On February 21, the Chinese government website released the "Notice of the State Council on Printing and Distributing the National Aging Development and Elderly Service System Planning for the 14th Five-Year Plan".
The notice emphasizes the need to vigorously develop the silver-haired economy, and plan and lay out a number of key development areas of the silver-haired economy.
In Beijing-Tianjin-Hebei, Yangtze River Delta, Guangdong-Hong Kong-Macao Greater Bay Area, Chengdu-Chongqing and other regions, about 10 high-level silver-haired economic industrial parks are planned.
Support Beijing, Tianjin, Shanghai, Hainan, and Chongqing to promote international and cross-regional cooperation in carrying out comprehensive pilot projects for expanding and opening up the service industry.
Combined with the selection of key cities that actively respond to population aging, a group of silver-haired economic benchmark cities will be built across the country, and exploration and innovation in the integrated development of the service industry, the transformation and upgrading of the manufacturing industry, and the cultivation of new technologies and new formats will be promoted.
Establish a regional market trading platform for elderly products, and support areas where conditions permit to hold expositions and trade fairs for elderly products.
On February 22, the Ministry of Human Resources and Social Security held a press conference for the fourth quarter of 2021.
It was also revealed at the meeting that, in accordance with the decision-making and deployment of the Party Central Committee and the State Council, starting from January this year, the national overall planning of endowment insurance will be implemented.
The "silver economy" in the new era is giving new propositions.
Behind this, what is the current status of home and community care in China?
What is the role of government and business?
What kind of elderly care services can be provided?
With the rapid development of digitalization today, what can technology do for the "last mile" of elderly care?
It is not easy for silver-haired people to "stay at home"
“Three meals a day is a problem”
Recently, every time it was near lunch time, 27-year-old white-collar Lin Meili (pseudonym) placed an order for the next day's takeout through her mobile phone during the break between work, and the note required "the combination of meat and vegetables and balanced nutrition."
This takeaway is for her grandmother and grandfather in her hometown in Guilin. The monthly budget is 1,000 yuan. "It is inconvenient to cook when you are old."
The retirement community where my grandfather lives actually has a canteen, but it does not deliver meals to the door. For my 80-year-old grandfather, it is no longer an easy task to spend nearly an hour traveling to and from the canteen every time to have a meal. "I fell down the stairs before. Once, my grandmother's sternum was broken, and it hurt to breathe.
Takeaway has become a not-so-ideal but "only" option.
According to the seventh national census, the number of elderly people aged 60 and above in my country has reached 264 million.
In February 2011, the "Twelfth Five-Year Plan for the Construction of Social Pension Service System" issued by the Ministry of Civil Affairs first proposed the "9073" pension model plan. For family care and elderly care, 7% of the elderly purchase community care services for elderly care, and 3% of the elderly live in elderly care service institutions for centralized elderly care.
However, according to the Ministry of Civil Affairs' reply to the old-age policy recommendations in September 2020, as of now, more than 99% of the elderly in my country are taking care of themselves at home and in the community, and less than 1% of the elderly are in old-age institutions, home and community. It is the current main way of old-age care, and the development of home-based community-based care services is of great significance for the elderly to care for the elderly nearby.
For the "home" in the traditional sense, the most common three meals a day are the primary problem.
Taking Beijing as an example, a special survey conducted by the Beijing Municipal Bureau of Civil Affairs on the demand for meals for the elderly showed that the elderly groups with relatively strong demand for meals in the city are mainly concentrated in three categories: the elderly, the elderly living alone, Demented elderly people.
According to statistics, there are about 800,000 elderly people in the city.
Uncle Zhang, who lives in Shuangjing Street, Chaoyang District, is still in good health at the age of 80, and his dining needs have been solved.
Uncle Zhang told reporters that he usually solves the problem with eggs, milk and bread and buns for breakfast.
Lunch and dinner were okay.
After opening the meal service at the Shuangjing Street Community Service Station, Mr. Zhang's lunch and dinner were resolved.
"I'm getting older, so I can only order food at the inn, and occasionally cook it myself at night."
A reporter from Shell Finance and Economics saw at Beijing Shuangjing R&F Community Pension Station that the meal assistance service here provides fixed-point meal service and meal delivery service respectively.
15 yuan a meal, can have two dishes and one soup.
Every day, it is really inconvenient to go out, and you need to spend 7 yuan to deliver the meal, and then the staff will deliver it to your home.
The staff of the pension station of Shuangjing Community Service Center told reporters that there are currently forty or fifty people ordering meals at the station for a long time.
Limited by the number of staff, only the elderly who are unable to go out will have staff to provide meal delivery services.
