In a senior-living facility in south Shanghai, a volunteer leads a dozen people in singing and moving their bodies to the rhythms of a song. It’s not an unusual activity for a senior-care center in the United States. But such specialized housing for the elderly is not widespread in China.

The facility, in the Xuhui district of Shanghai, is one of three senior-living facilities in China owned and operated by Cascade Healthcare, which is part of the Seattle-based international health-care business Columbia Pacific Management. Other U.S. firms testing the market include New York City-based Fortress Investment Group and Seattle-based Merrill Gardens.

China is facing a rapidly aging population, and that upward trajectory is similar to the one in the U.S., yet the problem is more challenging for the Chinese government. The rapidly aging population combined with the facts that the country’s economy is still developing and that it doesn’t yet have a strong system of elder care, is driving the need for outside involvement. The Chinese government has been making efforts to get foreign companies with expertise in the field to open senior-care facilities in the country and share their managerial models and technologies.  

But the challenges are big as well. The senior-living facilities opened by Cascade Healthcare in Beijing and Pudong are only about 25 and 30 percent filled respectively. “We didn’t expect a rush of people to move in,” said Dan Baty, the founder of Columbia Pacific. “We understand that it was going to take time for the concept to take hold.”

One challenge is figuring out pricing. Rooms at Cascade’s Xuhui facility run from about $1,000 to $4,000 a month, which means the facility caters largely to the upper middle class. There’s also a lack of geriatrics-trained health professionals. And there’s a big cultural hurdle. Traditionally, Chinese society has emphasized that families take care of elderly parents and grandparents. The aged who were sent to institutions were usually those who were widowed or had no children to support them.

But as China’s middle class expands, that cultural expectation is changing. China’s one-child policy has also put pressure on the family-based care system, since looking after elderly family members often now falls onto the shoulders of one child. Bee Lan Tan, President of Cascade Healthcare China said a good sign is that there’s less stigma attached now, and “if it’s to reduce the stress on the family and help the children to cope,” there’s more readiness by the elderly to live in senior-care facilities. (By Janet?Tu, Chinese translation: Nie Jing)