All HCFA's staff are trained and must first obtain old-age care qualification certificate from the Ministry of Human Resources and Social Security. "They are experienced to guarantee the seniors handy and professional home services just by a phone call," Zhang says.

They evaluate the physical condition of the elderly who need home care and keep track of their service to see if there is room to improve.

Zhang Dongmei, dean of the Yuetan Home for the Aged, says that they receive most requests for home help at the end of the month, mainly for baths and haircuts.

Her colleague Mu Yuemei has visited three elderly women over the past week, one of whom is in her 90s. "The lady has been in bed for years. I bathe her and give her a haircut once a month," Mu says. The old lady lives with her family and is tended by a domestic helper.

Mu's own mother was once hospitalized for a year and she took care of her. "I thought it was quite easy to nurse the elderly before I started working here (at the old-age home)," she says. "I took the training courses and realized that past experiences are not enough. The job requires professional skills and communication with older people is also essential to relieve their loneliness."

Despite the growing need for home help, there is a chronic shortage of eligible staff. Latest figures from the China National Committee on Aging show that the number of people working in elderly healthcare was 321,600 at the end of 2007 but less than 10 percent had the job qualification certificate.

"Sometimes people do not appreciate our services or take our job and professionalism seriously. Some people think we are just domestic helpers," Bai Bing says.

"Almost all of our care staff are migrant workers. It is not uncommon for them to quit and shift to other less tiring professions," Zhang Yan says.

The Beijing municipality is piloting an elderly home care system in all its communities. The government grants eligible senior citizens a monthly allowance of 50 to 250 yuan, which they can use to pay for different services. The beneficiaries are usually elderly people from low-income groups, those who live alone or with disabled offspring, those between the ages of 80 and 89 and those confined to bed, or in their 90s.

Zhou Xiangshang, deputy-director of the Tuanjiehu Neighborhood Committee, says of the 9,800 elderly people in the area, just 150 are eligible for government-funded home services. Many others also apply and are even willing to pay by themselves.

Zhou's neighborhood has a home for the elderly but its professional care-givers are too busy with their own work to provide additional home help. The committee now works with a domestic service agency, which employs 20 domestic helpers and arranges basic training for elderly healthcare.

The agency has been planning to extend its home help service to care for more elderly residents, with a special focus on their mental well-being. It hoped to attract local women in their 40s and 50s, perhaps those who had lost their jobs and couldn't find other work. A survey of potential candidates, however, found just a few who were interested.

"Services for the elderly have great potential," says Zhang Yan. "The whole of society should change its mindset and show more respect to people in this career."

(China Daily May 6, 2009)