Housekeeping becomes the main bearer
"The door-to-door service has started, but the escort service is not perfect"
Home care needs to solve more than just three meals a day.
In addition to basic living needs, the elderly also have needs such as accompanying medical treatment, rehabilitation guidance, and health management.
At this time, various door-to-door services have become the first choice.
Shell Finance reporters visited and found that at present, large and small housekeeping companies are carrying the largest manpower demand in the home care market.
"There are very few elderly people who really live alone at home. They are usually accompanied by a nanny. If they are not accompanied by a nanny, they will be called cleaning or hourly workers. Some nanny takes care of the elderly for many years."
Previously, the staff of the pension station in Shuangjing Street, Chaoyang District, Beijing told reporters that the pension station in Shuangjing community can also provide many home services for the elderly, and there are five or six hundred people around the station to book cleaning and other door-to-door services.
According to the reporter's observation, the station can provide day care services, short-term home care, cleaning services such as home cleaning and air conditioning cleaning, and medical assistance services such as accompanying doctors or professional nursing.
Even daily transfers, aging-friendly renovations, medical care equipment rental, and sewer access are also included.
According to the price list posted on the street, the service fee is basically charged by the hour or by the number of times.
For example, escort to see a doctor, door-to-door bath assistance, etc., according to the self-care ability of the elderly, the corresponding service prices are also different, some can be solved by tens of yuan, and some may require hundreds or hundreds of yuan.
"We cooperate with housekeeping companies. When the elderly find us, we find housekeepers to serve them." The above-mentioned staff said that the pension station itself does not have a canteen, and the food delivery service of the station is also provided by a special food delivery company.
Like Shuangjing Community Service Station, most of the service providers that provide door-to-door services are housekeeping companies.
On the Beijing 96156 home-based elderly care service platform, an online shopping mall has been specially opened, as well as a query function for providing elderly service providers, which are classified into "elderly care institutions", "housekeeping services", "life services", "shopping malls and supermarkets", " Catering Services", "Culture and Entertainment", "Medicine and Medical Care" special areas.
In the "elderly care institutions", most of the elderly care service stations can provide cleaning assistance, haircuts, pedicures, and accompanying medical services.
The reporter made a few random calls and learned that after making an appointment for door-to-door service through the pension station, it was also a housekeeping company that finally came to provide cleaning, care and other services.
Although the demand for home services is being paid attention to, the reporter found during the visit that there are still some elderly services that need to be improved.
A staff member of Beijing Dashang Supermarket told reporters that at present, many elderly people will go shopping in supermarkets with old-age and disabled cards, but some stores do not sell elderly products such as elderly diapers.
Digitization: Making the Divide, and Filling the Divide
"Teach the elderly to use smartphones"
The "last mile" needs of the elderly that cannot be fully met by manpower are being filled by digital technology in various ways.
Shell Finance reporters noticed that in recent years, some digital platforms dedicated to elderly life services are emerging.
For example, in Beijing, Shanghai and other places, there are small programs or APPs specially designed to serve the elderly, or in the elderly care industry, some companies have begun to provide digital elderly care services, but they still need to be improved.
The reporter saw that Beijing alone has a number of small programs for the elderly.
The reporter inquired through the e-commerce platform of Beijing 96156 that there are small program entrances such as "Golden Home" and "Sincerity and Respect", which allow the elderly to purchase the required nursing supplies, bed aids, transportation tools and other services.
The original intention of online platforms is to solve needs, but it also brings an additional need: the need to use online tools.
54-year-old Yang Huijuan is a staff member from the housekeeping company. She is currently taking care of a person in her 80s. In her usual work, she is responsible for taking care of all the daily affairs of the elderly: grocery shopping, laundry, cooking, cleaning, Reminder to take medicine on time, etc.
In addition to these basic life services, she needs to understand the psychological needs of the elderly and enrich the spiritual life of the elderly.
"You are so smart, how can you learn? The phone's power button is on the right side, come, you press the screen. We will use your finger to open the screen, click on WeChat ..."
The old lady saw that people around her were using smartphones to make calls and videos, and she was envious. In order to teach the elderly to learn to use WeChat, Yang Huijuan specially hand-painted a series of WeChat usage guides, showing each step of using WeChat with simple and clear diagrams Come out, and then explain and demonstrate over and over again.
In fact, the digital life needs of the elderly have been paid attention to by some institutions and organizations.
In March of this year, Ant Group launched a special campaign of blue vest, mainly to help the elderly in digital teaching and popularization of anti-fraud knowledge.
