Caixin Weekly | Who Will Care for Elderly Living Alone? (AI Translation)

财新周刊｜谁来监护独居老人

The article addresses the growing challenge of elderly guardianship in China, amid an aging population, shrinking family sizes, and increased prevalence of elderly people living alone or without children. The traditional family-based support model is under strain, leading to the rise of alternative guardianship mechanisms, particularly "intentional guardianship" (意定监护), which allows adults to appoint guardians of their choosing in anticipation of potential incapacity [para. 1][para. 2][para. 3].

The acute need for such arrangements is illustrated through the experience of Fang Tian, a 69-year-old woman who, after the sudden death of a friend, becomes deeply concerned about who would care for her or make decisions if she faced incapacity or passed away. With no children and not wishing to burden siblings, her solution is to formally appoint her long-time close acquaintance as her “intentional guardian” through a notarized agreement, enabled by China’s Civil Code [para. 3][para. 4].

However, not all elders can find suitable informal guardians. Many, including childless elder couples or those with estranged families, struggle to identify willing and trustworthy candidates. In response, social organizations offering professional guardianship have begun to emerge, providing an alternative to family and state guardianship [para. 5][para. 6][para. 7].

Social guardianship services, while still rare and limited in reach, attempt to fill the gap by handling critical tasks such as medical decision-making and daily care. For instance, Beijing’s Luwei Silver Age Center and Shanghai’s Jinxian Guardianship Center are among the pioneering institutions, though fewer than ten such organizations exist nationwide as of 2024. The demand far outpaces supply, with estimates suggesting that at least 17,500 people in Beijing alone need such services [para. 10][para. 12][para. 13].

These organizations face multiple challenges. Firstly, regulatory ambiguity exists regarding qualification requirements and licensing, with most organizations operating as registered nonprofits and subjected to rigorous approval processes [para. 14][para. 15]. Secondly, awareness of intentional guardianship remains limited among elders, necessitating substantial outreach and education efforts. Thirdly, building trust with elders, who are often reluctant to entrust their lives to strangers, takes significant time [para. 16][para. 17].

The legal and operational boundaries of guardianship are often unclear, with confusion over what responsibilities supervision entails and concerns over the high costs relative to elders’ willingness or ability to pay. The current service fee structure—typically 500 yuan per month during the agency stage, rising to 2,000–2,500 yuan during full guardianship—is at best barely sustainable for organizations, given the high labor and overhead costs [para. 21][para. 22][para. 23].

Additionally, there are risks related to guardianship scope and liability. Under current legal interpretations, social guardians may bear unlimited joint liability for any harm caused by their wards, yet lack corresponding access to their wards’ estates as compensation—unlike family guardians [para. 26][para. 27].

A key unresolved issue is supervision: how to ensure guardians—especially organizations—act in good faith and protect elders’ interests. Existing models emphasize “separation of person and property” (e.g., using third-party supervision and holding only emergency funds for wards), citing international examples like Canada and Singapore where public guardianship offices play active monitoring and support roles [para. 28][para. 29][para. 30][para. 32].

The article concludes that a complete system is needed—combining family-based, social, and state “bottom line” guardianship, with clear boundaries and cooperation among relevant government departments. Progress is being made in some localities toward integrating community organizations, street committees, and social organizations in a coordinated support system, but many regulatory and practical questions remain [para. 34][para. 36][para. 37][para. 38][para. 40].

Overall, the growth of intentional and social guardianship reflects not only demographic trends, but also evolving societal attitudes toward aging, autonomy, and collective responsibility for the elderly [para. 41][para. 42].