Ageing in Place in China: Small Facilities, Community-family Care Integration, and Governmental Coordination

Abstract

In the year 2000, China met the United Nations' criteria for being considered an ageing nation, as 7% of its population was aged 65 and above (Lu and Liu 2019).1 Since then, the country has experienced an increasing demand for elder care and has suffered an insufficiency of public health services, institutional care, integrated medical and care systems, long-term care insurance systems, and a physically and socially age-friendly environment (Han et al. 2020). The significant drain on public resources imposed by its ageing population has prompted the Chinese government at different levels to seek immediate solutions to the deterioration of older adults' health and early admittance into nursing facilities. As the ecological theory of ageing is one of the most striking ideas presented by Lawton and Nahernow, who conducted a study of dynamic connections between housing conditions and the physical capacity of older adults "to maintain themselves in the community" (1973: 619), China has been keen to incorporate this idea into its policy agenda as part of a long-term elder care strategy in the name of ageing in place (AIP), aiming to make living environments more autonomous, pleasant, safe, and cost-effective for older adults, without depending on public amenities.However, attaining such living environments through urban renewal requires a long time to plan, design, and construct. The Chinese government started incorporating barrier-free design elements into the indoor and outdoor spaces of residential areas in the 1980s.2 This endeavour aimed to enhance safety and accessibility for older adults and individuals with disabilities within the city. Despite decades of preparation, it was not until the early 2000s that AIP gained global recognition as a new paradigm in elder care policy as indicated by a significant rise in the number of AIP publications (Vasunilashorn et al. 2012). In line with this worldwide trend, China also embraced the introduction of AIP programs starting from the mid to late 2000s, serving as an alternative to traditional nursing homes for its elderly citizens.