As a result of the continuous deterioration of the Chinese economy, there has been a noticeable increase in cases of rural nursing home residents being discharged since 2024. In a southern city, the director of nearly ten rural nursing homes stated that in the first half of the year, the rate of rural elderly choosing to “leave the facility” for economic reasons reached 25%.
In recent years, with the advancement of urbanization in China, more and more migrant workers have left their hometowns to work in cities, forming a mobile labor force. However, with the ongoing economic decline in China post-pandemic, a large number of migrant workers have become unemployed and returned to their villages.
According to the report on monitoring and survey of migrant workers released by the Communist Party of China, the proportion of migrant workers engaged in the construction industry decreased from 19.0% in 2021 to 15.4% in 2023, with 9.757 million migrant workers leaving the construction industry.
With no economic source after losing their jobs, migrant workers are unable to afford the elderly care fees for their family members.
On June 25th, Economic Observer Network reported that in early June, Chen Jianliang, in his fifties, unable to afford the elderly care fees, brought his mother back home from the nursing home where she had been living for three years.
Chen’s mother had lost her ability to take care of herself due to a stroke in 2021. Chen Jianliang, who had been working outside with his wife for years, had sent his mother to a nursing home, where the monthly fee was 2600 yuan, with Chen Jianliang and his sister splitting the cost.
However, in the first half of this year, Chen Jianliang could not find a job, and even the contractor he had been working under for years was idle at home.
Initially, Chen Jianliang decided to temporarily postpone paying the nursing home fees and negotiated with the nursing home to make up for the payments after he found a job. But after more than three months passed, he still couldn’t find work.
After several disputes with his family, he brought his mother back home for care, and his sister transferred the fee payment to him.
Reports say that since the beginning of this year, cases of elderly leaving nursing homes due to economic reasons, like Chen Jianliang’s mother, have quietly increased, especially in rural areas.
Zhang Tong, who operates nearly ten rural nursing homes in a southern city with a strong GDP, said, “In previous years, the proportion of elderly people leaving the nursing home due to deaths or economic reasons was about 15%.
“But in the first half of this year, many families of elderly people have actively come forward saying that due to reduced job opportunities and spending most of their time at home, they have brought the elderly back home for care. This has led to an overall discharge rate of 25% for facilities.”
Rural or town-based nursing homes generally adopt a universal model aimed at providing services to elderly people from surrounding rural areas and towns, with monthly fees typically ranging from 2000 yuan to 5000 yuan.
The nursing homes operated by Zhang Tong belong to the mid-to-high-end level of universal facilities in rural areas. The average age of residents in these facilities is around 80 years old, and most of the elderly residents are unable to live independently, with the monthly fee for semi-disabled elderly people being around 3000 yuan.
Zhang Tong mentioned that the elderly care costs are usually shared among two or three children, requiring each person to pay 1000 to 1500 yuan per month. The children are usually the main workforce of the family, responsible for taking care of both children and the elderly.
If the monthly income of one child in a family is less than 3000 yuan, it is highly probable that they will bring the elderly back home for care. During the process of discharging them, there is a noticeable sense of embarrassment among the family members.
An expert from a certain industry association stated that in recent communications with several nursing homes, it was understood that there is indeed an increase in rural elderly leaving nursing homes due to economic reasons.
In addition to choosing to leave the facilities, some families also opt to transfer the elderly to nursing homes with lower fees.
Song Tao, responsible for the operation of rural nursing homes in three southern provinces, said, “Since the beginning of this year, some families have reported a decline in income from working outside. Due to the lack of care in their hometown, they can only transfer the elderly to nursing homes costing only a few hundred yuan per month.”
This “downgrading” trend is also happening in rural areas of first-tier cities.
In nursing homes in towns under a first-tier city, about 20% of the elderly residents are non-local registered residents. Most of these elderly people followed their children to live in first-tier cities but were later sent to nursing homes due to disabilities and dementia.
However, according to the head of the institution, the number of non-local registered elderly people in the facility has been decreasing over the past two years.
With more and more elderly people “leaving the facility,” a large number of rural nursing homes are struggling to balance their finances.
Zhang Tong mentioned that the prices of nursing homes are currently highly competitive, and the occupancy rates cannot be further increased. Additionally, in comparison to the income of rural residents, even universal nursing homes are too expensive.
“The Green Book of Rural Areas: Analysis and Forecast of China’s Rural Economic Situation (2023-2024)” shows that the average amount of pension received by farmers is 204.7 yuan per month.
Compared to the fees of universal nursing homes costing over 2500 yuan per month, the farmers’ pensions are just a drop in the bucket.
Song Tao mentioned that due to economic capacity and elderly care concepts, rural elderly people generally do not choose to live in nursing homes unless absolutely necessary. Many elderly people worked on the mountains one day and could be bedridden the next. Hence, the vacancy rates in many rural nursing homes are quite high.
Chen Jianliang said that their generation and the previous one are bound to not be able to afford to live in nursing homes based on their own ability. Most of them are only children, and when both sets of parents are bedridden, the pressure of elderly care on them may be even greater.
Statistics from the seventh national census of the Communist Party of China show that the population of elderly people aged 60, 65, and above in rural China is 121 million and 90.33 million, respectively. China’s rural areas have entered a moderately aging society ahead of many other regions.