How the Luwan District Deals with Senior Care

Even if you have only made a handful of trips to Shanghai, more than likely you have been in Luwan.  Why?  Because one of the ubiquitous stops most visitors make is to the shops and western-friendly restaurants at Xin Tian Di.  Not quite two years ago, Luwan petitioned to become a member of what is called the “International Safe Community Network” (ISCN).  Communities that become members have pursued and successfully implemented a variety of practices and infrastructure build-outs that address common safety concerns which range from child safety to protecting the disabled.  One specific area of focus in order to become a member is meeting safety and care issues related to seniors.  has several insights that are worth considering (the data that follows is from their 2010 submission to the ISCN).

At the time of their application in 2010, the last census showed 310,100 people living in the district.  Of those, over 60,000 were aged 65 years or older (more than 12,000 were 80 or older).  Of the eight working groups Luwan established to pursue its membership in the ISCN, one was dedicated to what they called “Aged Safety.”  This group went out and surveyed 4,706 of its residents that were 55 or older.  They found that 189 had experienced a fall in the last year (2.31% for males and 5.53% for females).  As the next step, they then broke this data out into five-year increments:

Luwan’s analysis found that “most falling accidents happened in the morning (48.15 percent), followed by afternoon (26.46 percent) and night (15.34 percent).”  In addition, most happened while doing housework (28.57%) and taking a bath (9.52%).  In attempt to improve these numbers, Luwan redid curbs to “eliminate barriers” and also refurbished homes to provide better grips for elderly people.  What I found most interesting was that the community leaders stepped back and pursued two main “intervention projects” that they believed would most positively impact their senior population.  The first was designed to prevent falls and the second was to better the mental health of their aged population.

To prevent falls, Luwan introduced seven improvements.  First, they “renovated and smoothed out … 198 lanes and footways within the community … installed armrests in the houses” (what they call “armrests” are railings and stairwell grips).  Second, Luwan budgeted 4,000 RMB to pay for volunteers to provide bathing assistance to the 95+ age group.  Admittedly this is not a lot of money and is a very old cohort, but it is a small step that represents much good about how China is going to solve its senior care problems at the community level.  Third, Luwan provides all elderly people 80 years or older with a free in-home physical once every quarter.  Fourth, Luwan budged 24,000 RMB for inspections and miscellaneous safety fixes for homes in the district.  Fifth, the community set up what they call “caring pairs” that match volunteers with elderly people in need of assistance.  Luwan successfully paired 3,166 volunteers with 3,712 elderly people.  These volunteers assisted in “bathing, housekeeping, shopping, [preparing] meals, and getting around.”  Sixth, and what I found most interesting, was that the district purchased accident insurance with a specific “fracture allowance” on all community members 50 and older who held a valid retirement certificate.  The seventh improvement Luwan made was the installation of what Chinese call “Ankangtong” devices that can be triggered in case of a fall.  The 2H Care Company is the largest company providing these devices to elderly Chinese, with well over 100,000 devices in use across four cities (Shanghai, Wuxi, Ningbo and Beijing).

With respect to mental health, Luwan’s approach is probably the area that needs the most improvement.  Given the age profile of their community, I am a little dubious about their claim that only 0.75% suffer from dementia (that may reflect the ).  Interestingly enough, Luwan volunteered in their ISCN application that “85% of the elders suffer from some kind of psychological problems more or less.”  I would imagine that a more comprehensive survey by people trained to identify dementia would find higher incidence rates; however, that is admittedly conjecture on my part given past experience.  The primary thrusts Luwan set in motion to help the mental health of their elderly population were to encourage painting, calligraphy, art exhibits of work done by the elderly, setting up “71 classes … and more than 20 courses including literature, English, Chinese opera, music, dance, singing.”  They are adding to these by offering courses on what they call the “Law on the Protection of Rights and Interests of the Aged.”  Beyond this, in an attempt to maintain the traditional concept of filial piety, Luwan awarded special praise for eight people and 20 families as models of filial piety.  This is likely an attempt to remind families that whatever good the community can do in offering your elderly family members care, this is a supplement to what you should be providing through your own family or financial support.

As the senior care industry in western countries expands into China, the efforts of Chinese governmental agencies will be interesting to follow.  Luwan is obviously within one of the most sophisticated parts of China (Shanghai) and as such, its practices in this respect are unique.  Luwan is also a model for what other local communities will be trying to pursue.  As an outsider evaluating this, I see immediate opportunities for product companies (tele-medicine to facilitate and coordinate the activities of volunteers, first responder devices, etc.), and for service providers (mental health counseling, memory care services, etc.).  Some of these are easier to monetize than others, but finding a way to offer complimentary services, technologies and products for districts like Luwan should not be overlooked as the senior care industry identifies market entry strategies across China.