Advertisement

Zeitschrift für Gerontologie und Geriatrie

, Volume 48, Issue 4, pp 354–364 | Cite as

An apocalyptic vision of ageing in China

Old age care for the largest elderly population in the world
  • Tao Liu
  • Li SunEmail author
Originalien

Abstract

According to the National Bureau of Statistics of China, by 2010 the number of people aged 60 or over had reached 178 million in China or 13 % of its population. With the largest elderly population in the world in absolute numbers, China faces a challenge of providing care for the elderly both in the present and the future. Unlike old age pensions and health protection for the elderly, in Chinese society elderly care had never been considered to be a social problem but rather the individual familyʼs responsibility. After the turn of the millennium, as the repercussions of increasingly ageing demographics, the results of the One-Child Policy and drastic changes in traditional family structures gradually became more apparent, this issue of elderly care has increasingly become one of the most pressing concerns for the ageing society. As there is little existing research on this particular topic, this article aims to shed light on elderly care in China, focusing on the care of elderly needing assistance with activities of daily living, since this group of elderly are most in need of care, their numbers having risen to 33 million in 2010. This article argues it is urgent for China to switch from informal family-based elderly care to the stateʼs formal long-term care, illustrates that a model of social insurance (e.g. as in Germany) is advocated by many Chinese scholars and points out the ways in which it is different from both the commercialized models (e.g. as in the USA) and state organized “Beveridge” models (e.g. as in Sweden).

Keywords

Elderly care Disabled elderly Gerontology Social insurance China 

Eine apokalyptische Vision der demographischen Alterung in China

Das Problem der Altenpflege in dem Land mit der größten Anzahl alter Menschen weltweit

Zusammenfassung

Einem Bericht des Staatlichen Amtes für Statistik der Volksrepublik China zufolge stieg die Zahl der 60- und über 60-Jährigen in China bis zum Jahr 2010 auf 178 Millionen. Das macht 13 % der gesamten Bevölkerung Chinas aus – und entspricht dem größten absoluten Wert in Bezug auf die Anzahl alter Menschen weltweit. Entsprechend sieht sich China bereits jetzt, vor allem aber für die Zukunft, mit dem Problem der Altenpflege konfrontiert. Anders als die Alterssicherung und die Gesundheitsversorgung alter Menschen wurde die Altenpflege bislang nicht als soziales Problem, sondern vielmehr als individuelle und familiäre Aufgabe betrachtet. Seit der Jahrtausendwende zeichnen sich immer deutlicher die Auswirkungen der zunehmenden demographischen Alterung und die Folgen der Ein-Kind-Politik ab, einschließlich der drastischen Veränderung der traditionellen familiären Struktur, sodass auch das Problem der Altenpflege in der Alterungsgesellschaft Chinas immer deutlicher zutage tritt. Da bislang nur wenige Studien zu diesem Thema vorliegen, möchte sich dieser Aufsatz dem Problem der Altenpflege, insbesondere der Betreuung alter, pflegebedürftiger Menschen und ihrer Unterstützung bei den täglichen Aktivitäten des Lebens widmen. Die Zahl der Menschen in dieser Altersgruppe ist bereits auf 33 Millionen gestiegen. Der vorliegende Beitrag kommt zu dem Schluss, dass China das familienbasierte in ein staatlich organisiertes Pflegemodell umwandeln muss. Außerdem weist er darauf hin, dass eine soziale Pflegeversicherung von mehreren chinesischen Wissenschaftlern bevorzugt wird. Dieses Modell geht zurück auf das Sozialversicherungsmodell in Deutschland und unterscheidet sich grundlegend vom kommerziellen Modell der Vereinigten Staaten von Amerika wie vom Staatsfürsorgemodell in Skandinavien.

Schlüsselwörter

Altenpflege Alte Menschen mit Behinderung Gerontologie Sozialversicherung China 

Notes

Compliance with ethical guidelines

Conflict of interest

T. Liu and L. Sun declare no conflict of interest.

The accompanying manuscript does not include studies on humans or animals.

