Who Takes Care of Old People
Term Paper Submitted
For Contemporary British Culture and Society Course
To Professor Xiao Huiyun
Name: Bai Qi
Topic，Who Takes Care of Old People
Thesis: The growing number of old people brings with it many problems for the old people
themselves, which can be revealed from different respects such as social security, family care,
social care, and mental health of old people. To solve these problems, every walk of the
society, like the government, the family, the society and the individuals, should work together
to provide better life for old people and to establish a healthy aging society.
I. Introduction: aging in both countries become serious (statistics？and the thesis
II Supporting ideas: the problems faced by old people in the UK and in China
A. Problems in the government pension system
(A) UK pension system: though a welfare state, problems are inevitable
a. High government expenditure and taxation, so the burden of individuals high
b. Old people have to work longer in spite of declining health (examples)
(B) Chinese pension system: developed later and far from perfect
a. Coverage rate not wide enough and regional distribution unbalanced, majority of rural
population has no access to the system (statistics and examples)
b. Management of pension funds lacks scientific basis and thus abuse of the pension funds by
B. Family care for old people is insufficient
a. Less old people live with children and less young people to support the old
b. Children have too much pressure of work to take care of parents
a. About the same with the UK, tradition of family taking care of old people being challenged
b. Declining of morality a contributing factor
C. Problems in the society in terms of taking care of old people
(A) UK: although with developed system of institutional care, there are problems
a. Old people too dependent and lose adaptability to the society
b. Some old people treated inhumanly in institutions
c. Government cannot always invest enough to meets the old people’s need
d. Fewer trained and experienced professional workers
(B) China: not as good as that of the UK and should learn from the experience of the UK
a. Regional distribution unbalanced and facilities comparatively worse (statistics)
b. Management and service hardly satisfying
c. Lack of health maintaining advices, psychological help and scientific care
d. Old people cannot have many meaningful activities (examples)
e. Environment of institutions depressing and boring
f. Visiting nurse: a new concept for Chinese people and is hardly accepted
D. Mental health for old people both in the UK and in China
(A) Lonely inside because cannot live with children and sometimes feel isolated by society
(B) Develop mental diseases apart from physical diseases because of depression
(C) Causes of depression: heart problems, low thyroid activity (hypothyroidism), vitamin B12 or
folic acid deficiency and cancer.
(D) Suicide of old people
a. The most remarkable problem in terms of mental health (statistics and example)
b. Causes of suicide: physical health problems and economic, social, cultural and religious
(E) Old people want something more psychologically satisfying: education, entertainment and
some other meaningful activities
III Conclusion: To provide the old people with a better and healthier life, the government, the society,
the family and the individuals in both the UK and China should all work together and
learn from each other. To build a healthier aging society, everyone should take full
responsibility and ensure a stable and happy life for all the old people. We should seek
a way towards a healthy aging society.
Who Takes Care of Old People
There are more and more old people in British and Chinese society as a result of longer life expectancy and lower fertility rate introduced by industrialization and urbanization. According to a UN report in 1997, there would be 27.3% of the UK population over 60 and 20.3% over 65 in 2025. In china, it is estimated that in 2025, 19.3% of the Chinese population will be over 60 and 12.9% over 65. The growing number of old people brings with it many problems for the old people themselves, which can be revealed from different respects such as social security, family care, social care, and mental health of old people. To solve these problems, every walk of the society, like the government, the family, the society and the individuals, should work together to provide better life for old people and to establish a healthy aging society.
Problems in the government pension system
Since there are some defects in the pension system, it can not work perfectly to provide old people with what they want.
The UK is a typical Welfare State where people get economic help from the government “from
cradle to grave”. Social security takes up about one third of the government expenditure in which
pension occupies the largest proportion, which is still increasing, reaching 49% in 2000. The pension system, which consists of three tires, that is, the funds from special tax payments of current workers; the occupational or state supplementary pension funded by insurance payments; and the private fund. Although this system meets the basic need of the old people and was used to be considered as one of the most developed pension systems, nowadays, as the average life expectancy prolongs, the expenditure of pension is higher year by year. The average life expectancy in the UK is 75-80, which means that the government has to pay for 10-15 years. And it is still growing, and the payment time will be longer. So the government expenditure on pension is inevitably growing. The deficit of the UK pension fund is 3000 billion pounds to 6000 billion pounds per year. There would be further problems. The taxation will be higher, which means heavier burden for the tax payers. The old people would probably have to work longer because the government has to make the working age five years longer than the current average retire age, that is, from 65 to 70. Therefore, as old people’s health declines,
they may have difficulties in their work.
In China, the pension system developed much later than that of the UK, and is not that good. At the very beginning, old people get their retirement pension mainly from the company. After the pension system reformation, the company and state take more responsibility in providing funds and individuals also contribute to the fund when they are still at work. But the coverage rate of the pension system is still not wide enough and the distribution not balanced. Only 15 percent of the Chinese population, mainly employees of various ownerships, is covered by the country's five-year-old pension system. Addressing the 2005 Asian Pension Fund Roundtable, Xiang Huaicheng, chairman of
China's National Council for Social Security Fund, said the percentage is lower than the minimum standard of 20 percent set by the International Labour Organization. Only 55 percent of urban employees are covered by the country's pension system and the majority of the country's rural population has no access to the system. In a small village in North Shaanxi Province, nearly every old people over 60 have to work in the field in order to meet their basic needs, because they get nothing from the government and they still have to pay taxes and other fees. Another problem of this system is that management of pension funds lacks scientific basis so that some officials abuse the pension funds and therefore corruption is frequent.
Family care for old people is insufficient
As the family size becomes smaller in both countries, there are fewer young people to support the old people.
