A guest column from Gary Kaye, founder of In the Boombox, and frequent contributor to AARP and AARP Radio.
I just returned from a fascinating trip to China, where grandparents play a very different role than they do here in the United States. In every Chinese city I visited, each morning you could see grandfathers and grandmothers pushing strollers through the local parks with their grandchildren. While here in the U.S., having grandparents raising children is the exception, in China it is the norm. There are no nannies, there is little daycare. Most middle class families consist of two wage earning adults, and because of China’s “One Child” policy, only one youngster. In order to allow the parents to work, it is the grandparents who take care of the children as infants, then take them to school and pick them up when they get older. The grandparents don’t view this is as a chore, it is something they are proud to do. It is one reason why despite China’s many problems, its family unit remains a major strength.
The arrangement takes on even more importance in China’s rural areas where 70 percent of its population lives. Parents seeking to improve their economic condition often seek work in the cities, in many cases getting construction work in China’s exploding urban areas. But under Chinese law, these workers do not have the same rights as citizens of those cities. They cannot bring their children to local schools. They cannot have their children seen by local doctors. As a result they leave their children behind for the grandparents to care for. The fathers will send money back home, but seldom get to see their children, in many cases traveling home only at the Lunar New Year.
Because of the unintended consequences of the “One Child” policy, China is becoming a rapidly aging society. In that same two wage earner family there may be four grandparents to support as they enter old age. According to figures from the United Nations Population Bureau, in 1980 China had roughly eight workers to support every person in retirement. But according to projections, by 2035 that’s expected to drop to only two workers for every retired person. Right now the retirement age is 60, though the government is actively considering plans to push that back to age 65 or 68 as a means of relieving a huge looming pension problem. In recent years China has actually expanded its version of social security, but now funding it for a rapidly growing aging population could prove daunting.
Here in the United States, the economic downturn since 2008 has forced more Americans to help support their adult children. And while we hope those same adult children will help take care of us as we age, there is no legal obligation for them to do so. Not so in China, where they are legally obligated to take care of them. In a worst case situation, parents have been known to sue their children for support, a measure which bring s great shame to the family.
One way China is considering easing the burden is to construct entire cities for the elderly. The Chinese government has approached the U.S. technology firm Intel, which is spearheading major research into “Aging in Place”. The Chinese are said to be considering as many as forty brand new cities equipped with technology to help care for an aging population. In theory that could bring huge economies of scale to eldercare, but it also raises fears of massive warehousing.
Bringing the Lessons Home
Intel is conducting aging research in 28 countries including the U.S. and China. It’s already deploying systems through its joint venture with General Electric, called CareInnovations, to monitor chronic populations. Together with institutional care providers such as Humana, CareInnovations has deployed hundreds of bedside devices that allow a congestive heart failure patient to be monitored on a daily basis. The tablet style device is equipped to do videoconferencing, so each day the patient receives a call from a caregiver who asks about their condition, then has them step on a scale and use a blood pressure cuff. By monitoring these vital statistics the caregiver can see if the patient is within normal parameters, or if an adjustment to medication or diet might be needed. The results so far have been promising. Congestive heart failure patients involved in these trials have significantly lowered hospital readmissions as well as reduced morbidity. This means both a better quality of life for the patient and a significant reduction in the costs of treatment, since a year’s worth of daily monitoring costs only a fraction of the price of a single hospitalization.
For both the aging grandparent in Guilin or Chengdu and the congestive heart failure patient in Madison, Wisconsin, the issue is the same, how to receive affordable health care at a time when their numbers are growing and the resources to take care of them are diminishing? One of the few solutions short of warehousing and sharply rationed care is new technology that, in terms expressed by Intel, will allow us to live longer lives better.