Posted By: Leah Bardfield on June 19, 2013

Labels: China , Chronic Disease

Lily Hsu, Project HOPE Program DIrector in China, addressing the audience at the launch of the Senior Care program.

Leah Bardfield is a Pfizer Global Health Fellow, volunteering for Project HOPE in China from May-July 2013. Leah will work with several Global Health Fellows and health care providers in China to strengthen health education on managing chronic disease and caring for patients with risk factors. Fellows will develop a web-based training curriculum and tools to measure the use of the training and to evaluate the impact of using web curriculum toward improved disease management. Additionally, Fellows will create training curriculum and develop patient education materials.

In May, Project HOPE launched the Senior Care Program, which will successfully benefit the elderly living in the Tang Qiao community in Shanghai, China. This project is a pilot program to improve the efficiency and effectiveness of a community and home-based healthcare system for seniors in the community through the funding support of Baxter International Foundation. Project HOPE has chosen the Tang Qiao community for the following reasons: 1) established partnership in previous healthcare initiatives (i.e. non-communicable diseases (NCD) management programs) and 2) approximately 25% of the community are over the age of 65.

China is facing an enormous challenge from an aging population. The number of people aged over 60 in China has risen to 194 million last year, and the figure is expected to top 200 million this year.  It is estimated that China could have some 400 million people over 60 years of age by 2050. Just over 13 percent of China's 1.3 billion people are elderly. (National Bureau of Statistics China)

In Shanghai, the number of people 60 years or older has increased to 3,673,200 in 2012, accounting for 25.7 percent of the city's population.  Therefore, one in four registered Shanghai residents are seniors (National Health and Planning Commission of the People's Republic of China). Most of the seniors are parents of the first generation of only children.  In 1979, China introduced the “One Child Policy” to control the population and reduce the strain on economic resources (One Child Policy in China).  In Shanghai, it is estimated that the number of elderly fathers and mothers of only children has surpassed 1 million. Shanghai residents are also living longer than before, with 1,251 of them 100 years old or older in 2012. The number of centenarians per 100,000 people also climbed from 8.1 to 8.8 during this period. The official figures show that women live longer than men.  Of Shanghai’s centenarians, 77 percent are women.

In recent years, China has changed dramatically, including a changing of family structure. In traditional Chinese society, the elderly used to live with one of their children. Today, more and more young adults are moving out, leaving their elderly parents alone. Many young couples now live with their parents not for family tradition. Rather, they cannot afford to buy a house or rent an apartment. Experts say family-based care is now impractical because most middle-aged children have little time to take care of their parents.  One of the challenges the elderly have to face is how to arrange for their care when their families cannot take care of them.

Pfizer Global Health Fellow, Leah Bardfield (center, pink) with Project HOPE Shanghai staff.

To address some of these challenges of home-based health care for the elderly with the support of Baxter International Foundation, Project HOPE’s Senior Care Program is providing free health screening (i.e. blood pressure monitoring and glucose screening) with the assistance of the medical staff at the local community center. This program started a home-based medication management by providing medication boxes to all the seniors in the Tang Qiao community and free medication consultations.  In the future, there were will be health fairs with guest health care professional speakers who will provide information on different disease self-management topics (i.e. diabetes and cardiovascular disease). During my fellowship, I will assist Project HOPE with these patient health fairs and help design some patient education booklets to be handed out at the health fairs. In addition to providing quality home based health care, Project Hope has developed a music therapy and exercise class.  The ultimate goal is to improve the physical and psychological well-being of the seniors of the Tang Qiao community. 

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