Chen Shuxian celebrates her 90th birthday with her family.	A three-generation family in Beijing's Palace Museum.	Senior Citizen's School, a relatively new institution across urban China, offers an alternative lifestyle to retired people.

The social convention of filial piety complicates old-age care institutionalization in China.

WEI Shouren, a 69-year-old widow living in Shanghai’s Jing’an District, has recently suffered a relapse into her old complaint of constant cramping of the leg muscles. The massages her late husband used to give her considerably eased her pain; now that he’s gone, she must go alone to a masseur. Ms. Wei has a son who has been living in the US for five years. She has, upon his insistence, tried twice to live with him and his family there, but has never felt at home in the US. On both occasions she returned to her 60-sq-m Shanghai apartment within two months. Neither is Wei in anyway interested in moving to an old folks’ condo. She tells her son, “As long as I can move around my own house I’m not going anywhere.”

Lonely Parenthood

Shanghai is China’s first aging city, and its 830,000 “empty-nest” senior citizens such as Wei Shouren account for one-third of the city’s aging population. This proportion is expected to increase to 80 percent by 2025.

“The empty-nest family phenomenon is concomitant to the popularization of the nuclear family concept, which was propelled by the family planning policy of the mid-1970s, and the industrialization, urbanization and modernization drives that followed,” says sociologist Tang Can.

Living alone inevitably causes both psychological troubles and living difficulties for the elderly, particularly the senile and infirm. According to a recent Shanghai Municipal Statistics Bureau sample survey, 5.7 percent senior citizens feel constantly lonely, 42.7 percent occasionally lonely while 35 percent have scant social interaction.

There have actually been significant improvements in the material life and welfare of senior citizens. Those above the age of 70 have free access to public transportation, parks and museums, and receive preferential services at public facilities such as hospitals and shops. Residential communities are equipped with exercise apparatus that encourages senior citizens to flex their muscles and stretch their bones, and governments at various levels run senior citizen schools and clubs. In the past, centenarians were rare in China, but there are many longevity villages and towns now in existence.

Why, then, do so many elderly people feel lonely and helpless? Expert opinion attributes this syndrome to the rapid change in family structure and the onslaught of modern lifestyle that has dislocated emotional, psychological and filial links based on the conventional extended family model. The Chinese Academy of Social Sciences conducted a survey of elderly people above the age of 60 in 1987. At that time 20 percent of respondents lived alone, while 70 percent lived with their children. These two percentages have, within the space of two decades, reversed, according to Feng Xiaotian, dean of the Sociology Department of Nanjing University.

“Whilst at work, my husband and I live completely separate lives from our parents. We seldom speak on the phone,” says 25-year-old Zhong Li. “At weekends and holidays, we visit either my or his parents. We sometimes argue over whose parents we should see. As it is, all four are in good health. Things will become difficult for us, as and when they become infirm.”

Filialness Stretched to the Limit

Although every country is under increasing pressure to provide old-age care, it is a particularly thorny problem for China. Population aging in developed countries occurred at a time when their per capita GDP stood between US $5,000 and US $10,000. When China became an officially aging country in 1999, its GDP was less than US $1,000. The obvious problem of dealing with aging prior to the country’s required level of affluence is, where will the money for old-age care come from? In 30 years’ time, every two Chinese workers will have one oldster to support, according to the latest statistics.

Guan Xingqin, 46, works full time. At home, she takes care of her 80-year-old infirm mother, who has had six falls within as many months and has also been hospitalized for pneumonia. “I receive calls from her every day, asking me to get home as soon as possible. I have a lot of work to do, but the thought of my mother helpless at home wrecks my concentration,” says Guan helplessly. Many middle-aged workers such as Guan Xingqin describe their life as comprising either “Struggling mornings,” “busy noons” and “fatiguing nights;” or “struggling weekends” and “fatiguing Mondays.”

Guan Xingqin is considering sending her mother to a retirement home, but has yet to find one with satisfactory conditions at a reasonable rate. Her sister, however, is the biggest obstacle to her mother’s moving out. She would prefer to continue taking turns with Guan to nurse her mother than send her away. “I can’t imagine how my only son will manage if both my husband and I become senile and infirm,” says Guan Xingqin, wryly.

In recent years a large number of welfare institutions and nursing homes for the elderly have been built in both urban and rural areas. They fail, however, to fill the accommodation need of the relentlessly graying population. Their living conditions also leave much to be desired.

The social convention of filial piety is, in contrast to the West, prominent within the Chinese mindset. Aging parents feel hurt at the prospect of living in a retirement home while they still have offspring. Children, by the same token, feel shame and guilt at the thought of sending their parents away from home. There is within Chinese culture a deep-rooted belief that the debt owed by children to their parents for bearing and rearing them can be repaid only by taking care of them in their old age. This is the social institution behind the concept of “More sons, more happiness.”

Bai Xue, 30, is senior manager of a foreign company in Beijing. She admits, “As I grow older, I feel ever more keenly that I’ve neglected my parents for too long.” Bai Xue now calls her parents almost every evening. “They refuse to come to me at the moment, but when they become incapable of looking after themselves, I’ll persuade them to move in with me. I will not send them to a nursing home,” she says, stoutly.

Conventional Dream

Today’s senior citizens in China are still psychologically attached to the conventional dream of spending their old age surrounded by children and grandchildren in an extended family arrangement. This is manifest in the overt willingness of seniors to look after their grandchildren.

A recent investigation shows that the offspring of 45.7 percent of single-child couples -- in which neither wife nor husband have siblings -- are taken care of by their grandparents. In instances where each spouse has siblings, 28.1 percent of offspring are cared for by grandparents. Single-child couples often leave their child with their parents in the morning, and call around in the evening to have supper with them before taking the child home. A common phenomenon is that of parents entrusting children to their grandparents’ total care while they work away and live Dink fashion. From the parents’ point of view, the “three generations under one roof” situation is the ideal arrangement. This is accomplished through buying the newlyweds an apartment nearby -- preferably downstairs or upstairs from them -- or at least within the same residential community. This arrangement avoids family conflicts and makes it easy for the two generations to help one another.

Two-thirds of China’s 50 million urban families reportedly rely on grandparents to rear young children. The head of one Beijing kindergarten acknowledges that grandmas and grandpas generally predominate the attendance at parent-teachers meetings.

Chinese society is currently transitioning from the convention of large families to that of the single-child household. Finance is now not the main problem, other than in low-income households. The extent of the problem of senior care is mainly attributable to the “empty-nest” syndrome. Experts warn that China will be confronted with a truly severe aging issue within three decades, when parents of the single-child generation enter their old age.