As China's population of the elderly grows, the private sector is stepping in to fill in the gap in services for the old

It is a cold day early in the Lunar New Year, and 82-year-old Cai Hongyi Is sitting in a wooden chair at the entrance of the four-storey Kangyi Nursing Home in Caiji Town in Suqian, in Jiangsu province.

The home, with a capacity of 400 beds, appears deserted as most of the 80 residents have been taken home by their families for the Spring Festival.

Cai has just returned from his original home in a village about 5 km away, where, as a farmer, he spent his whole life and raised four children with his departed wife.

Clockwise from top: Elderly people play poker in Caiji Social Welfare Center; Liu Yulong, 74, cleans the center's canteen; Cai Hongyi, 82, sits at the entrance of Kangyi Nursing home, where he spends 1,500 yuan a month for a place with two-bed ward with an attached bathroom. Photos by Yang Yang / China Daily

About 10 years ago, Cai's wife was bedridden. So, in order for her to receive appropriate care, the couple moved into a nursing home.

Then, when Kangyi was set up two years ago, the family decided to transfer the couple there as it offered better facilities and was closer to their home.

On the third floor, the nursing home is connected with a neighboring hospital.

At the end of 2016, Cai's wife died, so now he spends 1,500 yuan a month for a place in a two-bed ward with an attached bathroom at Kangyi.

"I've become used to this place, so staying at home is not as comfortable as living here," he says, explaining why he returned to the home quickly after the New Year celebrations at home.

Most of the home's residents are over 80, and are either wheelchair-bound or bedridden.

On the third floor, two men aged over 100, are in a three-bed ward.

Zhou Qin, the 38-year-old in charge of nursing services, goes over to one of them and says: Xin Nian Hao (Happy New Year)!

The man listens carefully and replies after several seconds with a quiet "Xin Nian Hao."

Crumbling old structures

Suqian, with a population of about 5 million, used to be a major agricultural hub in northern Jiangsu province, but the local economy is now diversified and young people now work in the finance and the technology sectors as well.

Earlier, the elderly in the countryside typically relied on their children to take care of them.

But, with the country seeing a growing population of the elderly, the old structures seem to be crumbling, forcing the authorities to step in.

Over the last three years, the local government is focusing more on how to care for the aged.

Now, the local government is encouraging private investment in this field to supplement the public social welfare centers.

Kangyi is just one of the 11 privately owned nursing homes built in Suqian's Sucheng District that comprises nearly 720,000 people.

The local government provided a subsidy of 5,000 yuan per bed when Kangyi was built two years ago, adding to the private investment of nearly 20 million yuan.

Now, residents at Kangyi pay 1,500 yuan a month if they not need nursing services.

"We charge between 1,500 and 2,500 yuan for nursing services," says Liu Peichao, 47, Kangyi's director.

Elderly care

Meanwhile, besides private nursing homes, the district's 11 towns each has a public social welfare center that houses the elderly who are unable to work and have no family members to care for them.

The government grants 500 yuan to each elderly person per month for their daily expenses.

At the Caiji Social Welfare Center, more than 30 such elderly residents shared 10 rooms.

At the center's canteen, 74-year-old Liu Yulong is cooking lunch. "We pay the elderly who help to cook or clean the place," he says.

"We do not take in people who need nursing care because we do not have funds to pay nurses," he says.

If residents need nursing care, they are transferred to the Kangyi home.

Speaking about how private nursing homes survive, Kangyi's director Liu says that as private businesses, nursing homes in China have very small margins of profit.

"Only 19 percent of privately run homes make profits. Almost half lose money and the rest barely make ends meet," he says.

"In last two years, we have lost more than 100,000 yuan annually," says Liu.

"Even if in the future all the 400 beds are taken we will still make only a small profit mostly from people who need nursing care," he says.

Besides, it is difficult to recruit qualified nurses, especially men, he says.

yangyangs@chinadaily.com.cn