Overcoming the 'paralyzed family' trap

For 36-year-old Zhao Zhiqiang, life stopped last November. That's when his 56-year-old father suffered a massive brain hemorrhage, leaving him nearly paralyzed, unable to speak, and dependent on Zhao's assistance for almost every bodily function.

With no savings for a professional caregiver and no other relatives to help, Zhao quit his job to provide round-the-clock care at their home in rural Kangxian county, Gansu province.

"I have no work and no income," Zhao told China Daily. "All I do every day is cook blended food, clean up feces, turn him over in bed, and guess why he is groaning. He can't tell me where it hurts."

The family survives on a monthly welfare payment of about 2,000 yuan ($276). Zhao's wife lives apart with their two young daughters, aged 4 and 7, while his 83-year-old grandmother — still self-sufficient — also needs occasional assistance. His father's monthly medicine and supplies — including diapers and incontinence pads — run to almost 1,000 yuan, leaving the family with just enough to cover the bare minimum of food, and nothing more. "I desperately need a professional caregiver so I can go back to work," Zhao said.

His situation is indicative of China's growing predicament. With an aging population and shrinking family sizes, many disabled and incapacitated elderly are falling through the cracks. The result is what some families call the "one disabled, whole family paralyzed" trap that robs breadwinners of their livelihoods and leaves the most vulnerable without proper care.

In late March, China launched a national long-term care insurance program. Dubbed the "sixth insurance" the program is intended to fill the gap not covered by the social pillars of the pension, and medical, unemployment, work-related injury and maternity support. The scheme follows nearly a decade of pilot programs that covered more than 3.3 million people and cut caregiving costs by over 100 billion yuan ($14.5 billion). It aims to provide professional services and financial aid for people with long-term disabilities, and will be available in home-based, community and institutional settings.

The new system will be rolled out in stages and implemented nationwide by the end of 2028, covering all residents regardless of employment status. Funding comes from employers, individuals and government subsidies, with premiums capped at roughly 0.3 percent of wages. Beneficiaries will pay no deductible amounts, though annual reimbursements are limited to no more than 50 percent of the previous year's local per capita disposable income, according to guidelines issued by the general offices of the Communist Party of China Central Committee and the State Council.

Zhao said he had never heard of long-term care insurance until contacted by China Daily for this interview. But once he learned about it, his hopes were lifted.

"My final wish," he said, "is for the policy to be rolled out faster and cover us as early as possible, so we can get back to work and earn a living. But the policy must reach villages — not just county seats. And the carers must be properly trained — not just anyone off the street."