UK and China: Comparing Age And Family Care

China

Traditional Elderly Care

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In China, elder care has been confined to the family sphere over thousands of years (Liu et al., 2014). Under the tradition Confucian concept of Filial Piety or xiao, it encompasses a broad range of behaviours for children to fulfil the duty of care to their aged parents, including ‘respect, obedience, loyalty, material provision, and physical care’ (Zhan & Montgomery, 2003. pp. 210). Children were expected to raise for the security of their elder parents by providing emotional, financial and physical care activities (Zhan et al., 2006).

In China, elder parents are commonly live with sons because the blood tie relationship have been seen as a crucial kinship culture concept (Zhang & Goza, 2006) and sons are recognized to pass on the family name uniquely. It therefore indicates that sons are are expected to provide the ultimate financial and physical care to their aged parents in the cultural value of Filial Piety (Zhan & Montgomery, 2003). However, wonmen have traditionally been care provdiers for parents in China as well as in the West countries (Zhan & Montgomery, 2003). The major difference is Chinese women were expected to take care of their parents-in-law, whereas daughters have been more likely to provide personal parnetal care in the West (Zhan & Montgomery, 2003). According to Chinese patrilocal tradition, after women married to their husbands, they were recognised have been given over to husbands’ families and are not responsible for their birth parents’ elder life (Zhan & Montgomery, 2003). As a result, daughters are not invloved in their own parents elderly care, but instead, they share the responsibilities with husband for parents-in-law. Regardless the gender of care, the traditional forms of family care dominates the major elderly care provision in China.

Aging issue factors

Since the communists came to power in 1949, the total population of China was not only young, but also at a level of 541.7 million (Zhang & Goza, 2006). However, Mao Tse-tung believed that more people meant additional strength to build a strong socialist state for the fight against capitalism (Blumenthal & Hsiao, 2005). As a result, the population nearly doubled over the next 25 years (Zhang & Goza, 2006). By 1971 when Mao relaised the population issues and started encouraging Chinese family later marrige, fewer children and longer birh intervals, the population still growing continously. The consequences revealed by more than 1.35 billion population in 2013 (National Bureau of Statistics of China, 2013).

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Flaherty et al. (2007) point out that China is becoming to an aging society as its aged population grow dramatically since 1970s. National Bureau of Statistics of China (2013) clearly states the aged 65 or over residents increased from 4.9% to 8.9% of the total population over thirty years from 1980. In 2012, there are 127 million of aged 65 or over elder people which dominate 9.4% of national population in China (National Bureau of Statistics of China, 2013). These patterns should continue and there will be 400 million aged 60 or over Chinese residents by 2040 (Zhang & Goza, 2006). Zhang and Goza (2006) comment it will represent 26% of the total population and be more than the combined current population of Japan, France, Germany and the UK. In addition, followed by the improved life condition, the Chinese Census data reveals the life expectancy in China extended from age 68 in 1982 to 75 in 2010 (National Bureau of Statistics of China, 2013). Zhang & Goza (2006) also commnet a reduced replacement fertility level shed lights on the limitiations of available care provider to take family care responsibilities in future. China is facing a great challenge to provide sufficient aged care.

Family structure

However, the low replacement fertility is criticised by voluntary action. In contrast, followed by the rapid population growth from 1940s. The Chinese government established the one child policy from 1979 which indicates each household is only allowed to have one child when either parent has siblings (Flaherty, et al., 2007). The policy was introducted to alleviate social, economical and environmental issues by control the population in China (Zhang & Goza, 2006). It reached 85%-96% of one child rate by the end of 1990s (Zhan & Montgomery, 2003).

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However, the rapid ageing and diminishing family size means China faces a called ‘4-2-1’ family structure. The phenomenon confronts each couple is responsible for four aging parents and their single child (none, 2012 economist). It is criticised by Chinese younger generation as they will unable to afford such a burden to look after their aged families by themselves even they have sufficient savings (None, 2012 economist). It therefore demonstrates only 57% of older people live with children in 2005 compared to 73% in 1982. In large cities, there are more than 70% of elderly only live with spouse or live on their own (Zhang & Goza, 2006). The elderly were concerned to live in ‘empty-nest’ families.

Although the Chinese constitution, Criminal Law and the Law on the protection of the Rights ans Interests of Older People, the altered family structure resist children to provide comprehensive care practices to their elder families. Therefore, the increased demand of social healthcare services emerged in China by the change of care practices of the aged-old pattern of xiao (Zhang & Goza, 2006).

Elderly care facilities

Elder homes which used to be literally called ‘Homes of Respect for the Elderly’ in China. They were built by government for physically dependent childless elders. However, the Health Care System became privatised by 1980s (Zhan et al., 2006). The central government transferred much of its responsibilities to provincial and local authorities for funding the medical and health facilities (Blumenthal & Hsiao, 2005). Former public-sponsored elderly homes were decentralised and a large number of private homes merged in the market (Zhan et al., 2006).

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Blumenthal and Hsiao (2005) argue the the reduction in governmental support of the health caere system largely effects health care facilities by forcing private organisations heavily rely on sale of services to subsdise their expenses. In hospitals, the major revenues are generated from sales of expensive new pharmaceuticals and high-tech services (Blumenthal & Hsiao, 2005). In nursing facilities, residents monthly accodmendation and sercice payments are crucial to support each home’s daily operations. It therefore indicates that the private organisations are operated by profit-driven approcah becme more and more expensive compares to government facilites which emphasis on residents’ social and walefare benefits. It therefore results unafforadable for most Chinese citizens.

In addition, Blumenthal and Hsiao (2005) also citisied the qualtiy of care that patients or residents received from private facilities. As a result of privatisation in social and health care sector, there is limited fund invest into elderly care services from Chinese central government. In particular, training is a primary concer as private orgnaisations are mainly implement afforts on fiscal restraint to maximise their profitbaility (Blumenthal & Hsiao, 2005). The insufficient government supply encouraged private nursing homes to enter the market and they have dominated the major growth of care providers since 2000 (Liu et al., 2014). However, it raise the concern of care quality as the short history of operating with insufficient experience of community elderly care practices in China.

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