Asia-Pacific

Ageing China faces dilemma on dying

People burn incense at the Old City God Temple in Yuyuan Garden, downtown Shanghai, China
Image caption China's strong traditions have dictated the country's approach to care for the elderly

Imagine a country in which the population is rapidly ageing and yet people do not want to talk about how to care for the elderly because they think it could bring bad luck.

And where most of the people do not even write a will, believing that it could actually bring death one step closer.

That country is China. And on the issue of ageing and dying, much of the country has a collective response: "We don't want to talk about it."

This is nothing new here.

One social commentator told me that these attitudes date back to the time of Confucius who lived 2,500 years ago.

The great Chinese philosopher was asked by one his followers about the issue. Confucius replied, "We haven't finished studying life, so why delve into the question of death?"

And so the debate largely ended.

China's economy has seen remarkable growth in the past 30 years.

The country is witnessing the largest migration in history as the young move to factory towns and cities in search of jobs and fortunes.

It is seen by many here as a march of progress, but less well documented is the painful process of social upheaval being felt across the country.

To be old is to be venerated in China. Tradition dictates that the young should care for the elderly; to die with dignity is to die at home surrounded by the family.

Painful issue

Now, largely because of the country's population controls, Chinese society is rapidly ageing. By 2050 it is estimated that more than 400 million Chinese will be of retirement age - a quarter of the population.

The issue of how to care for the country's elderly is becoming more acute, and slowly China is beginning to wake up to the problem.

The government is building up pensions, and in the state-run newspapers you can read stories about the empty nests of ageing parents who have been left behind as their children live elsewhere.

It's a topic that is widely discussed on TV talk shows, a painful dialogue about a problem that is only going to increase in the future.

Yan Yunying, 22, is a finance worker in Shanghai who also cares for her grandparents and helps her father look after her mother, who is ill with cancer.

It is tough holding down a job and looking for a boyfriend while you are supporting your entire family.

In her quiet voice, she says that many of her friends were optimistic about the future after graduating from university. But she added: "They've yet to feel the pressure."

The pressures of juggling family, personal life and work has become more acute because of China's one-child policy, and it has already led to some change.

A handful of residential homes and hospices for the elderly have opened across the country, the first in the 1980s.

In Beijing, there are believed to be a handful of hospices offering palliative care. Other hospitals and retirement homes are also believed to offer the services, but such as the sensitivity of the issue, that they are not advertised.

And such institutions, which are taken for granted in the West, are nothing short of a social revolution here and have faced stiff resistance.

Social stigma

To grow old - to possibly die - somewhere other than your home is seen as being abandoned by your family, and in China there is no bigger social stigma.

One hospice in Beijing was forced to move locations seven times, because locals felt that a building in which so many people were dying brought bad luck.

Image caption How China decides to care for its elderly population is an increasingly pressing issue

Opponents blocked the entrances, preventing staff and families from getting into visit their dying relatives.

The head nurse at the Songtang hospice, Yuan Jie, says that attitudes need to change.

"The Chinese need to realise that hospices offer the best way to care for old people," she says.

She compared sending old people to hospices to young children attending kindergartens.

"It is," she says, "simply the cycle of life."

In China, caring for the elderly is an issue that goes to the very heart of this culture.

But it is also a fundamental question about what the country wants to be, what it will stand for in the future and whether its prepared to compromise on it traditions for continued economic growth.

And at the moment it is not clear how China will answer.