China's Homes for the Elderly

In China—where Confucian tradition and the communist Constitution still require sons and daughters to look after their parents—adult children risk losing face if they allow strangers to do the job. Yet mass migration and the one-child policy mean that more than half of China's elderly city dwellers are now empty-nesters. And often it's impossible for those who need it to find professional help. While 48.5 percent of aged urbanites surveyed by the China National Committee on Aging (CNCA) last year expressed a need for home nursing, only 16 percent said they had access to such services. And those few willing to live in institutions were hard-pressed to find adequate space.

That's making high-quality and innovative facilities all the more attractive. Case in point is the Yixian Home for the Elderly in Shanghai's Changning district, which is filled to capacity with 300 residents and has 500 to 600 more on a waiting list. The claim to fame for Yixian, founded in 2003, is a system of Webcams, or "global eyes," mounted in public areas such as the restaurant, gym and leisure hall. By going to the Yixian Home's Web site,, relatives of patients, even in far-off locations, can watch their loved ones eat or take part in organized activities like singing or dancing. Call it guilt- alleviation by remote control.

The Yixian home hopes its computers will help residents as well. It boasts 10 computers for residents' use, and its staff helps patients transmit photos to, and chat online with, distant family members. Octogenarian Ding Ailin, who moved into the home more than two years ago, says she now chats online once a week with her daughter, who lives in Australia. And Yu Deying, an 84-year old former teacher, told local media earlier this year that she likes to sit close to the Webcam so that her granddaughter in Hainan can watch her more carefully. "She saw me having a meal in the restaurant [and] said I look good and healthy," Yu reported.

Of course, high-tech accessories don't come cheap. Yixian patients are charged between $183—around the price of a normal nursing home, and the cost of a shared room at Yixian—and $422 per month. That latter figure (the price of a single room at Yixian) is more than one fifth of China's average annual per capita income. All that money goes to facilities and to fund more than 80 staff members, including administrators, nurses and seven doctors.

Although some clients have kids living as far away as North America, many still own homes in Shanghai. "None of them feel lonely here," says administrator Tan Minhua. "We organize singing, dance parties, classes for reading newspapers and medical forums. The old folks feel happy."

Still, most Chinese who need outside support prefer to get it in their own homes; in the CNCA survey, 85 percent of elderly Chinese said they preferred home-based care to living in a nursing home. New facilities, run by grassrootsneighborhood committees, are now cropping up to cater to them. Beijing's Shichahai Community Public Service Center, for example, has started offering meal delivery to the community's elderly empty-nesters. It's similar to the U.S. "Meals on Wheels" program—except here the "wheels" are battery-powered bikes with insulated food containers.

A Shichahai delivery consists of rice, soup and two meat-and-vegetable dishes—provided free to old folks with no income, and for less than $1 to those on a pension. The government subsidizes the program. "Beijing is a graying society," says the center's director Liang Hua, 36. "The elderly supported us when we were young. Now it's our turn to care for them." He says that organizations like his help meet President Hu Jintao's goal of a "harmonious society." The community centers promote harmony in more literal ways as well. Some old folks with local but neglectful children have complained to their neighborhood committees about their negligent offspring—and the committees have stepped in to mediate new arrangements between the generations.