Caring for Aging Chinese- Lessons Learned From the United States

Caring for Aging Chinese- Lessons Learned From the United States

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114 Caring for Aging Chinese: Lessons Learned From the United States HONGWEI WAN, MD, MSN, RN Shanghai Jiao Tong University School of Nursing FANG YU, PHD, CRNP, RN University of Minnesota School of Nursing ANN KOLANOWSKI, PHD, RN, FGSA, FAAN Pennsylvania State University School of Nursing After two birth peaks and the “one child per family” policy, China is facing unprecedented challenges with regard to its aging population. This article analyzes the problems associ- ated with three traditional ways of caring for older Chinese, the current health care system, and social supports avail- able to older Chinese. The “4-2-1” family structure and the “empty nest” undermine family support, the prevalence of chronic illnesses and lack of money reduce older adults’self- care abilities, and insufficient care facilities threaten social support. Lessons learned from the United States show that community-based nursing models, nursing curriculum reforms with a gerontology focus, and reformed health care systems are pivotal for addressing China’s crisis. Keywords: aging population; gerontological nursing; China; Chinese; community-based care; health care system BACKGROUND China is facing unprecedented challenges in population aging in the 21st century. Population aging is defined as the process whereby over a period of time, older individuals, usually 65 and older, make up a disproportional share of the total population. In comparison with the United States, pop- ulation aging in China is characterized by a late onset with a rapid and long-lasting effect. The Fifth National Census in November 2000 showed that the number of people age 60 and older had already reached 126 million and consti- tuted 10% of the total population in China. It is projected that the aging population will keep growing at a rate of 3% every 10 years until 2050, with the fastest growing period from 2010 to 2040. By 2050, the number of people 60 years old and older will reach 400 million, accounting for 25% of the total population (Z. Wang, 2004). Similarly, in the United States, the number of people age 65 and older is expected to triple during the first half of the 21st century. The growth among the oldest old cohort is the most remarkable. The number of people age 80 and older grew at an average rate of 159% between 1960 and 1990 and will con- tinue to increase at a rate of 70% between 1990 and 2020 of older Americans will reach 50 million, making up 20% of the total population. Other than historical events such as the baby boom from 1947 to 1964, reasons for the rapidly grow- ing older population in the United States include declines in fertility, longer life expectancy, and improved living conditions (Kingma, 1999). Improvements in health care and technology Blixen, 1998). Unlike the United States, two main reasons for Chinese
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Caring for Aging Chinese- Lessons Learned From the United States

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