In China, some of us are keeping elderly care in the family – for now

My grandma, now in her 90s, has long held together an extended family including four children and six grandchildren. As a Chinese saying goes, “Having an elder in the family is like having a treasure.” While my aunt, Father and two uncles all live near her in the same city in northern China, my generation has ventured out to different places. Yet no matter where we have settled, no trip home is complete without a visit to Grandma.When I first moved to Beijing, I had to travel about five hours by train – a journey that takes only two hours by high-speed rail nowadays. In the intervening decades, I have completed my studies, found a job and started a family of my own in the national capital.Meanwhile, Grandma has been facing one battle after another: lung cancer, a stroke, Alzheimer’s disease. Her days follow a strict medication routine, increasingly and carefully managed by her ageing offspring.My Father still recalls the emotional and financial strain that was put on the family when she was diagnosed with lung cancer, the leading cause of cancer-related deaths in China. One pill to be taken daily “used to cost about 500 yuan”, he said.Gefitinib, the key targeted drug sold under the brand name Iressa, was thus unaffordable for many, as the total cost of treatment could run to several hundred thousand yuan. My grandpa emptied his savings. My Father and his siblings didn’t have much but also stepped up and shared the expenses.A turning point came in 2018, when drugs like gefitinib were included in China’s medical insurance catalogue. Today, the catalogue covers more than 230 anticancer drugs, making critical therapy accessible to families like ours. Moreover, as the population ages – as of 2024, 310 million people or 22 per cent are 60 and older – an action plan is being implemented to build a comprehensive dementia prevention and care system by 2030.