This article examines the changing demographics of China,
with particular attention paid to the effect of the one-child
policy in relation to long-term care of older people. It also
examines the current state of health care for older people.
Long-term stays characterize hospital care. Most geriatric
syndromes are less common in hospitalized older people
(e.g., delirium, falls), but some (e.g., polypharmacy) are
more common. A high volume of patients and brief targeted
visits characterize outpatient care. Nursing homes exist in
China, but relatively fewer than in the most developed
countries.
Geriatric departments in university-based hospitals
primarily have developed out of a need to care for retired
government officials and workers. There are no formal
geriatric fellowships or national board certifications in
geriatrics
Health care is primarily based on fee for service. Not all
elderly have healthcare insurance. Although costs of health
care and medications are less expensive than in the United
States, they are relatively high for lower-and middle-class
Chinese and have increased more quickly than has the
standard of living in the past 20 years.
Family and community support for older people is
strong in China. Some older people have one-to-one care
from a baomu (literally ‘‘protection’’ (bao) ‘‘mother’’ (mu)),
a type of live-in maid who also provides care for the older
person. Some of the challenges facing China in the care of its
aging population are how to increase geriatric research and
training, how to care for the uninsured or underinsured,
and how to handle the inevitable growth of disabled and
frail older people.