Sunday, June 3, 2007

Answers to Questions

Several questions were posted on this blog. I'll do my best to respond to them!
1. BBF: Decades ago? Couldn't you have just said years ago? Even as a gerontologist, I find years ago easier to acknowledge then decades!
2. M&L: Yes, Mom knows how to post to a blog!
3. Cobosn: regarding differences between the visit to the Beijing Retirement Home (BRH) and our system of residential/skilled care in the US: the BRH is a type of social welfare institution. The requirements for admittance to this home are an age of 60+, free of contagious disease or mental disorder, capable of self-care, and able to live in a group setting. The director did tell us that they were debating whether to open the admissions policy to people with disabilities or in need of more care.

My understanding is that the government does support different types of institutional care for the elderly with varying degrees of disability, including lodging and nursing homes. These homes may be government or private institutions, and variations in-between.

From The Development of China's Undertakings for the Aged by the Information Office of the State Council of the People's Republic of China, provided to us during the National Committee on Aging lecture: "By the end of 2005, there were 39,546 institutions providing services for seniors, such as social welfare institutions for the aged, elderly people's homes, senior citizens' lodging houses, and nursing homes for the aged, with a total of 1,497 million beds, including 29,681 rural elderly people's homes with 895,000 beds."

Thanks for reading!

Friday, June 1, 2007


While there's no place like home, home does look a little different now. Certainly, visiting Beijing and attempting to make generalizations about China is akin to visiting Chicago and generalizing to all of the United States; and Chicago reflects very little of the life here in the Flint Hills of Kansas! Yet, reflections on the experience do bring up points to ponder.

The commonality of the problems to the aging challenge are astounding. What is also astounding, and a little discouraging, is that there also seems to be a commonality in the lack of adequate solutions. China does have an opportunity to craft new policy and programs, but, at least as outlined during the seminar workshops and visits, there are obvious gaps and deficits. It seems that while the Chinese do believe that the government has a social responsibility to its citizens, this responsibility is carried only to a certain point, in light of the reforms to a type of market economy and other social policies. Particularly disturbing was the open way many of the presenters discussed the breakdown of traditions in children caring for older adults. The government is strongly encouraging Family Support Contracts: a legal document that outlines what children will provide for their parents. Can you legislate family caregiving? And if you can...should you?

The absolute sheer numbers and enormity of what they face in China is overwhelming. One older person of every four will be 80+ years of age in 40 years, and China will have 25% of the world's 60+ population in 2030. No wonder adequate solutions are hard to come by. Embedded in these numbers is the apparent disparity in urban and rural populations in China. From differing health insurance plans to lower levels of education and the abandonment of older adults by their children in rural areas, it may be that the urban older adult programs seen in Beijing are not yet an option for rural older adults.

China is an interesting mixture of tradition, technology, and a changing social and economic system. Perhaps they can learn from our past mistakes and successes, and perhaps we can learn from their current ones as we plan a more hopeful old age for our citizens.

Please go to, global aging, photo album, for pictures of the seminar!

Wednesday, May 30, 2007

Traditional Chinese Medicine (TCM)

A visit to a traditional Chinese Hospital was the highlight of the day. There were so many extraordinary and eye-opening experiences that picking just a few to share is challenging!

Generally, the enormity of it was overwhelming. From the capacity (650 beds), to staff (1200), to total patients seen per day (5000), to the pharmacy (delivering 4 tons of medicine per day), what becomes obvious is the scope of health care in China now, and what those amazing statistics we learned previously portends for the future.

Our lecture outlined the five aspects that constitute TCM: nutrition, lifestyle, emotion, exercise, and mental fitness. The details revealed that many of our tenets of preventative health are similar to these aspects. The details also revealed that we can be very different in how we practice these aspects/tenets. As an example, our presenter recommends chewing black beans (don't go out and try this as I'm leaving out a few details). He called this Tai Chi for the tongue!

It will be interesting to watch the interplay and integration of Eastern and Western medicine in China as the country continues its social and economic reforms.

Plane ride tomorrow!

Tuesday, May 29, 2007

Jingshan Park, Senior University, & Beijing 5th Senior Compound

Today we had an opportunity to explore several relevant issues for older adults: preventative health, residential housing, and civic engagement. Through presentations and visits to three aging centers, we witnessed firsthand China's attempts to implement practical programs that are the result of the social policies we learned about in previous days.

