Respite centers sharing the load

Community support system gives families looking after elderly or infirm relatives a chance to take a break. Zhou Wenting in Shanghai reports.

Feng Zhifang had to make many sacrifices when she began caring for her 87-year-old mother full time. For years, she missed out on vacations, time with her friends, and, as a Christian, even struggled to make it to church on Sundays.

Then, two years ago, her prayers for relief were answered.

A new nursing home in her community in Shanghai started to offer short-term respite care, which meant Feng could place her mother, who has mobility issues, in the hands of trained nurses while she took a well-earned break.

"Last month, I placed my mother in a home so I could attend my son's university graduation ceremony in Australia," said Feng, 60, a retired middle school teacher. "It's very convenient, as the traditional homes don't accept residents for just a few days."

As part of efforts to support the growing number of families caring for elderly or disabled relatives, the Shanghai government has opened 79 respite care centers since 2015.

Residents can use the facilities for just a few hours or for up to three months, with prices ranging from 35 yuan ($5) for basic day care services, such as assisted showers, to 160 yuan a night for a bed and three meals a day. The homes are all managed by organizations or companies that specialize in care services.

Beds are also open to people recovering from surgery who would prefer to convalesce closer to home than at a hospital.

"Many of the homes are fully booked due to the sheer weight of demand," said Zhang Haixiang, deputy director of civil affairs for Jing'an, the city district with the highest percentage of senior residents. "When the families go on vacation or if a caregiver falls ill, these facilities can take over."

The city aims to have at least one respite care center in every community by the end of this year, according to the Shanghai Civil Affairs Bureau.

"I like the description that the local government uses, 'Such care homes are where a bowl of soup brought from home is still warm'," said Feng's mother, Liu Cuilin. "I'm still in the community, so I don't feel lonely."

Age-old problem

Shanghai ranks No 1 domestically for many things - the length of its subway system, for example, or the performance of its students in international math tests. Yet the city also has an unwanted title: the oldest population in China.

The city has 4.58 million residents age 60 or older, according to the latest data from the civil affairs bureau, accounting for more than 31 percent of the city's population (nationally, the proportion is 16.7 percent). That number is forecast to reach 5.3 million by 2020.

Meanwhile, the average life expectancy in Shanghai was "more than 83" last year, the bureau said, far higher than the national average of 76.3 in 2015, and almost equal to Japan, where the average life expectancy is 83.7, the highest in the world.

In addition, although families have gotten smaller, the preference among seniors to spend their twilight years in their own home has not, which is piling the pressure on their children, particularly those without siblings.

With a potential social care crisis on the horizon, the Shanghai authorities saw a solution in repurposing public-owned properties in or around residential communities to offer affordable respite care.

Each has 10 to 40 beds, and priority is given to residents who are entirely dependent or from low-income families.

"These establishments have so far proved popular among the elderly and their children," Zhang said. "Seniors can enjoy professional services without the need to leave their community, and it's convenient for relatives to visit."

He added that he hoped the care centers would gradually remove resistance to the idea of nursing homes among the elderly.

Home comforts

Some seniors don't even need to leave their home to access nursing services, such as those living around the central Jing'an Temple.

In 2014, before the respite care center project started, the Jing'an district authorities selected 100 seniors to receive 100 hours of free in-home services, ranging from nursing care and therapeutic massages to haircuts and housekeeping.

"The elderly need care, not just beds. So for those who can't or won't go to care homes, we go to them," said Fang Pei'er, director of the home-based care services center near Jing'an Temple.

He cited a Chinese idiom that "few dutiful children stand at the bedside of a parent with chronic diseases", and added, "We want children who act as caregivers to be able to take a break, which we feel will ensure the devotion to their parents is sustainable."

Cheng Shanfen, 67, is among the residents who have benefited from the policy. She cares for her 97-year-old mother, who has been bedridden since 2010, and receives little help. Her husband died three decades ago, her sister lives in the suburbs and her brother is seriously ill.

"When my son got married four years ago, I told him not to start a family soon because I don't have any spare time to baby-sit," she said.

The biggest headache was bathing her mother, she said, "as I can't do it alone and it's torture for my mother and I to travel to the public bath". So, Cheng used her 100 free hours to book a nursing assistant for an hour each day to wash her mother in a special inflatable bathtub.

"I now have more confidence that there will be more services that cater to the real needs of citizens as we grow older," she said.