Zhang Jianya, the initiator of the blue vest project and director of Ant Group, told reporters that with the acceleration of digital technology to cover all aspects of life such as medical care, elderly care, and transportation, "some product interfaces are complex and unfriendly to operate, and there is a lack of professional talents for the transformation of aging products. The accessibility of various APPs is low. More importantly, for smartphones, no one is teaching, and the functions are not used; the elderly have a short forgetting curve, and there is a shortage of people who can consult at any time.”
Zhang Jianya told reporters that the current blue vest mainly focuses on two aspects, one is the needs of the elderly to use mobile phones and smart devices, and the other is anti-fraud, "Although the elderly are not the most cheated group, but the elderly group is cheated. The larger group.”
It is understood that Blue Vest has specially launched a health code for the elderly in Zhengzhou, Henan Province. After the elderly download and print the health code, show it to the staff to scan, so as to reduce the difficulty of operation for the elderly.
Ant Group has also upgraded the "Blue Vest" barrier-free plan, launched a "Warm Ocean Special Line" for the elderly on Alipay, and opened a fast channel for one-click inbound calls to direct labor.
The innovation of the blue vest lies in "the elderly help the elderly".
Zhang Jianya told reporters that many of the volunteers and lecturers of the blue vest are elderly people. "The one who impressed me most was the uncle Lu from Zhengzhou. He was very enthusiastic. After retirement, he compiled a 360-page booklet to teach everyone how to use mobile phones. During the epidemic, we also spread knowledge to the uncles and aunts through live broadcasts."
At present, Blue Vest has 4 major services: service community lectures, 1-to-1 Q&A at the station, immersive anti-fraud exhibition, and digital life experience points.
Since its establishment, Blue Vest has entered 40+ cities, 3,200+ communities, held 10,000+ venues, and served more than 200,000 people.
"Next year, we hope to sink in, step by step from first-tier cities, second-tier cities, to third-, fourth-, and fifth-tier cities and counties to meet the needs of more elderly friends." Zhang Jianya said.
There are more than 330,000 pension enterprises
Community pension "cannot be pushed" in the county?
If some housekeeping companies and other door-to-door service agencies mainly serve 90% of the elderly, community pensions and institutional pensions mainly serve the remaining 7% and 3%.
Previously, the reporter visited a pension station in Chaoyang District, Beijing, and heard the call bell on bed 106. After hearing the bell, the nursing staff responded quickly and rushed to inquire about the needs of the elderly.
This is a small nursing home that has just been built. It can only accommodate 40 elderly people. It can be cared for by nurses 24 hours a day and has complete infrastructure.
The reporter saw at this pension station that the elderly people's rooms are equipped with elderly facilities, such as the elderly handrails next to the toilets, the desks with handles that can be supported, and the beds are medical beds that can be raised and lowered.
"Basically, we serve disabled and semi-disabled elderly people, two people in a room, and there is always a nurse to take care of them." The staff of the station told reporters that basically the elderly who still have the ability to live will not choose When you come to a nursing home, "if there is no problem with a simple life, the money to come to a nursing home may not be affordable."
Although such a pension station is small in scale, the monthly fee for a bed alone starts at 3,500 yuan, plus meals and nursing fees, and some monthly fees can be as high as 13,000 yuan.
Different from high-priced nursing stations, some public nursing homes can get government subsidies, and the price is relatively low.
Yuezhuang, a 70-year-old in Xinxian County, Liaocheng City, Shandong Province, has been living in a nursing home in the county seat for three years.
He told reporters that life in the nursing home where he lives is not bad. It is also a room for two people, 1,600 yuan per month.
Behind this is a huge silver-haired economic industry composed of elderly care service industry, elderly care products industry, elderly care real estate, and elderly care finance.
Using the enterprise search data to retrieve "elderly care", 336,000 enterprises can be retrieved, and there are 28,750 enterprises that appear in the retrieval of "nursing homes".
From the perspective of the elderly care service industry, institutional elderly care is more mature.
Zheng Zhigang, deputy director of the Research Office of China Ageing Industry Association, told reporters that compared with home-based care and community-based care, institutional care developed earlier, from our nursing home to various care institutions, such as nursing homes, pension apartments, etc. At present, the institutional pension system in my country is the most mature.
"The key to measuring the operational capability of an elderly care institution is its level of digitalization. The premise that a elderly care institution can have digital capabilities is that it has achieved standardized management, has talents related to digital applications, and generally has achieved chain-linking. business operation.”
From the perspective of Beijing alone, as of the end of June 2021, the city has built 576 elderly care institutions with 110,000 beds.
Enterprises are also making efforts in the elderly care industry.
The relevant person in charge of Swan Daojia told the Shell Finance reporter that elderly care has always been one of the company's core strategies. "From our perspective, it is expected that in the next 5 to 10 years, the demand for elderly care will be in a state of rapid growth."
