December 7, 2009

CHINA: Hard work, dedication needed for care of elderly

. Health care systems around the world are being reformed. Getty Images Copyright The Financial Times Limited 2009. See FINANCIAL TIMES' special report STATE OF HEALTH, December 7, 2009. ----------------------------------------------------------------------------------------- BEIJING, China / The Global Times / Opinion / December 7, 2009
As China's population grays, the elder care industry, traditionally small in a country where the aged are usually cared for directly by their children, is growing. The following is an interview by Global Times (GT) reporter Wang Yuan with Zhang Yan (Zhang), deputy secretary-general of Tianjin-based Hetong Senior Citizen Welfare Association, and Ninie Wang (Wang), CEO of Beijing-based Pinetree Senior Care Services Co Ltd, on the opportunities and difficulties of providing suitable care.
GT: What role can non-governmental agencies play in an elder care industry that was hitherto dominated by the government? Zhang: Take our agency, Hetong. All the elderly people living in our seven old folks homes are no longer able to look after themselves. We choose to accept only this kind of elderly people not only because we possess the skills of long-term care, but also because there is heavy demand. In most large Chinese cities, it is very difficult for poorer elders to enter State-owned homes as the preferred clientele is rich people or retired officials. More importantly, State-owned old folks homes do not accept those who cannot take care of themselves. These homes generally have luxury facilities like swimming pools and fitness centers. They are only suitable for healthy elderly people. Wang: Due to China's economic limits, the number of existing old folks homes in the country is not enough. This year, over 8 million beds in old folks homes are needed in China, but there are only slightly over 2 million beds available. As the population is graying, such demand is increasing rapidly. Building new old folks homes is costly, and it's financially impossible for the government to build enough homes in the next 10 years. Thus the government has begun to promote home-based care for the aged. Home-based care needs different systems to provide elderly people with long-term care, including both physical care and psychological consolation. This enables seniors to maintain a relatively independent life, still get involved in the society and feel needed rather than isolated. In this field, the government should only make policies and provide a favorable environment, and encourage the social sector to become engaged. It shouldn't operate by itself, since the government does not necessarily have enough resources or skilled personnel. GT: Are there any favorable government policies for charitable groups and other parts of the social sector that become involved in elder care? Wang: New favorable policies are being formulated, since existing ones are more or less impractical. For example, the government encourages people and businesses to become involved in providing elder care, but only non-profit organizations can enjoy tax relief. This is the Catch 22 of encouraging an industry and attracting investments. Photo credit: Pinetree Moreover, sometime it is high-level government institutions, like the General Office of the State Council, the National Committee on Aging, or the Ministry of Civil Affairs, that release favorable policies, but executive institutions, such as business administration offices and tax departments, do not have enforcement notices to follow. The elder care industry is still in the early stage in China. It needs time for both relevant policies and market maturity to develop. Zhang: Every year, the government invests several million yuan in every State-owned old folks home for their salaries, facilities, and utilities, and these homes do not need to pay taxes. On the contrary, non-government agencies receive little financial support. Actually, it is dependent and destitute elderly people that really needs help. All of Hetong's seven old folks homes charge low fees, and are not-for-profit. We set the price according to our costs. As a rule, privately-run homes charge less than State-owned ones, but, despite heavy demand, their occupancy rate across the country does not exceed 60 percent. This is because a large number of elderly people still cannot afford this kind of care. In many developed countries and regions, the occupancy rate is 100 percent, as their governments bear the fees for those who cannot take care of themselves. But in China, things are different. GT: Is it hard to find people with the right skills for the industry? Wang: The most important goal of long-term care is to increase the independence of elderly people, "to enable those staying in beds to sit up, and to enable those sitting to walk." Our care-givers should master both professional care and communication skills. Therefore, we recruit only people with nursing education backgrounds, professional certificates, and clinical care experience. China's large number of nursing graduates could be the main resource of our staff. Driven by cost considerations, Chinese hospitals often employ an insufficient number of nurses – there are often only three nurses for every two doctors – and many graduates who major in nursing cannot find jobs in hospitals. This gap provides us with an opportunity to find sufficient qualified care providers. Zhang: Although such graduates could be a large resource for us, we still suffer from serious human resources problems. It takes courage to work in this industry. Most Chinese still consider caring for elderly people as a menial job, and because of a lack of funds, the salaries for workers in old folks homes are generally not good enough. Moreover, few care workers in old folks homes work only eight hours a day, partly because of the lack of workers and partly because employers needs more operating funds and thus have to cut costs as much as possible. These factors lead to the current situation where few talented people would like to do such jobs. Consequently, the overall quality of elder care workers is comparatively low, producing a vicious circle in which the low quality of workers contributes to the poor reputation of the job, and vice versa. GT: What are your personal feelings about working in this industry? Zhang: Elder care is different from any other industry, as it caters to people in their last years. Therefore, people engaged in this industry should display an abundance of love, responsibility and enterprise. These elderly people have devoted their whole life to the society, and without them we would not enjoy our lives. We cannot discriminate against them. We must get rid of the idea that caring for elderly people is a menial job. It's a respected industry, and people should attach the same importance to it as to others like assisting impoverished students and post-disaster work. People in this industry should be treated equally and respected. Their rights and interests should be protected, and they deserve good salaries and enough time for relaxation. Wang: We are trying to change the traditional image of caregivers by providing professional care with highly qualified staff. It has taken many years for the industry to grow out of its infancy. It will take even longer for the senior care industry to professionalize, and the challenges and frustrations have made it very tough. However, we believe that serving the aging population is one of the most rewarding businesses. Our persistent efforts are seeing positive results, both in terms of the differences we have made to the lives of senior citizens and their families, and in terms of the long-term return on investment. We consider elderly people to still be an active part of society. Satisfying the needs of seniors and their families with a healthy perspective and a sustainable business model is the future. [rc] Copyright by Global Times © 2007-2010,