Before 1900, in UK families, parents lived together with their children and were taken care of by the children. But the urbanization and industrialization made the size of the family shrink. The children always work and live far away from their parents and they have more important things to do than just taking care of their parents at home. They have high pressure of work and other things in the society because the competition is severe. They have to work hard to survive the competition and to support the family. Furthermore, as the family size shrinks, the children’s attention tends more to their
own children than their parents.
In China, the tradition of family taking care of old people is also challenged. As a direct result of family plan, family size becomes smaller. Usually one couple have to support four or even more old people. At present, about 90% of old people are supported by family, but there are always old people who sigh that their kids have less fillet piety than before and are taking less care of them. Their children again complain that work is harder than before and the conflict between working and taking care of their parents is becoming severer. In Beijing, the average work time for a middle aged man is 7.7 hours per day and the time spent on housework is averaged 2.18 hours, while the time spent on taking care of parents is only 0.94 hours. The declining of morality is also a contributing factor of the insufficiency of family care.
Problems in the society in terms of taking care of old people
In the UK, there is a complete system of community service. The government invests money to establish Old People’s Homes and other institutions to take care of old people who have nobody to rely on. Mainly it is the government that pays for the care, community, family and individuals do not have to pay much. The institutions are mostly non-profit. Those who serve in this field include government employees, professional workers and volunteers. This system is multi-level and meets various needs of old people. These ways are effective in part to those old people, but it also allows the old people to be too dependent and to gradually lose the adaptability to the society. Some of the old people are treated inhumanly in these institutions. More importantly, the government cannot always
invest enough to meets the old people’s need as the number of old people is growing so fast. And there
are fewer trained and experienced professional workers.
In China, community service began from about 1988 mainly in large and middle sized cities. The general condition of the institutions, such as the Old People’s Homes, is far from meeting the needs of
the old people. In 1998, there are altogether 289 institutions for old people in Beijing and 6732 old people (only 0.4% of old people in Beijing) are living in these institutions. There are some regulations for taking care of old people among communities. In actual fact, however, the implementation of the measures faces many problems. The regional distribution of the institutions is unbalanced and the facilities are comparatively worse. The management and service are hardly satisfying. There are fewer professional workers, thus it is hard to provide old people with health maintaining advices, psychological help and scientific care. Since the management of these institutions lacks scientific basis, old people cannot have many meaningful activities. Even if they took part in some activities like poker, majiang, chess, taiji, and morning exercises and so on, they are only entertained but not psychologically satisfied. The atmosphere in these institutions is depressing and boring. Visiting nurse is a new concept for Chinese people, which means a nurse drop in the old people’s and helps them with chores such as clothes washing, cleaning, cooking, and shopping and so on. Many Chinese people think this is a profession that is disgusting and is something like a baby sitter, which is considered indecent. So the community service is not as good as that of the UK and we Chinese should learn from the British in this respect.
Mental health for old people
Getting older brings many advantages: wisdom, patience, contentment... But it also brings negatives, especially as our bodies become less able to do what they once did. For many old people, they have the basic needs of life met by the economic aids provided by the government or by the family, but what they need is much more than this. They are lonely inside because they cannot live with their children and sometimes they feel isolated by the society. For example, in the years after retirement, when people may struggle to adjust to a new role and routine in life, they find themselves hardly adapt to the society. Many older people hide their worries and struggle alone when they feel very low. And even though effective treatments are available, they are more likely to see suicide as the only way out. Others are so depressed that they develop mental diseases apart from physical diseases. This is true both in the UK and in China, and, I believe, in almost every country in the world.
There are several conditions that can cause depression in the elderly, including heart problems, low thyroid activity (hypothyroidism), vitamin B12 or folic acid deficiency and cancer. There is an increasing need for services for people with Down's syndrome who develop dementia in later life. In 1998, there are 29% of old males and 59% females over 75 living all alone in the UK and about 21% old people over 85 are living in long-term hospital or nursing homes. According to a report of Xinhua Website in 2004, there are at least 23,400,000 old people in China who do not live with their children.
In the cities, the percentage of older people living alone is more than 30% and it will probably be over 80% in the year 2010.
The most remarkable problem related to mental health is the suicide of old people. October 19, 2003, an 88-year-old lady jumped from the fourth floor and killed herself just because she had a disease and she wanted to release her daughter’s burden of taking care of her. This is just one of the numerous examples of old people who have committed suicide. In China more than 100,000 old people over 55 commit suicide every year for various reasons, especially because of loneliness and depression and so on. The percentage of old people’s suicide occupies 36% among the total suicide
cases and old people become the age group with the highest suicide rate. Why do old people suicide? Among those old people who committed suicide, 10% are depressed and 1% of them are with dementia. Apart from the mental diseases, there are other factors that contribute to old people’s suicide including economic, social, cultural and psychological factors.
There are more demands for old people. They are not satisfied just with sufficient materials meeting their basic needs, but demand much more than that. They want something more psychologically satisfying, such as education, entertainment and some other meaningful activities.
To provide the old people with a better and healthier life, the government, the society, the family and the individuals in both the UK and China should all work together and learn from each other. The government, as the main role of help provider, should try its best to enforce the law and improve the pension system. The society should give more concern to old people and provide help, material and psychological, to the old people. The family, especially, should be responsible for taking care of old people and the morality level should be improved. The institutions should seek better conditions and provide more advanced facility and management. Every individual in the society should pay more attention to old people and make them less lonely and less depressed and try to reduce the suicide rate of old people. To build a healthier aging society, everyone should take full responsibility and ensure a stable and happy life for all the old people. We should seek a way towards a healthy aging society.
Reference: Modern British Society and Culture, 2003, 王虹编著？上海外语教育出版社