Deep Dive: China’s elderly population is rising, but low pay, lack of advancement means there aren’t enough caregivers

Yan Guizhen established her first elderly care facility at the turn of the millennium. Now Yan, 53, manages six facilities that employ around 100 carers, tending to more than one thousand beds in China’s eastern Shandong province. But her dream to keep those of the older generation safe and comfortable has not been easy.

With China’s population ageing fast, she wonders how parents of the “one-child generation” can receive affordable care when they need it. “People are reluctant to take this job,” she said, citing the caregiving industry’s low social status, training and income.

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On average, each carer looks after three to six individuals at Yan’s homes, but there have been instances where one has to look after up to 10 at once.

The demand for senior care is still growing. By the end of 2022, 209.78 million people – 14.9 per cent of the Chinese population – were aged 65 and above, outnumbering the combined populations of France, the United Kingdom and Thailand.

Compounding the issue is the fact the already small pool of carers is ageing fast, contributing to the urgency.

Elderly care is among the major issues puzzling Beijing, prompting a campaign to develop a “silver economy” that serves the needs of the aged population.

Last month, Beijing introduced the first national comprehensive document on the elderly care workforce, which included a programme to improve the labour force.

Home and community-based senior care services have been the focus of development in recent years. As of the third quarter of last year, there were 359,000 community elderly care institutions and facilities nationwide with 3.09 million beds. According to the 2021-2025 development plan, the number of elderly care service beds is expected to exceed 9 million by 2025.

Analysts said most personnel in senior care are middle-aged or elderly women from rural areas without much education, and carers continue to bear a stigma associated with their jobs, said Wu Xinyue, a postdoctoral fellow at Southeast University’s School of Humanities.

Compared to specialised childcare, which also comes with a much higher salary, the lack of societal recognition of the economic value of aged care has resulted in those caring for the elderly being the oldest on average and occupying the lowest rung on the professional ladder within the caregiving industry, Wu added.
Staff writers

Question prompts:

1. Why does Yan believe people in China are unwilling to be elderly care workers?
(1) The job guarantees stability.
(2) The job of an elderly care worker does not pay much.
(3) The job does not have a high social status.
(4) The industry for senior care does not offer a lot of training.

A. (1), (2) and (3) only
B. (2), (3) and (4) only
C. (1), (2) and (4) only
D. all of the above

2. State TWO reasons behind China’s plans to develop a “silver economy”.

3. Using News and your own knowledge, explain why senior care workers receive the least recognition within the caregiving industry.

Question prompts:

1. Describe the trend shown in the graph.

2. How has the information displayed in the graph affected the “silver economy” in China?

• China faces a shortage of young, qualified elderly care workers as youth seek better job opportunities

• Government is investing in education for carers

In China, more senior citizens are turning to care homes where they can be looked after in their old age. But keeping the people in those beds comfortable and happy requires staff – and there are not enough young, qualified carers, said Yang Fan, an associate professor of social policy at Shanghai Jiao Tong University.

But younger women tend to choose better-paying jobs, such as nannies or factory workers.

“Older female migrant workers gather in urban nursing homes, [and older] men gather at construction sites in cities. Younger people tend to avoid these two industries,” Yang said.

The government has invested heavily in educating and placing staff in senior care homes; it covers tuition fees, provides living allowances during the study period, guarantees employment and distributes post-employment allowances.

However, Yang said one problem lies in the low retention rate, citing an example of a class in a vocational college in Shanghai. Of the 40 students, only 20 to 30 per cent went into care work after graduation. Only a few students remained in the field after a year.

Even among those who stay, many switch to high-end institutions, head to bigger cities or transition to insurance projects in long-term care, which offer higher incomes. Yang said few professional carers would choose to stay and work indefinitely in regular institutions.

Other regions have tried to ease their staffing shortages with immigrants, but that has not been the case in China, Yang said.

To encourage inflow, in 2019, entry requirements for senior carers were changed, and they are no longer required to hold a junior high school education. But Yang warned of a potential mismatch between the desire for a better quality of life in old age and carers’ capabilities.

