

Home-based care should be considered the cornerstone for strengthening elderly care services. In the comprehensive scope of home services, emphasis should be placed not only on the elderly receiving care at home, but also on the family caregivers providing the care. To this end, Beilun has fully implemented a nursing skills training system, with a focus on fundamental knowledge of family care and the provision of free public welfare training. In 2021, a total of 602 family caregivers received training.

Beilun has built several elderly communities with the aim of ensuring aging in the right place. In certain townships and subdistricts, Beilun has incorporated specially designed communities for the elderly into their new village planning. This has been achieved through two specific methods: for example, the 8 villages of Guoju Subdistrict have collaboratively established an elderly community, while the Chenhuapu community in Xiapu Subdistrict has adopted a “village within village” pattern for the elderly community. Both locations are now equipped with specialized home service institutions and activity venues for elderly communities.

Prioritizing the needs of the elderly, Beilun’s “Love Kitchen” project has been delivering meals to their doorstep since 2009. This initiative has provided meals to the elderly in need in the area for over a decade.

A community platform has been established to provide elderly care in both health and social aspects. The health services in Beilun are characterized by “immediate treatment for emergencies, meticulous care for chronic diseases, and close attention to disabled individuals.”

Zoning restrictions have been dismantled to tailor services to specific needs. For instance, in Xiapu Subdistrict, the entire area is currently divided into Xinpu area (comprising 9 villages and 1 community) and Jiufeng area (consisting of 5 villages) based on the living conditions and service requirements of the elderly. There are plans to create a third area by dividing several communities near the central urban area.

Beilun has been developing a robust elderly association, offering volunteer services to support elderly care. Through the elderly association, Beilun has meticulously developed a distinctive volunteer service brand called “Happiness Knocks on the Door,” and has implemented a “1+10+360” volunteer organization system. This innovative approach has revolutionized the home-based elderly care assistance mechanism, complemented by targeted support from professional volunteer organizations, particularly for elderly and advanced elderly individuals. This initiative provides daily care, safety protection, rehabilitation and health care, as well as intellectual comfort and cultural entertainment for disabled, solitary, and elderly individuals aged 80 and above in the district.

Beilun focuses on practical results with intelligent elderly care. At present, the most widely used intelligent device is VR (Virtual Reality)-GIS (Geographical Information System) technology. Elderly people can query the “distribution map of elderly service facilities” through their mobile phones, and make appointments for four professional services: smart monitoring, rehabilitation, nursing, and daily care.

Responding to real needs

The above measures complement each other’s functions and have demonstrated outstanding effectiveness, representing an innovative attempt by Beilun to transform the elderly care service system into a comprehensive entity. Institutional care, community care, and home care systems form an “elderly care system” through functional coupling. Among them, the six measures of “love kitchen delivery” in home services, “running elderly associations well” and “providing according to needs” in community services, as well as “introducing professional institutions,” “embedding institutions into communities” and “equitable treatment of self-fund and impoverished elderly” in institutional services, exhibit strong operability and are being systematically implemented throughout the district, entering a relatively smooth virtuous cycle of self-operation, self-management, and self-development. 

The three aspects of “home-based service as the foundation” in home services, “intelligent elderly care with high efficiency” in institutional services, and “balancing health and social aspects” in community services are particularly focused on the transformation of mindsets. The purpose is to embrace new values in elderly work, and to achieve positive tangible results by connecting theory with practice. 

In the context of the rural revitalization strategy, effectively responding to the real service needs of the elderly is an important benchmark for the construction of high-quality elderly services.

Tang Jun is a research fellow from the Institute of Sociology at the Chinese Academy of Social Sciences.

Edited by ZHAO YUAN