Compared with home-based care in first-tier cities, the need for elderly care in towns and rural areas is more urgent.
According to the data of my country's seventh census, there is a significant difference between urban and rural areas in the level of aging in my country: the proportion of elderly people aged 60, 65 and above in rural areas far exceeds that in urban areas, which means that the aging speed of rural areas in my country is faster than that of urban areas. The first stop of the shock.
"In the process of visiting the countryside, we encountered not many empty nesters. Most of our places are where children live with their parents, or they live separately with different children."
Xi Zidai (pseudonym) works in a civil affairs unit in a county in Yunnan. Before poverty alleviation, her county was a national-level poverty-stricken county.
According to her reflection, the main mode of home care is adopted in rural areas.
For the elderly care environment in remote areas, there are still many problems that need to be solved.
Yu Jianwei, chairman of the China Aging Development Foundation, told reporters that the degree of aging in my country's rural areas is significantly heavier than that in urban areas.
Due to the relatively lagging economic and social development in rural areas, the relatively weak grass-roots organization construction, the scattered living of farmers, the shortage of public service investment funds, the low efficiency, and the obvious weakening of the rural family pension function, "lack of money" is the root cause of rural pension difficulties. Support is the difficulty of rural old-age care.
Xi Zidai told reporters that because of the request of the superior, the county where she is located had previously built a central nursing home, which was initially a public nursing home. At first, more than 30 extremely poor elderly people who had no children to support were admitted free of charge.
"Later, it was converted into a public-built and privately-owned nursing home and began to recruit elderly people from the society. Now there are a total of 70 elderly people in the nursing home. It is not clear how many people are paying for the elderly."
"The day care center for community elderly care is basically an empty shell in our places, because community elderly care needs a professional volunteer team and professional service personnel, including community staff. It needs to be fully equipped. In the absence of sufficient funds, the community pension model cannot be effectively promoted.”
The profit margin of the sunrise industry is not high
The average occupancy rate of nursing homes is less than 50%
Whether in cities or villages, the solution to the "last mile" of the silver-haired economy will eventually come to the pension industry.
According to data, the scale of China's pension market in 2018 has exceeded 6.5 trillion yuan. In 2021, the scale of the pension market may exceed 10 trillion yuan, and it is expected to reach 22.3 trillion yuan in 2030.
Zheng Zhigang said that more and more companies are joining the elderly care industry, and they are providing more and more types of elderly care services. Many door-to-door services are becoming more and more professional, such as door-to-door bath assistance and home medical care.
The elderly care service is integrated with catering, real estate, finance, tourism, education and other fields, showing the characteristics of diversification and multi-level.
"The elderly care industry is sure to make money if it does well, but it's not about huge profits, and its profit margin is generally not high. The elderly care industry is a sunrise industry with broad market prospects. From the perspective of the institutional pension model, it often requires a large amount of investment in the early stage. The payback period is very long, but once the management system is established, the service quality is guaranteed, the customer base grows steadily, and the long-term benefits will be considerable,” Zheng Zhigang said.
However, in terms of industrial development, pension institutions also face many difficulties.
Yu Jianwei, chairman of the China Foundation for Aging Development, told Shell Finance reporters that the nursing homes he visited included high-end nursing homes in cities, as well as nursing homes in townships and rural areas. Aged care institutions with very low operating and occupancy rates.
"At present, the general superficial problem of elderly care institutions is that the occupancy rate is low. The average occupancy rate is roughly 50%, and some occupancy rates are less than 40%, and some are even less than 20%."
Yu Jianwei said that the underlying reasons for the low occupancy rate of elderly care institutions are more complicated. Some do not do market research and build hospitals blindly; some choose the site improperly, and people do not want to go;
The lower the occupancy rate, the worse the economic benefits, which in turn affects the quality of service, and the elderly cannot be retained, forming a vicious circle.
According to a research report released by Essence Securities in July this year, 80% of middle-income seniors cannot be admitted to public nursing homes because they do not meet the government’s minimum guarantee, and they cannot afford the high cost of senior nursing homes. As a result, the vacancy rate of beds in commercial nursing homes is as high as 46%.
So, to improve the old-age service system, what areas still need to work harder?
Zheng Zhigang said, "From a national perspective, we should more actively implement relevant fiscal and taxation support policies, strengthen the construction of talent teams, and create a more open and fair business environment, so that state-owned enterprises, private enterprises, foreign capital and domestic capital can compete fairly. From the perspective of enterprises, as the main body of the market, they need to develop their own business models, clarify their own positioning, and enhance their core competitiveness.”
Beijing News Shell Finance reporter Li Yunqi Zhao Fangyuan Yan Xia Xi Lili