Lois A. Bowers
Lois A. Bowers

Demographics are changing, with no cohesive plan apparent to address the care needs of the aging population. A shift in societal norms sees adult children moving away for economic opportunities, complicating family caregiving responsibilities.

The previous two sentences refer to China, although it’s understandable if you read them and believed I was talking about the United States.

After all, National Investment Center for Seniors Housing & Care Chief Economist Beth Mace told those attending a session at the organization’s recent fall conference, in the United States today, there are about seven adults aged 45 to 64 years for every one adult aged 80 or more years. By 2030, however, that ratio will be roughly 4:1, and by 2050, 3:1. Clearly, as we’ve heard at the NIC conference and other industry meetings, a family and professional caregiver crisis is looming.

In China, according to XinQi Dong, M.D., M.P.H., the country’s One Child Policy, which was in effect from 1980 to 2015, means that today there is one adult child to provide care for four grandparents and two parents. The resulting caregiver burden stresses historic roles that called for children to care for their elders and, in return, for the elders to “contribute to the harmony of the family and society with their guidance and wisdom,” Dong writes in a recent issue of JAMA Internal Medicine. It also is leading to increases in elder abuse, adds the professor at Rush Medical College and associate director of the Rush Institute for Healthy Aging in Chicago.

How is China addressing these challenges? In 2013, the country mandated that adult children support parents aged 60 or more years, including visiting frequency. Parents are supposed to sue adult children who don’t comply, claiming neglect, although Dong says that enforcement has proved difficult because the law did not specify punishment.

Shanghai and other areas of the country with large populations of older adults have tried to address that oversight, Dong says, by specifying that adult children whose attention to their parents is deemed insufficient “will find their names publically [sic] and shamefully called out and their credit standing negatively affected by the government.” An individual’s ability to open a bank account, buy a house, start a business or even obtain a library card could be affected by behavior thought to be lacking. Shanghai’s law became effective in May and, therefore, it’s too soon to know whether such punishments will result in a change in adult children’s actions, Dong points out.

As policymakers and other thought leaders in the United States have pondered ways to finance long-term care, reduce the burden on family caregivers and ensure enough professional caregivers for an increasingly aging American population, public shaming and threats of damaged credit ratings have not been among the solutions put forth — rightfully so.

More thinking about these important financing and caregiver issues is important, of course, and the industry will learn much from agencies and organizations that already are implementing programs that address these challenges, even if on a relatively small scale. It also is time, however, to seriously vet and then start acting on the big ideas that have been suggested and have the potential to make a difference not just in one geographic area or at one company, but across the country and the senior living industry. Nobody is getting any younger.

Lois A. Bowers is senior editor of McKnight’s Senior Living. Follow her on Twitter at @Lois_Bowers.