Digitization of the long-term care industry needs to be accelerated to meet the needs of the country's growing elderly population

The shortage of long-term care workers has evolved into a major social concern with the accelerating population aging in China. With the weakening role of the family in providing long-term care, the country has to develop a more robust formal care system to cater for the needs of its over 40 million elderly people living with functional disabilities. According to the Ministry of Civil Affairs, the current approximately 500,000 long-term care workers are far from enough, and more than 1 million are still needed to gain a balance. But caring for the elderly has long been characterized by low pay, poor social recognition and high turnover rate, which poses a key challenge for the well-being of China's senior citizens. Thus, more policy attention and creative solutions are required to tackle the problem.

In recent years, central and local governments have made relentless efforts to support the training, career development and sufficient income of long-term care workers. For instance, in 2019, the Ministry of Human Resources and Social Security proposed policies to encourage linking long-term care workers' payment with the certified level of vocational skills. Between 2019 and 2020, Shanghai, and Jiangsu, Fujian, Guangdong, and Shandong provinces introduced subsidy programs for the training of long-term care workers. During the same period, Shanghai, and Sichuan and Gansu provinces, implemented tuition fee reduction and exemption policies for college students majoring in long-term care services, and Guangdong, Zhejiang and Shaanxi provinces initiated subsidy programs for people taking up positions in long-term care industry. In 2021, the Ministry of Civil Affairs declared support for local governments to introduce preferential policies, including free training, long-term service subsidies, access to local hukou, or household registration, and job assignments, to attract more people into the long-term care workforce.

These policies are mostly about economic incentives and their effectiveness is becoming evident. Yet they are not enough. In practice, still more has to be done to decrease the caregiver burden, increase efficiency of care-giving and improve care management.

Smart technologies can provide creative solutions in these aspects.

The past years have witnessed the digitization of the long-term care industry as a result of the widespread application of 5G, internet of things, artificial intelligence, and other smart technologies. New products and services are pouring in and reshaping the industry, which in turn provides valuable solutions to deal with the long-term care worker shortage.

First, these smart technologies can decrease the need for human labor by maintaining and enhancing older people's ability to live independently. For instance, the health management facilities, using cloud technology, can assist older people to do physical examinations and provide tailored health intervention suggestions, including chronic disease management solutions and exercise plans, as well as guidance on lifestyle intervention. At the same time, the data will be uploaded to personal health archives in the cloud, based on which family doctors can make timely medical decisions and thus decrease risks of disability among community-dwelling older adults. Taking another example, assistive devices that use smart technologies, such as rehabilitation robots, mobility aid robots and balance training vehicles, can help the senior citizens at the early or medium stage of functional disability, accomplish basic life tasks and decelerate functional decline with minimal human assistance. Utilizing these devices, older people can live in familiar community environments independently for a longer period.

The second solution is to replace human labor as well as decrease the caregiver burden using smart technologies. Past research reveals that the high work burden is a key predictor of the turnover in the long-term care workforce, especially of young workers. And refuse disposal, graveyard shifts, and concerns about missing or falls of the elderly constitute the major anxieties of caregivers. Thanks to smart technologies, many institutions have been equipped with smart refuse disposal systems, smart mattresses, and security systems that monitor the movement of older people. These devices are making long-term care giving easier. More importantly, they increase both the quality and efficiency of caregiving.

Third, data platforms can be constructed to enhance the effectiveness of long-term care management. A full display of the role of smart products in long-term care is based on the construction of big data platforms for smart aging (using technology, innovation and design to improve the quality of life for the elderly).Taking Shanghai as an example, all of its districts are building big data platforms for smart aging and connecting them to the municipality-level platforms for elderly services. The platforms can provide relevant service information for senior citizens and their family members, and allow quality control and accurate service delivery for social organizations. And for governments, subsidies and other supporting policies for long-term care services can be more targeted by analyzing the big data in the platforms.

It is worth noting that smart technologies bring about both benefits and challenges for the long-term care workforce. The biggest challenge lies in its inaccuracy and non-intelligence in some long-term care scenarios. In practice, high false alarm rates and perplexing operating procedures are common for smart products, which add to the burden on caregivers rather than alleviate it as intended.

Second, it is still common for older people and care workers to resist the use of smart products. So, more user-friendly design and intensive training on smart technology use are needed.

Finally, due to the absence of agreed standards and management mechanisms, the existing platforms for smart aging are troubled by poor user experience, difficulties in information sharing and unguaranteed information security.

Smart technology is essential to build a sound long-term care system. Though faced with challenges, it points out the future direction for the long-term elderly care industry. Basically, smart technology is not to replace care workers, but to help them. That means smart technology should make the long-term care process more sustainable and empower care workers to provide tailored services with warmth. This aim is also in line with the principles of building an aging-friendly society in the new era.

The author is an associate professor at the China Institute for Urban Governance and School of International and Public Affairs at Shanghai Jiao Tong University. The author contributed this article to China Watch, a think tank powered by China Daily. The views do not necessarily reflect those of China Daily.