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In China, aging in the care of strangers

China's  elderly are now treated differently than they once were. The country's modernization and one-child-only policy have shifted assumptions about old age.
/ Source: a href="" linktype="External" resizable="true" status="true" scrollbars="true">The Washington Post</a

Tian Deren is only 58, but poor eyesight means he must be helped across the street. He also has diabetes and is hard of hearing, so earlier this year a son-in-law brought him to a privately run home for the elderly.

Because he is still mobile, Tian isn't relegated to the fourth floor, where the most infirm residents live and where some have been known to throw cups of tea at the staff. His room is clean, the food plentiful. Life is good, he said.

But like many of China's graying citizens, Tian understands that the elderly are now treated differently than they once were, that the country's modernization and one-child-only policy have shifted assumptions about old age.

Only children often bear the burden of taking care of their parents alone, while the cradle-to-grave welfare associated with state-owned factories is becoming a thing of the past. Two or three decades ago, a more traditional way of life emphasized the Confucian ideal of respecting one's elders. Today, making good money is the slogan of choice.

"I understand why children send their parents to rest homes," Tian said. "It's not a shame at all today. It's really a big change." His daughter, who is busy selling cosmetics part time and caring for a 4-year-old daughter, has health problems of her own.

A deeper unhappiness
Here in Liaoning province, in China's northeast, Tian spends his time in a simple bedroom bare of any decoration. He keeps some peanuts and a thermos on a side table, and two blue shirts hang above his bed. He says the staff treats him well.

Still, there are times when Tian's upbeat demeanor falls away, and something else shows through.

"The director always says to me, every extra day that I live, she will be happy for me. My own daughter does not say that," he said the other day, fighting back tears.

"They really treat me very well here, as if they were my own children," Tian added later, beginning to sob. "The director always takes me outside for a walk or a concert. My daughter cannot do that because she doesn't have the time."

Tian's sentiments, and those of many elderly Chinese, signal a deeper unhappiness than is often acknowledged within a system that has failed to adequately provide for the aged. While China has created opportunities for a younger, more affluent population, many older people have been left to fend for themselves.

There remains in this country a greater sense of filial piety than in most Western societies. But young people no longer like to talk with their parents as they once did, said Zhang Kaidi, director of the China Research Center on Aging, a government-supported research organization.

"People value money more than family ties. It is very dangerous," Zhang said. "Parents have put all they have, all their money, attention and hope on their child, and they expect to get a return from him when they get old. But the rapid development of the society has changed the traditional give-and-get social contract."

Depression among senior citizens is on the increase, experts say. China's state media are increasingly filled with accounts of elderly parents left abandoned at hospitals or suing their children for financial support. In some cases, Chinese who move overseas initially leave it to their elderly parents to care for children. When the children are eventually sent for, the grandparents are left feeling bereft and sometimes suicidal.

Parents are accustomed to sacrificing everything for their children, but their children hardly understand that sacrifice, said Yang Fubin, director of the social welfare department of Dalian's civil affairs bureau. "Though they are sad at being left alone, they will never admit it. They would rather think their children are busy with work and just need time to rest."

Yang tried bringing his own mother, 80, and father, 75, from their home province to an old-age home in Dalian. But after six months, they missed their old surroundings and returned home. "I have lots of work and lots of pressure every day, so I can hardly take care of my parents. I feel guilty and sorry thinking of this," Yang said.

At the same time, Yang said, "I don't totally agree that people are too busy to visit parents. It's partly true, and it's also an excuse. If you want to do something, you can find time. We have to admit that nowadays, people value money more than family."

At the end of 2005, China had 144 million people older than 60, a number that is increasing by about 100 million every decade, government officials say. But there are only 10 nursing home beds for every 1,000 elderly who need them.

Aggravating the problem is the fact that while the mandatory retirement age for men is 60, and women 50, many companies force employees to retire earlier so more positions will be available for the young.

Unlike in more developed societies, China's elderly are also unevenly distributed across the country. Most of China's elderly live in less well-off rural areas.

Economic problem
The elderly population is also expected to balloon before China has sufficient economic capability to cope with the problem, said Li Bengong, executive deputy director of the China National Committee on Aging.

Each year, 3 million people retire, and only 15 percent of them have pensions. The ratio is even worse in the countryside. By 2035 to 2040, forecast to be the peak of China's aging problem, the country will face a social security deficit of $128 billion a year, Li said.

In Liaoning province, the elderly make up about 9.7 percent of a population of about 42 million. Those older than 65 increased by 2.3 percent from 2004 to 2005, a faster rate of increase than in Shanghai or Beijing.

The market has responded accordingly. Before 2000, Dalian had fewer than 20 rest homes, said Yang, of the civil affairs bureau. Now the city and its surrounding area have 256 mostly private homes and have been adding 30 or 40 homes a year.

City officials have been using tax breaks, cash payments and discounts on water and electricity to encourage younger retirees to open small rest homes. That way, more beds and more jobs are created at the same time.

Wen Min, 49, opened the Baiyun Home for the Elderly when she discovered that her hilly neighborhood near downtown Dalian included about 60 families with elderly residents. She had been operating a student dormitory, so it was easy to have the restaurant staff make meals and send them to elderly neighbors. She began buying exercise equipment and mah-jongg tiles.

She charges the self-sufficient $80 a month; those who need more care, $113; and those who can't walk, $138. But given the lack of pensions or lack of adequate pensions, some residents beg her to accept them for less. Wen says she breaks even.

"At the beginning I just thought, 'This is a potential market.' Then I realized that not every elderly person can pay," Wen said. "Now the money is not so important anymore."

Things could be worse
Wang Xiulian has worked at the Baiyun Home for 10 years, since she was laid off from a garment factory that went bankrupt. Her father stayed at the home in 1991. He has six children, but all work and don't have the means to take care of him, Wang said.

"When the residents first arrive, they cry almost every day, saying: 'My children don't want to take care of me. There's no more filial piety.' After a while, they say they wish they had moved in earlier," Wang said.

When Tian first arrived, he was bad-tempered, Wang said.

"He hated everything. I think he felt a little bit abandoned by his family," Wang recalled. "Actually, we have sympathy with them because they have the same feeling as we had when we lost our jobs, kind of ashamed."

Tian's retirement benefits are $163 a month, plus the $64 a month he earns from renting out his house. That's enough to cover his rent and medical insurance "if I spend very carefully," he said.

His experiences have taught him that things could be worse. He was among the Chinese who were "sent down" to live with peasants during the Cultural Revolution, a brutal period of social upheaval from 1966 to 1976.

"I worked with poor farmers and I learned from them. Life was really tough, especially for old people. It was a luxury to eat rice. We didn't waste anything," Tian said. "So I'm satisfied with what I get."

Researcher Li Jie contributed to this report.