Rural elderly care offers a revealing lens on China’s social transformation, reflecting the interplay among urbanization, population aging, and changes in family structure. Data from China’s Seventh National Population Census shows that roughly 121 million people aged 60 and above live in rural areas, accounting for 23.81% of the rural population—7.99 percentage points higher than in urban areas. As growing numbers of young and middle-aged rural residents leave for education or work, rural households have become smaller, and the number of older adults “left behind” in villages continues to rise. Against this backdrop, improving the population service system that covers all demographic groups and the entire life cycle—while prioritizing rural areas and providing greater support for remote and impoverished regions—has become especially urgent.

At present, rural elderly care needs have shifted from a focus on basic survival to an emphasis on quality of life, giving rise to a multidimensional demand structure encompassing economic security, daily care, and health management. The traditional model of “raising children to provide for old age” is no longer sufficient to address these increasingly complex challenges on its own. It is therefore imperative to accelerate the development of a multidimensional elderly care community built on collaboration among families, individuals, and society at large. Through a more reasonable allocation of responsibilities and shared risk among these actors, rural older adults can truly enjoy a later life marked by dignity, warmth, and security.

Challenges in rural elderly care

Field research we have conducted in rural areas of Tai’an, north China’s Shandong Province, suggests that older villagers rarely speak openly about elderly care. Beneath this silence, however, lie a series of structural challenges—including the weakening of family-based care, the difficulties of sustaining self-reliant aging, and the fragility of underdeveloped social support networks—which together shape the current predicament of rural elderly care.

First, the caregiving function of the family has weakened, with children increasingly opting for “online” expressions of filial piety. As large-scale rural-to-urban migration continues among young and middle-aged workers, many older adults remain in the countryside to “guard the home,” either by choice or by necessity.

Second, self-reliant aging is difficult to sustain, as hidden expenses have become a major obstacle to genuine self-sufficiency. Today, support from rural children to their elderly parents is often subordinated to investment in the education and development of the next generation—an arrangement that many older adults generally seem to accept. Under such circumstances, supporting oneself into old age becomes a more realistic, if challenging, option.

Third, social support networks remain fragile, and public services often struggle to reach individual households. When both family-based care and self-reliant aging come under strain, a socialized elderly care service system should function as a safety net. In reality, however, many rural areas struggle with the “last mile” problem, preventing services from reaching those who need them most.

Multistakeholder responsibility, co-construction

Today, perceptions of elderly care in rural areas are undergoing subtle transformation. Older adults still regard blood ties with their children as their emotional core, yet they no longer place their entire expectations for care on their children alone. Children, for their part, retain a strong sense of filial piety, but are also keenly aware of how difficult it is, in today’s fast-paced society, to return to rural areas and remain physically close to their parents. As a result, the future of rural elderly care is more likely to take shape as a diversified and integrated system: Families provide emotional support and primary financial assistance, villages build service networks and mutual-aid platforms, and the government offers a basic safety net alongside professional services. Together, these complimentary elements form an elderly care community with clear divisions of labor and shared responsibility.

Reshaping the role of children in elderly care can help make long-distance filial piety more tangible. While children’s involvement remains the emotional cornerstone of rural elderly care, it has shifted from constant physical presence to cross-regional engagement, and from one-way provision to mutual effort, ultimately achieving a balance that both sides can accept. In everyday life, care increasingly relies on online communication and remote supervision, while physical presence is reserved for special occasions.

At the same time, strengthening the role of village collectives can help ensure that “being in the village feels like being at home.” Priority can be given to expanding and reinforcing village-level platforms, creating comprehensive service networks that are both better tailored to local needs and more sustainable over time. Village Party-mass service centers can serve as hubs where basic services—such as meal assistance, household cleaning, cultural and recreational activities, and health checkups—are integrated into one-stop elderly care stations. Taking into account the characteristics of rural acquaintance-based societies, village committees can also take the lead in organizing and promoting mutual-aid models such as “time banks” and “neighborly support,” encouraging younger and healthier elderly residents as well as “left-behind” women, to assist older or partially disabled villagers with meal delivery, accompaniment to medical visits, and household chores.

Promoting the localization of services and bridging the “last mile” of policy implementation is equally important. What rural older adults hope for is not simply “more policies,” but rather “policies that are closer.” The focus should therefore be on ensuring that existing policies truly take root in rural communities and that social services truly benefit elderly residents.

Finally, for many elderly rural residents, land remains their last line of security. Transforming land resources into long-term, sustainable assets for elderly care—without undermining the interests of older residents themselves—is another avenue that merits careful consideration.

Li Gen is from the National Academy of Chinese Modernization at the Chinese Academy of Social Sciences.