A final paradise: nursing homes and care for the elderly during the Great Leap Forward

Abstract

Today, China faces a deepening demographic crisis with people aged 60 and over constituting over 20% of the population. This phenomenon, and the accompanying construction of old-age homes nationwide, raises important questions about the history of eldercare in modern China. In fact, the roots of collective eldercare trace back to at least the early Mao period (1949–1976). In the late 1950s, the People’s Republic of China established 100,000 to 150,000 old-age homes that collectively housed some two to three million residents. Focusing primarily on Shaanxi province, this article probes the construction of nursing homes during the Great Leap Forward (1958–1961), a campaign to enact rapid industrialization and agricultural collectivization that led to a historic famine and more than 30 million deaths. Restructuring family life and ‘liberating’ women from the domestic sphere—including intergenerational caregiving responsibilities—were two core objectives of the Great Leap Forward. Drawing on archival documents, published sources, and interviews, this research compares the official rhetoric associated with aging and nursing homes with local records. I argue that conditions generally improved for the most marginal elders, but the long-term realities of collectivization were more complex. Elders of all socioeconomic backgrounds were expected to contribute their labor to the collective. Moreover, the newly-established nursing homes experienced issues like supply shortages and mismanagement, and some elders even faced abuse. For older people living at home, official media continued to promote household responsibility—and in reality, women’s responsibility—for eldercare. For most families, then, collectivization did little to ease the burdens of either elders themselves or the younger generation of people supporting them. By exploring the historical dimensions of institutionalized eldercare and gendered caregiving responsibilities, this article sheds light on the origins of contemporary trends.