A/HRC/45/14/Add.1 children, make the family provision of long-term care in rural areas difficult.58 According to information received, the phenomenon of so-called empty-nest families59 accounts for some 50 per cent of the older population and is predicted to reach up to 90 per cent of the older population by 2030.60 As a result, the availability of support within the family is greatly reduced and demand for long-term care assistance at all levels is increasing and will continue to do so.61 46. Care for older persons in an increasingly ageing population constitutes a serious barrier to women’s equal access to economic opportunities, as women are the primary caregivers for older persons.62 Caregivers, moreover, tend to face income inadequacy and insecurity. 47. Home care accounts for more than 90 per cent of caregiving, while 7 per cent of older persons are accommodated in community-based care centres and less than 1 per cent in care homes.63 By the end of 2019, there were 29,000 registered care homes for older persons with a total of 7.614 million beds. The number of specialized, rehabilitation and geriatric hospitals has increased steadily in recent years. However, three quarters of these specialized units are located in economically well-developed regions of China.64 48. About 40 per cent of the social welfare and caregiving support institutions (e.g., care homes) are private and located in rural communities in order to keep operational costs low. Despite having increased in recent years, the number of nursing homes for older persons or community day-care centres do not meet the need,65 providing care for only a very small fraction of older persons. It is furthermore to a large extent market driven. As a result, most care homes will only accept those older persons who can live independently and not those who have more complex needs due to cognitive conditions, such as dementia, or other neurological and mental health conditions, such as depression, or those who need palliative care.66 With an ageing population, demand for palliative care increases. It is essential to improve patient awareness of palliative care and improve accessibility of services and ensure adequate training for health-care professionals. 49. Around 300,000 formal care workers are engaged in old-age care, but less than one third of them have formal qualifications. The shortage of trained gerontological and geriatric professional caregivers, as well as of other specialized staff, such as nurses, dieticians, rehabilitation therapists, and psychologists, is a critical concern. 67 50. China has the largest number of Alzheimer’s disease patients in the world. Figures are projected to increase to some 14 million in 2020 and to more than 23 million in 2030. China is currently struggling with low levels of awareness of the disease, low rates of visits to health-care providers and even lower rates of treatment.68 58 59 60 61 62 63 64 65 66 67 68 Economic and Social Commission for Asia and the Pacific (ESCAP), “Long-term care for older persons in Asia and the Pacific”, Project Working Papers Series: Long-term Care for Older Persons in Asia and the Pacific (Bangkok, 2015), p. 5. There are three types of empty-nest families: older persons who do not have children or spouses/partners, also referred to as lonely older persons; those whose children do not live in the same house; and those whose children live in faraway cities. Of note in the context of family care, according to collated information, older persons can sue their children for infrequent visits. The children will be put on a credit blacklist as a result, which will impact, for instance, their ability to open bank accounts or get loans. ESCAP, “Long-term care for older persons in Asia and the Pacific”, p. 5. A/HRC/26/39/Add.2, para. 50. UNDP, China National Human Development Report Special Edition, p. 210. WHO, China Country Assessment Report on Ageing and Health, p. 23. ESCAP, “Long-term care for older persons in Asia and the Pacific”, p. 5. WHO, China Country Assessment Report on Ageing and Health, p. 23. Glinskaya and Feng, eds., Options for Aged Care in China, p. 51. Government submission on the protection of rights and interests of older persons in China, p. 17. 11