References

  1. 1.
    Barr N (2010) Long-term care: a suitable case for social insurance. Soc Policy Adm 44(4):359–374CrossRefGoogle Scholar
  2. 2.
    Berger PL, Luckmann T (1980) Die gesellschaftliche Konstruktion der Wirklichkeit. Eine Theorie der Wissenssoziologie. Fischer, Frankfurt a. M.Google Scholar
  3. 3.
    Birg H (1996) Die Weltbevölkerung: Dynamik und Gefahren. Beck, MünchenGoogle Scholar
  4. 4.
    Bogner A, Torgersen H (2005) Wozu Experten? Ambivalenzen der Beziehung von Wissenschaft und Politik. VS Verlag für Sozialwissenschaften, WiesbadenGoogle Scholar
  5. 5.
    Castles F (1978) The social democratic image of society. Routledge & Kegan Paul, LondonGoogle Scholar
  6. 6.
    Dai WD (2007) Introduction of German long-term care insurance. Chinese J Nurs 42(1):85–86Google Scholar
  7. 7.
    Dai WD (2012) The construction of long-term care insurance system in China. Peopleʼs Publishing House, BeijingGoogle Scholar
  8. 8.
    Deacon B, Hulse M, Stubbs P (1997) Global social policy. International organizations and the future of welfare. Sage, LondonGoogle Scholar
  9. 9.
    Ding C, Qu QC (2008) Entstehungsgründe, Merkmale und Reformkonzept der deutschen Pflegeversicherung. Deutschland-Studien 23(3):42–47Google Scholar
  10. 10.
    Haggard S, Kaufmann RR (2009) Development, democracy, and welfare states: Latin America, East Asia, and Eastern Europe. Princeton University Press, PrincetonGoogle Scholar
  11. 11.
    Harper S (2006) Ageing societies: Myths, challenges and opportunities. Hodder Arnold, LondonGoogle Scholar
  12. 12.
  13. 13.
    Hesketh T, Lu L, Xing ZW (2005) The effect of Chinaʼs One-Child family policy after 25 years. N Engl J Med 35(3):1171–1176CrossRefGoogle Scholar
  14. 14.
    Jackson R, Howe N (2004) The graying of the Middle Kingdom. In Presentation at the CSIS/CASS Conference on Preparing for China’s Aging Challenge, Abridged Version, 25 May 2004Google Scholar
  15. 15.
    Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW (1963) Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychological function. J Am Med Assoc 185(12):914–919CrossRefGoogle Scholar
  16. 16.
    Kohli M (1985) Die Institutionalisierung des Lebenslaufs: Historische Befunde und theoretische Arguments. Köln Z Soziol Sozialpsychologie 37(1):1–29Google Scholar
  17. 17.
    Korpi W (1978) The working class in welfare capitalism: work, unions and politics in Sweden. Routledge & Kegan Pau, LondonGoogle Scholar
  18. 18.
    Korpi W (1983) The democratic class struggle. Routledge & Kegan Paul, LondonGoogle Scholar
  19. 19.
    Lawton MP; Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9(3):179–186PubMedCrossRefGoogle Scholar
  20. 20.
    Leisering L, Liu T (2010) Globale Wissensdiffusion in der Sozialpolitik. Die Einführung einer Arbeitsunfallversicherung in der Volksrepublik China. Z Sozialreform 56(2):173–205Google Scholar
  21. 21.
    Li JF, Hou HJ (2009) A study on the construction of long-term care insurance system for elderly in China. Insurance Stud 29(11):65–71Google Scholar
  22. 22.
    Li J, Hou A (2012) A study on the construction of long-term care insurance system for the elderly in China. Insurance Studies 32(11):65–71Google Scholar
  23. 23.
    Liu T (2005) Die Reform der Alterssicherung in der VR China. Entwicklung und Determinanten. Dissertation at Bielefeld University, BielefeldGoogle Scholar
  24. 24.
    Liu J, Chen S (2012) Construction of long term care insurance. Res Financial Econ Issues 33(3):78–82Google Scholar
  25. 25.
    Liu T, Flöthmann EJ (2013) Die neue alternde Gesellschaft. Demographische Transformation und ihre Auswirkungen auf Altersversorgung und Altenpflege in China. Z Gerontol Geriat 46:1–12CrossRefGoogle Scholar
  26. 26.
    Liu L, Guo Q (2007) Loneliness and health-related quality of life for the empty-nest elderly in the rural areas of a mountainous county in China. Qual Life Res 16(8):1275–1280PubMedCrossRefGoogle Scholar
  27. 27.
    Lue XJ (2011) Exploration of the acceleration of the establishment of a long-term care insurance system in China. http://society.people.com.cn/GB/15926060.html. Accessed 2 Feb 2014
  28. 28.
    Luhmann N. (1997) Die Gesellschaft der Gesellschaft. Suhrkamp, Frankfurt a. M.Google Scholar
  29. 29.
    Luo R (2012) Across the institutional passage of migration: the hukou-system in China. InterDisciplines 3(1):120–147Google Scholar
  30. 30.
    Meyer JW (2005) Weltkultur: wie die westlichen Prinzipien die Welt durchdringen. Suhrkamp, Frankfurt a. MGoogle Scholar
