The elderly population is increasing year by year, and urban and rural diversified models solve care problems

In recent years, the number of elderly people in my country has been increasing year by year. Data shows that as of the end of 2023, the end of 2024, and the end of 2025, the country's elderly population aged 60 and above will be 297 million, 310 million, and 323 million respectively. On the other hand, based on the same statistics for the past three years, the number of elderly care beds in various elderly care institutions and facilities across the country has been decreasing year by year. What is the reason behind the increase and decrease of these two data? Can it meet society’s elderly care needs? What are the response measures taken by various places? What challenges and development trends are currently facing the construction of my country’s elderly care system?

What kind of service is "home care bed"?

At present, in most cities in my country, about 90% of the elderly choose to take care of themselves at home. The other part will choose community care or nursing home care. In the past, many cities proposed calculating and arranging bed requirements for elderly care institutions based on an elderly population ratio of 3% to 4%. In recent years, some places have lowered this figure to 1%. What are the reasons and specific practices behind this data adjustment?

Dongcheng District, Beijing, has a permanent elderly population of 60 years and above of 219,000 people. If we simply use the standard of institutional centralized elderly care, which is 1% of the elderly population, the entire district will need more than 2,000 elderly care beds, while Dongcheng District currently only has about 900 elderly care beds. Although on the surface it seems that there is a large gap in beds, the reporter's investigation found that the existing local institutional elderly care beds are actually not full, and more elderly people choose to enjoy the service of "home elderly care beds" at home. What kind of service is this?

The 95-year-old Zhang Jinghao has multiple chronic diseases and has difficulty walking. He is usually taken care of by his daughter. After signing a contract for a home care bed, staff from a nearby nursing home will visit his home once a week to provide psychological comfort, storage, basic care and other services. Family caregivers of the elderly are also regularly trained. The elderly can call the staff at any time in case of emergency.

The post station responsible for elderly care services is about 1 kilometer away from the elderly family. This post station covers an area of ​​less than 200 square meters and has a restaurant and activity room. It has signed a contract for 155 home care beds, which is equivalent to building a medium-sized elderly care institution. The post station establishes a health file for each elderly person.

Next door to the inn is the community health service station. The inn and the community health service station provide medical services to the elderly in the area. Some chronic diseases can be solved without leaving the community. When the elderly have incurable diseases and other problems that cannot be solved by the inn, the inn will coordinate the elderly care inn, catering, housekeeping and other enterprise resources according to the needs of the elderly through the neighborhood elderly care service center, and provide services to the elderly nearby.

Going up from the street, at the district level, Dongcheng District has established a senior care service guidance center as the "general service desk" for senior care services in the district, coordinating the entire region's senior care resources, and forming a complete operating system from industry standard setting, senior-related data collection to service quality supervision.

Like Dongcheng District in Beijing, my country is currently establishing such a three-level elderly care service system in cities. More and more elderly people can enjoy the same services at home as in elderly care institutions. By the end of 2025, a total of 495,000 home elderly care beds have been built across the country, which is equivalent to increasing the number of institutional elderly care beds.

Are rural nursing homes in poor condition and unused? How to transform and upgrade?

A large proportion of institutional nursing homes in my country are located in township nursing homes. In the past, almost every township had a township nursing home. Due to outdated facilities and poor service quality, a large number of beds in these nursing homes were idle. In recent years, the civil affairs department has promoted nationwide the upgrade of township nursing homes into regional elderly care service centers. Currently, more than 60% of township nursing homes have been transformed and upgraded into regional elderly care service centers. Although the number of beds in these institutions has not increased, the bed utilization rate has greatly increased.

Xuzhou Xinyi City Zhongwu Elderly Care Service Center used to be a township nursing home. Due to backward facilities, the elderly were unwilling to live there, and the bed utilization rate was less than 40%. In Xinyi City, this phenomenon existed in the past 20 township nursing homes. On the one hand, there were a large number of idle beds, and on the other hand, the elderly's care needs were not met.

In order to revitalize the resources of rural nursing homes, Xinyi City has unified planning and design to integrate and build 20 nursing homes in the city into 7 regional elderly care service centers. The number of beds in a single hospital reaches 300 to 400, which can radiate to 2 to 3 surrounding towns. After the Zhongwu Elderly Care Service Center has been upgraded, the rooms are equipped with safety call bells, medical care beds, safety guardrails and other protective facilities.

