China

The demographic wave is the whole story. China had about 296 million people aged 60 or older in 2023, a figure projected to pass 400 million — over 30% of the population — by roughly 2035, with the worker-to-retiree ratio falling fast (gov.cn). No country has aged at this scale or speed, and everything below is a response to that pressure.

The official care model assumes families that no longer exist at scale. The "9073" framework expects about 90% of older adults to age at home, 7% in community care, and just 3% in institutions. But the one-child policy produced the "4-2-1" family — one adult child responsible for two parents and up to four grandparents, with no siblings to share the load — and researchers now describe a generation "caring alone" (The Lancet). The workforce gap is severe: estimates run to millions of aides needed against only a few hundred thousand registered.

The state's signature move is to industrialize care. In January 2024 the State Council published its first central-government document on the "silver economy," a market projected to reach roughly 19.1 trillion yuan (about US$2.68 trillion) by 2035. Since 2017 the Ministry of Industry and Information Technology has run nationwide "smart elderly care" pilots — monitoring platforms, IoT data integration, smart terminals — and in 2025 China issued a national white paper on emotion-recognition AI for elder care (Global Times).

Robots are a national project, not yet a household reality. A 2025 national pilot calls for deploying care robots across hundreds of families for multi-month trials, and the elderly-care robot market topped roughly 30 billion yuan ($4.1B) in 2024. Yet the reporting is unusually candid that robotic caregiving "remains more potential than reality," with institutions — not individuals — as the main buyers (SCMP). Devices are scaling faster in the home — infrared sensors, door alarms, GPS locators, radar-based inactivity detection — but adoption tracks income, prompting calls for means-tested subsidies so the technology reaches beyond affluent urban seniors (Frontiers).

The financing experiment is real but unfinished. Long-term care insurance pilots began in 15 cities in 2016 and now span 49, covering concrete help — bathing, eating, basic medical care for people with disabilities (PMC). There is still no national scheme, results vary sharply by region, and the honest verdict is that China's vision outruns its delivery. For an American family, the lesson isn't the robots; it's the underlying bet — that caregiving is national infrastructure worth funding deliberately, tested city by city, rather than a private catastrophe each household faces alone.