Particularly interesting was the absolute priority given to physical fitness, not just by older adults, but by the entire population. An early morning (6:30 AM) visit to a park captured the extent to which exercise is a daily habit in the lives of the Chinese. This dedication to physical fitness extends into a commitment to mental fitness for older adults as evidenced through a visit to a Senior University. With more than 26,500 such schools, it seems that China is making strides in this area.

One commonality between the nations was evident during the tour of the residential facility. Shared rooms, public recreation areas, a planned activity calendar, and a lack of transportation for residents all were familiar.

It was clear today that China and the US share many of the same problems and challenges.

Monday, May 28, 2007

China's National Committee on Aging

We met with senior government officials today, including Mr. Lei Bengong, President of the CNCA. The CNCA helps to guide aging activities throughout the country. There are many common problems and challenges that China and the US share. Based on some of the statistics presented, and the general tone of our Chinese hosts, it is apparent that that the future conditions of China will be more difficult than those in the US, based on the sheer numbers of the elderly. For example, by 2050, there will be 400 million people age 60+ in China. That is 31% of their entire population. To put this into perspective, 400 million people is more than the entire population of the US right now. In China, in 40 years, one of every three people will be age 60+; one in every four elders will be 80+.

Another point of interest is in the frank and open discussion by our Chinese hosts concerning the breakdown of the traditional values related to respect and reverence for the elderly. This change has taken place over a relatively short period of time as China has changed its economic course as it attempts to become a superpower. Young people are leaving rural areas, and their parents, to seek opportunity in China's major cities. It is not clear how China will address this issue or even if they wish to if it were to interfere with economic growth.

Also evident is China's attempt to balance resources to aid the elderly with their challenges, but to do so in a way that is fiscally responsible and that does not hinder the growth pattern that China has charted for itself.

Tomorrow: visits to aging centers!

Sunday, May 27, 2007

Today: Cultural Experiences Abound

Today we had an opportunity to become immersed in the Chinese history and culture. Our visit to the Great Wall took us from the urban Beijing into the rural countryside. We saw horses pulling carts, farmers working cooperatively in gardens, and elders being pushed through the streets in wheelchairs. We saw artists at work today, in areas that were quite tiny and that certainly would never pass OSHA standards! We heard about Sunny's (our coordinator's) family, and how the generations interact and get along--or don't--and the differences between those generations in terms of the modern changes that are occuring within the country.

Generations. It is impossible to imagine how the Great Wall was built or the fortitude and determination of those who built it. The immensity of it provides a scope for understanding the pride the Chinese have in their heritage and ancestors.Tomorrow we are received by the President of the National Committee on Aging and have a presentation on the government's policies and dilemmas related to aging. The juxtaposition of the Great Wall today and a look to the future tomorrow should provide quite a perspective.

Saturday, May 26, 2007

Overview of China's Public Healthcare for the Elderly

Breakfast. Bus ride. Presentation. Tour. Lunch. Bus ride. Museum tour. Bus a break, soon another bus ride, and then the Peking Duck Banquet...there's sure a lot of eating!

Today, Dr. Chen Jianpeng, a research fellow at the Information Center of Chinese Ministry of Health, gave us an overview of health care in China. There are currently 149 million people age 60+ in China; that will increase by 20 million in 5 years. A challenge that he mentioned concerns the health conditions that come with an aging population. Another is the changing culture. More and more elders are living apart from their families, due to the younger generation leaving the rural areas. However, in China, they believe that it is the government's responsibility to oversee the public health of the elderly. To this end, they have developed a new framework that covers people in both urban and rural areas, and is too complex for this blog!

Perhaps one of the most interesting things that he shared today (and he shared quite a bit!) was that men tend to use health care services more frequently than women. The second was that the older you are (he used both 80 and 100 as age markers), the more health care services you are likely to receive (due to cultural norms). He even went so far as to say that government officials who do not treat their elderly family members well are not promoted...

Please note that our lecture took place in private facilities provided by the Landgent Group, a private company in real estate development, international and vocational education, and senior services--and they did link these together into a comprehensive strategy for us when they gave their part of the presentation today. The photo was taken in the wine cellar, which holds the collection of one man...more than 200,000 bottles of wine (you read that right), mostly from France. And yes, they did serve some at lunch. And no, I didn't have any (although Dad did!)