Graying population gets green tinge

Homes for the aged given an environmentally-friendly touch

Sun Xiaoman switched from studying education to medical care in a British university last year, one of the reasons being that she wants to ensure her parents receive better healthcare once she returns to China.

Sun, a postgraduate student at the University of London, is doing research on senior citizens and related nursing services in Britain, which she believes can learn a lot from the UK.

"When I get back home I want to invest in the medical care and elderly nursing industries, and the UK has a lot of experience in community nursing that would greatly benefit my research," says Sun, who attended a conference on environmentally friendly hospitals and senior housing last month.

More than 60 professionals, including heads of hospitals in China, chief executives of British healthcare facilities and housing designers, attended the UK-China Green Hospital Design Summit. The consensus was that nursing and caring for the elderly in communities or at home is becoming more common in both countries.

About 90 percent of elderly people in Britain receive nursing care at home, and the rest are in special medical institutions, says Roger Battersby, managing partner of PRP Architects, which specializes in residential housing, special housing, and healthcare.

The British government supports and encourages the elderly to be nursed at home, and it provides services and develops new care products for them, says Battersby, who in 2009 was appointed to head a government think tank to advise on senior housing.

That trend is also apparent in China, where the population is ageing quickly, he says, and community-based nursing, which is being experimented with in Britain, can help the government, including healthcare authorities such as the National Health Service, to reduce spending.

"To help the aged get nursing care at home, we are developing a housing standard according to which any new building must leave space that can be changed into a nursing home in the future."

The quarters of a nursing home should have a bedroom and a shower, he says, and those staying in the home can share a kitchen and a living room. In some of the better homes the sleeping quarters generally include two bedrooms, in addition to which there is a living room. The home would be free of barriers and accessible to wheelchairs.

"A nursing home needs to be designed just like any other residence, because we want it to be like a home for those living there and not like a medical institution," Battersby says.

Cao Chunli, head of the Asian branch of the Building Research Establishment Environmental Assessment Method, agrees, and says the standards used in housing for the aged are higher and more stringent than for some types of buildings.

"There are five levels in gauging whether a building is green or not, and a nursing home must reach level three," Cao says. "We check materials the homes use, confirming that they can save energy and reduce pollution, and we check the design, including fire prevention measures."

Cao's institute, which was set up in the 1990s and claims to have the world's first green homes' assessment method, also supports community-based nursing and suggests providing a better living and nursing environment by cleaning out polluted construction materials and improving facilities at home.

"For example, we can set up an emergency alarm system for the aged, and for those who find it difficult to go out we can install a system by which they can do their shopping. Such innovations can be put in our assessment for a green nursing home, and I hope it can be extended to China."

The Building Research Establishment Environmental Assessment Method is teaming up with Chinese companies, hoping they can adopt its assessment method to ensure that buildings, especially those for seniors, are more environmentally friendly, Cao says.

Jeremy Nixey, CEO of Shaw Healthcare, an agency in Britain providing rehabilitation for the aged, is also steering a wholly foreign-owned enterprise that is registering in China. What China really lacks is trained nursing home managers rather than properly designed buildings, and in this regard it can learn from Britain, he says.

At the end of May, a fire in a nursing home in Henan province, Central China, killed 38 people, highlighting the importance of such homes being properly managed.

"The UK has many nursing experts or social workers in communities, not only in hospitals," Nixey says. "They are trained well and put into a work system, which makes community-based nursing in Britain easier than in China."

Shaw Healtchare is in talks with several Chinese companies looking for nursing experts, and hopes to reach an agreement on training or managing staff with the Chinese partners providing jobs.

China has more developers than the West, but does not have a nursing system with enough services, "and that's the aim of our working together", he says.

"I don't think China should build more nursing homes. I think it should establish more teams or staff to train kind, loving people to provide care for the elderly."

A critical issue is how to pay for these people, he says.

"Kind-hearted people are everywhere; there's no shortage of them at all. What the government should do is to motivate and inspire them, and give them a framework and some training. The difficulty in every business is how you pay for them, and I think more hospital spending can be allocated to train caring people. If so, the elderly may get better at home."

Mobile nursing is also likely to become more popular worldwide, which means people can be looked after and get healthcare using mobile devices, he says. There will be alarms in nursing homes or common houses in the future, he says, "and the aged will be able to get help by pressing a button and learning more about mobile devices from their children.

"Mobile nursing will become a lot easier to use when a new generation becomes old."

Battersby says building design is just the first step in improving nursing, the most difficult issue being to building up management skills.

"Setting up a high-level category or luxury nursing homes is not an end in itself. We need a long-term follow-up and service supplement. That is what is lacking in China. The country needs more training and rules on senior housing and nursing services."

Chen Guoliang, a participant at the summit and manager of the medical building department at Shanghai Institute of Architectural Design and Research, says regulations are now being formulated on setting up aged care housing and nursing centers in China.

"We are researching what materials should be used in nursing homes and how to build homes suitable for the elderly, and the summit is a good chance to learn from the UK's experience."

He does not specify when the regulations will be ready.

Under the Chinese government's 12th Five-Year Plan (2011-15), 3,000 new hospitals are to be set up and 26 percent of existing hospitals will be upgraded. Community-based nursing has been repeatedly mentioned in the leadership's work reports.

The government is encouraging domestic and international companies to set up care centers and offers tax incentives and utilities subsidies to them, Chen says, but China still lacks investment in the nursing industry.

"The cost of designing and building a nursing center is very high, but not all elderly people in China, who are different from the British, many of whom have insurance, can afford the accommodation, which needs to be taken into account."

caoyin@chinadaily.com.cn

(China Daily European Weekly 06/26/2015 page22)