China is aging at an unprecedented rate. Improvements in life expectancy and the consequences of the decades-old family planning policy have led to a rapid increase in the elderly population. According to the United Nations World Population Prospects, the proportion of older people age 65 and over will increase by about one-fourth by 2030, and the elderly will account for about one quarter of the total population by 2050. Population aging will not only pose challenges for elder care but also have an impact on the economy and all aspects of society (World Bank, 2016a). The government is aware of the need to develop an efficient and sustainable approach to aged care. To this end, the General Office of the State Council issued the 12th Five-Year Plan for the Development of Aged Care Services in China and the Development Plan for a System of Social Services for the Aged (2011-2015). It is now in the process of formulating the 13th Five-Year National Plan on Aging, which will further elaborate and finalize the reform roadmap for 2016 to 2020. The Plan is expected to be finalized and launched by June 2016. The National Development and Reform Commission (NDRC) helped draft these plans and is now leading the development of policy measures for the provision of social services for the elderly. This volume has been prepared to support the translation of the broad ideas on aged care provision expressed in the 12th and 13th Five-Year Plans and other government plans into reality and to help the government tackle the challenges described above. It strives to identify a policy framework that fits the Chinese context and can be put in place gradually. Specifically, it aims to provide an up-to-date understanding of the evolving aged care landscape in China; review international experiences in long-term care provision, financing, and quality assurance and assess their relevance to China’s current situation; discuss implications of current developments and trends for the future of aged care in China; and propose policy options based on available evidence and best practices.

The population of Asia is growing both larger and older. Demographically the most important continent on the world, Asia's population, currently estimated to be 4.2 billion, is expected to increase to about 5.9 billion by 2050. Rapid declines in fertility, together with rising life expectancy, are altering the age structure of the population so that in 2050, for the first time in history, there will be roughly as many people in Asia over the age of 65 as under the age of 15. It is against this backdrop that the Division of Behavioral and Social Research at the U.S. National Institute on Aging (NIA) asked the National Research Council (NRC), through the Committee on Population, to undertake a project on advancing behavioral and social research on aging in Asia. Aging in Asia: Findings from New and Emerging Data Initiatives is a peer-reviewed collection of papers from China, India, Indonesia, Japan, and Thailand that were presented at two conferences organized in conjunction with the Chinese Academy of Sciences, Indian National Science Academy, Indonesian Academy of Sciences, and Science Council of Japan; the first conference was hosted by the Chinese Academy of Social Sciences in Beijing, and the second conference was hosted by the Indian National Science Academy in New Delhi. The papers in the volume highlight the contributions from new and emerging data initiatives in the region and cover subject areas such as economic growth, labor markets, and consumption; family roles and responsibilities; and labor markets and consumption.

The contributors to this book present case studies of elder care in China and India, and draw comparisons between the two – illuminating some of the key issues facing the two largest Asian countries as they develop rapidly. Caring for the elderly is a major challenge for all countries, and one which is of acute concern for rapidly developing economies. Development tends to run counter to long-established cultural norms of family-based caring and filial piety, even as it also tends to lead to longer life expectancy. Taking a range of methodological and conceptual approaches to understanding these challenges, the contributors present a multifaceted understanding of elder care issues in both India and China. They focus in particular on caregiving within families and at care homes – and the impacts these have on quality of life and the experience of caregiving for both caregivers and the aged themselves. An invaluable collection for scholars and students of gerontology and aging in Asia, that will also be of great interest to scholars with a broader interest in global trends in caregiving.

Informed by the social-ecological framework, this book focuses on the development of Home and Community Based Services (HCBS) in urban China. Bringing a timely discussion around HCBS development in Shanghai, it presents an interplay of formal caregiving relationships, evolving caregiving culture, and the trajectory of long-term care in China. Drawing on surveys, in-depth interviews, and government archives, this book explores the emergence of one of the most developed HCBS programs in Shanghai, its development over the past decade, its administration and services, resource allocation, staff members’ work experiences, older adults’ service experiences, as well as service evaluation and improvements. Offering fresh insight into new forms of caregiving in community settings, and shaping a new discourse on caregiving policy, this book is a key read for both students and practitioners in the fields of long-term care, gerontology, geriatrics, health care, and health policy.

Growing Old in a New China: Transitions in Elder Care is an accessible exploration of changing care arrangements in China. Combining anthropological theory, ethnographic vignettes, and cultural and social history, it sheds light on the growing movement from home-based to institutional elder care in urban China. The book examines how tensions between old and new ideas, desires, and social structures are reshaping the experience of caring and being cared for. Weaving together discussions of family ethics, care work, bioethics, aging, and quality of life, this book puts older adults at the center of the story. It explores changing relationships between elders and themselves, their family members, caregivers, society, and the state, and the attempts made within and across these relational webs to find balance and harmony. The book invites readers to ponder the deep implications of how and why we care and the ways end-of-life care arrangements complicate both living and dying for many elders.

If modernisation means mass longevity, it raises hopes that everyone may enjoy a full span of years. It also brings the fear that many will not be able to take care of themselves and will rely upon society to provide special care. Modernisation in this sense also means the rise of the welfare state: let the government take care of the frail and the old.Mass aging has proven to be a financial crisis for welfare states in the advanced economies of the West; it also raises questions about the future of family-based care in the East while professionals and academicians in the advanced economies of the West continue to debate about whose responsibility it is to take care of the elders (the state or the individual?), governments in East Asia hold firmly to the position that it is the family that has the primary responsibility to take care of old members, and that the government's role is to assist families in discharging elder care responsibilities.This publication examines some of the often-raised questions identified in the research literature in the past 25 years — for example, the nature and scope of caregiving, the issue of care burden, and the claim that family-based care is really women care that is sex-biased. The author marshals evidence to show from studies conducted in China that care burden is a complex form of social relations that is shaped by the culture. Furthermore, the gender and type of relations may largely determine in what type of kin relations are the subjective feelings of burden the greatest and where objective indications of burden may remain constant. In conclusion, the author suggests that the best common resolution for both the East and the West is to establish a workable partnership between the state and the family in facing the forthcoming crisis of elder care in a fully aged society.