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Wu Xinyue, a postdoctoral fellow at Southeast University’s School of Humanities, said elderly care workers’ demands are also overlooked. Their career paths can be highly fragmented, depriving them of the opportunity to accumulate skills or qualifications.

Prizes for exemplary performance, like the Elderly Caregiver Skills Competition, can be good early platforms to enhance social recognition of the profession, Yang said.

The eastern province of Jiangsu rolled out the country’s first professional title system for elderly caregiving in September. Specific criteria regarding work experience and qualifications were set up for eligible personnel to apply for junior, intermediate and senior professional titles.

According to Yang, initiatives like this, which lay out a clear pathway for career advancement, can help turn senior care into a respected occupation.
Staff writer

1. Which of the following statements about China’s senior care is false?
A. Many Chinese youth do not want to enter the elderly care workforce.
B. The Chinese government is ramping up efforts to improve access to education for elderly care workers.
C. Few professional carers would choose to stay in regular institutions for a long time.
D. China has introduced immigrant elderly care workers to tackle the manpower shortage.

2. Using Issue, list TWO reasons younger people tend to avoid working in elder care homes.

3. Using News, Issue and your own knowledge, what can be done to make senior care a recognised and respected occupation in China?

1. Explain why there is a queue of elderly individuals waiting for assistance in the illustration.

2. Using News, Issue and your own knowledge, to what extent do you think China has enough resources to meet its growing demand for senior care?

• caregiving industry: services that help people with daily living activities. The industry includes workers who take care of the elderly, people with disabilities or diseases, and those with mental disorders or special needs. According to official data, as of the end of 2022, there were a total of 387,000 caregiving facilities in China, with 8.29 million beds under their operational umbrella.

• migrant worker: people who move within their country or go internationally to find work. They often don’t intend to stay in the area long-term.

• one-child generation: refers to those born in China between 1979 and 2015, when the government restricted families from having more than one child to slow population growth

• retention rate: the percentage of people who continue doing something over a period of time, compared to the number who began

• silver economy: products and services that meet the needs of the elderly

• stigma: a strong feeling of disapproval or disrespect

News:

1. B

2. China needs to develop its “silver economy” because the population is ageing, and there aren’t enough people to take care of them, partly due to the government’s long-time “one-child policy” and partly because elder care does not pay well, meaning people are less attracted to the job.

3. There is a stigma against caregiving, especially senior care. It does not pay well or offer much training. Compared to specialised childcare, which also comes with a much higher salary, the lack of societal recognition of the economic value of aged care has resulted in those caring for the elderly being the oldest on average and occupying the lowest rung on the professional ladder within the caregiving industry.

Chart:

1. The chart shows that China’s ageing population is on the rise. By the end of 2022, 209.78 million – 14.9 per cent of the Chinese population – were aged 65 and above, outnumbering the combined populations of France, the United Kingdom and Thailand.

2. More elderly individuals mean the need for products and services in the “silver economy” has increased. For example, the demand for senior care has risen, but China struggles to recruit elderly care workers. The current pool of carers is also ageing fast, prompting the government to focus on home and community-based senior care services in its development plans.

Issue:

1. D

2. Younger people tend to choose better-paying jobs as nannies or factory workers. Elder care also lacks clear career advancement opportunities and is not widely recognised or respected as a profession.

3. Developing and implementing professional standards and training programmes for senior care providers and employees is essential to making senior care a recognised and respected occupation in China. This includes establishing clear job descriptions, competencies, and certification requirements. Training programmes should cover topics such as geriatric care, medical knowledge and communication skills. In the meantime, prizes for exemplary performance, like the Elderly Caregiver Skills Competition, can be good ways to enhance social recognition of the profession, as well as a professional title system with pathways for career advancement.

Illustration:

1. The scene of elderly citizens waiting in line for care services refers to China’s growing demand for senior care and the understaffing situation within the elder care industry.

2. Currently, China is struggling to meet the high demand for senior care, and it does not have enough resources. There aren’t enough carers, and those in the profession are ageing. The industry is struggling to recruit and retain new workers thanks to its low pay and lack of career advancement. There also aren’t enough facilities to house the rapidly ageing population.