From being largely idle to being hard to find a bed, while the hardware facilities are upgraded, professional care services are being followed up. The elderly care center monitors the vital signs of the elderly every day, and has dedicated personnel to control chronic disease medications.

In addition to renovating and upgrading original township nursing homes, some township health centers have also used idle hospital beds to open "nursing homes" and "long-term care areas" to provide chronic disease management, rehabilitation physiotherapy and emergency green channel referrals for the elderly. Jing'an Nursing Home in Peixian County, Xuzhou, Jiangsu Province is an integrated medical and nursing home hosted by the town central health center. The current 180 nursing beds are basically full.

How do community elderly care service agencies function?

Home elderly care beds and upgraded township nursing homes can meet the care needs of some elderly and disabled elderly people. At the same time, there are 349,000 community elderly care service institutions in our country. How do these institutions play a role in the elderly care of residents?

In Zhongping Village, Changde Gang, Hunan Province, every morning, the elderly gather in the village's "Mutual Aid Happy House" to play, play and sing. The site of this Happy House was transformed from an idle house in the village. There are no full-time managers, so the voluntary services of old party members and volunteers in the village are used. The Happy House provides a lunch for the elderly at noon every day. The chefs and waiters are elderly people who are able to work in the village. Vegetables, grains and oils and other ingredients are donated by caring villagers, and lunch is provided at low prices to the elderly in the village.

In order to subsidize the operation of the Happy House, the village has also set up a rural live broadcast base. The elderly people transform into "silver-haired anchors" and promote local specialties such as camellia oil in dialects, allowing more local goodies to come out of the countryside.

In Shaxian District, Sanming City, Fujian Province, the village established a senior school based on Xingfuyuan, which offers a variety of courses such as singing, aerobics, handicrafts, and writing. Many elderly people who have never been able to write learned to type and surf the Internet here. After classes, the elderly can eat here, and if they have a headache or fever, they can also see a doctor. Neighborly communication and mutual help and companionship have become the norm.

With the development of information technology, intelligent equipment has entered every elderly family, and elderly care services such as home safety monitoring and emergency services are no longer limited by spatial distance. Xingshan County, Yichang City, is located in the mountainous area of ​​northwest Hubei. The mountains are high and the roads are far away. The elderly live relatively scattered. The local area has established a three-level linkage response mechanism of "child-village-county level" to equip elderly people with special difficulties with smart bracelets, cameras and other facilities. The elderly can ask for help with just one click, and the platform will dispatch orders to the nearest location based on their location. Mutual aid workers will come to their homes within 15 minutes, realizing offline pairing services and online cloud protection, which double guarantees the home safety of the elderly in mountainous areas.

What challenges does the construction of my country’s elderly care system face? What are the development trends?

From the reporters’ visits to various places, we can also see that elderly care requires more than just a physical bed, but a complete elderly care service system. As the elderly population continues to increase in recent years, what challenges does my country face in terms of elderly care? What trends and development ideas does the construction of the elderly care system show?

Deputy Chairman and Secretary-General of the National Technical Committee for Standardization of Social Welfare Services Zhen Bingliang: As my country's elderly population continues to increase, my country's elderly care services are facing many challenges, such as the mismatch between supply and demand for elderly care services, rural elderly care services still have shortcomings, the construction of a talent pool for elderly care services cannot meet the demand for elderly care services, investment in elderly care services is far from enough, and the quality and supervision of elderly care services need to be further strengthened. The most prominent and important challenge here is the mismatch between supply and demand, which is what we call the mismatch between supply and demand.

Now our country has entered a moderately aging society, and it will probably enter a severely aging society in about ten years. Therefore, the country proposes to actively improve the three-level network construction in urban and rural areas during the "15th Five-Year Plan" period, that is, to build a guidance and management platform for elderly care services at the district and county level, to build comprehensive elderly care service centers at the township and street level, and to build elderly care service stations at the village and community level to meet the elderly care service needs of the majority of elderly people at home. Further increasing the construction of home care beds, carrying out door-to-door services, strengthening the aging-friendly renovation of homes and the construction of barrier-free facilities in communities, creating an age-friendly society, and meeting the needs of the elderly, especially the elderly at home, will be the focus and trend of the development of elderly care services in my country in the future.

(CCTV reporters Li Yumei, Zhang Jing, Yao Yao and Wan Cunling)