  31. 31.
    Offe C (1987) Democracy against the welfare state? Structural foundations of neoconservative political opportunities. Political Theory 15(4):501–537CrossRefGoogle Scholar
  32. 32.
    Pearman WA, Starr P (1988) Medicare: a handbook on the history and issues of health care services for the elderly. Garland, New YorkGoogle Scholar
  33. 33.
    Pellissery S, Sun L (2012) Rural Development. In: Anderson R (ed) Berkshire Encyclopedia of Sustainability: Vol. 7: China, India, and East and South East Asia: Assessing Sustainability, Berkshire Publishing Group, Beijing, pp 324–27Google Scholar
  34. 34.
    Pierson P (2001): The new politics of the welfare state. UP, OxfordCrossRefGoogle Scholar
  35. 35.
    Rogers EM (1962) Diffusion of Innovations. The Free Press of Glencoe, New YorkGoogle Scholar
  36. 36.
    Saltman RB, Dubois HFW Chawla M (2006) The impact of aging on long-term care in Europe and some potential policy responses. Int J Health Serv 36(4):719–746PubMedCrossRefGoogle Scholar
  37. 37.
    Schetsche M (1996) Die Karriere sozialer Probleme: Soziologische Einführung. Oldenbourg, MünchenGoogle Scholar
  38. 38.
    Schubert K, Bandelow NC (2003) Lehrbuch der Politikfeldanalyse. Oldenbourg, MünchenGoogle Scholar
  39. 39.
    Shi SJ (2008) Emergence of the notion of retirement in rural China: the case of rural districts of Shanghai. Z Gerontol Geriat 41:334–344CrossRefGoogle Scholar
  40. 40.
    Shils EA, Finch HA (1997) The methodology of the social sciences. Free Press, New YorkGoogle Scholar
  41. 41.
    Steffen M (2010) The French health care system: liberal universalism. J Health Polit Policy Law 35(3):353–387PubMedCrossRefGoogle Scholar
  42. 42.
    Stepan M, Müller A (2012) Welfare governance in China? A conceptual discussion of governing social policies and the applicability of the concept to contemporary China. J Camb Stud 7(4):54–72Google Scholar
  43. 43.
    Sun L (2012) Women, public space, and mutual aid in rural China. Asian Women 28(3):75–102Google Scholar
  44. 44.
  45. 45.
    The World Bank (2013) World development indicators: reproductive health. http://data.worldbank.org/indicator/SP.DYN.TFRT.IN. Accessed 2 Feb 2014
  46. 46.
    Ullrich, CG (2005) Soziologie des Wohlfahrtsstaates. Campus Verlag, Frankfurt a. M.Google Scholar
  47. 47.
    Wang XC, Shao H (2012) Consideration about installment of a long-term care insurance system with Chinese characteristics. Manag Technol SME 04(2):196Google Scholar
  48. 48.
    Wang L, Ye X (2011) Development of Japan elderly care insurance system and its referential significance for China. Jpn Stud Forum 47(1):145–150Google Scholar
  49. 49.
    Wu C, Du P (2012) Ageing society and harmonious society. China Population Publishing House, BeijingGoogle Scholar
  50. 50.
    Wu H, Zhang R (ed) (2011) Gerontological social work. Peking University Press, BeijingGoogle Scholar
  51. 51.
    Wu GM, Zhong HL (2010) The models of long-term care insurance in Germany and Japan and their implications for China. J Nurs Sci 25(23):76–78Google Scholar
  52. 52.
    Yao, H (2006) The long term care insurance abroad and its inspiration for China. Mod Econ Res 6:41–44Google Scholar
  53. 53.
    Zhang X, Li D (2011) Sociology of ageing. Social Sciences Academic Press, BeijingGoogle Scholar
  54. 54.
    Zhang ZG, Jiang Q, Zhao YX, Yu LH, Zhang ZZ, Lang QQ (2011) Long-term care insurance policies in Germany and its implications for China. Chin J Nurs Education 08(8):93–94Google Scholar
  55. 55.
    Zhang K, Sun L, Mou X et al (2011) Research on situation of urban and rural disabled elderly. Monogr Study 2:11–16Google Scholar
  56. 56.
    Zhao N (2008) A method on the establishment of a multi-level long-term care system in China. http://shfl.mca.gov.cn/article/llyj/ylfwmsts/200812/20081200025485.shtml. Accessed 1 Feb 2014
  57. 57.
    Zhi XX, Zhou L (2012) The German long-term care insurance and its implications for the work of long-term care in China. Using Pract Res 09(8):93–94Google Scholar
  58. 58.
    Zhong W, Zheng Y, Zhang M (2013) The collapse of the state. Research on the sovereign debt restructuring. Shanghai University of Finance and Economics Press, ShanghaiGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Fakultät für SoziologieUniversität BielefeldBielefeldGermany
  2. 2.Faculty of Technology, Policy & ManagementDelft University of TechnologyBX DelftThe Netherlands

Personalised recommendations