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.

On the lakeside, a sparkle in twilight years

Retirement communities offering comprehensive services are springing up nationwide as more property developers delve in to a lucrative market fueled by China's aging population.

One of the most high-profile real estate projects completed this year was in the Tieshan Lake Forest Park in Xuyi county, Jiangsu province, which welcomed its first 2,000 or so residents in March.

The development, an hour's drive from Nanjing, the provincial capital, covers 48 square kilometers, half of which is made up of five- or six-floor residential buildings containing 13,000 apartments.

The other half has a nursing home and day care center for people who need regular care, with 380 beds, as well as a hospital and a fitness center with a swimming pool, badminton courts and hot spring pools.

Those who need urgent medical help or routine daily assistance can use on-site transportation services or receive home visits from a nurse.

"The advantage of such a community is that it takes into consideration the whole time span of the elderly, from when they are still very energetic to when they become dependent on caregivers," said Chen Weichi, design director at the Shanghai office of international architectural firm Perkins Eastman, which designed the project.

Sales for the high-end development have been better than expected, according to Nanjing Jinling Hotel Group Holdings, the main investor.

Most residents live in either a one-bedroom apartment of 95 square meters or a two-bedroom apartment of 116 sq m, with most enjoying a view of Tieshan Lake, according to Hua Yan, assistant to the group's general manager. Prices range from 650,000 and 850,000 yuan ($97,600 to $127,600).

"Most of our buyers are in their 60s. They are well educated and were well paid before retiring from industries such as education, medical health and technology," she said, adding that about 95 percent of residents are from Nanjing, while the rest have come from neighboring areas, such as Shanghai, or have returned from overseas.

"On average, 400 households are cared for by one licensed nurse, who is responsible for keeping track of their health and providing guidance," she said.

"The first group of residents have spontaneously formed amateur clubs, such as for calligraphy, music and dance," Hua added. "The community has become known as a fairyland among the elderly of Nanjing."

Youthful energy helps inspire aged residents

A care home on Yangqu Road in downtown Shanghai not only welcomes the older generation, but also children and teenagers.

The center, which opened in January to help families with elderly dependents, has play areas with slides, games and toys, and a reading room for older children to read and complete school assignments.

Plans are also in the works to start looking after students during the gap between when they finish class and when their parents get off work, according to Jiang Lili, director of the Linfen community service office in Jing'an district.

"We don't want this facility to be an isolated island just for the elderly," she said. "We hope to build it into a platform of openness and inclusion, so the elderly can spend their twilight years in an energetic atmosphere.

"It looks like a service for the children, but it benefits the elderly, too. On one hand, the children inspire a passion for life in the elderly, and on the other, the children's parents and grandparents can get some free time to do something for themselves."

Jiang added that older students who regularly use the reading room have volunteered to take care of children in the play rooms as well as spend time with elderly visitors, either chatting or leading recreational activities. During the winter holiday, they arranged a timetable so that two of them would be on duty every day, she said.

The center is managed by Aizhaohu, a Shanghai company that provides professional eldercare services. Zeng Chao, the company's director of operations, said the aim of the Yangqu Road facility is to encourage older people, who perhaps do not feel as useful in society as they once did, to take part more in activities rather than sit around or lay in bed.

Jiang said when construction of the care home began two years ago, some nearby residents objected, as some imagined it would bring a gloomy atmosphere to the community.

"But now people applaud this lively spot and the real benefit it brings," she added.

(Source: China Daily)