Addressing the challenges of an aging population is a vital part of safeguarding public well-being. The strategic blueprint for the "15th Five-Year Plan" emphasizes the need for coordinated planning of elderly care infrastructure, optimizing the provision of essential services, and enhancing both the scale and quality of support. By the close of 2025, Hunan Province was home to 16.05 million residents aged 60 and above, representing an aging rate of 24.72%, with over 3 million individuals facing disability or cognitive impairment. Recognizing its unique circumstances, the province is diligently executing the national strategy for actively responding to population aging. The focus is on developing the "Sanxiang Yiyang" (Comfortable Care in Hunan) service brand, aimed at the core objectives of ensuring seniors can be cared for, can afford care, and receive high-quality care. This involves accelerating the improvement of the senior care network to transform the promise of "aging without difficulty in Hunan" into tangible benefits that residents can see and feel, allowing the elderly to truly enjoy their later years.

Strengthening the Foundation: Building a Network for Accessible Care

Adhering to a principle of deploying resources at the grassroots level and moving services closer to communities, Hunan is constructing a three-tiered senior care network spanning counties, townships, and villages. This initiative aims to bridge gaps in facility infrastructure and consistently push services into urban neighborhoods and rural areas. For instance, Zhuzhou City conducted a thorough assessment of high-quality, idle state-owned assets, identifying over 300 properties. Nearly 70 of these have been repurposed into senior care centers, canteens for the elderly, and daytime care stations, effectively addressing the shortage of community-based care resources. In a novel approach, Changsha's Yuhua District is piloting a model that transforms unused kindergartens in densely populated areas into integrated hubs for both elderly and child care. This "old-young integration" strategy fosters intergenerational connections, where seniors and children mutually benefit, adding warmth and vitality to community care. These examples illustrate the province's broader effort to refine its care infrastructure, building a system where demonstration facilities are available at the county level, comprehensive service centers operate in townships, and mutual-aid networks function in villages, thereby enhancing the accessibility of essential services. Currently, Hunan boasts 1,800 care institutions with a total of 191,300 beds. Every county (city, district) now has a facility dedicated to centralizing care for disabled seniors. Regional comprehensive care centers are strategically located, with one serving every two to four townships. Urban communities enjoy full coverage of care services, making the "15-minute senior care circle" a reality. The three-tiered network in rural areas continues to expand and solidify.

At the Cognitive Impairment Care Unit of the Jianghua Yao Autonomous County Social Welfare Center, bright and open activity rooms are filled with nursing staff engaging residents in activities like paper folding, puzzles, and crafts, alongside their rehabilitation exercises. He Dan, a family member of a resident, expressed her relief: "Caring for an elderly person with cognitive decline at home was incredibly demanding and stressful for us. The services here are meticulous and attentive, with plenty of recreational activities. Since moving in, my mother's spirits have greatly improved, and we feel much more at ease." To address the scarcity of cognitive impairment care in rural regions, Linli County has piloted a dementia-friendly community in Pengshi Community, Mumaoshan Township. This initiative offers a full spectrum of services—from screening and assessment to intervention training and professional care—catering to elderly individuals who are elderly, live alone, or are empty-nesters. Over the past year, it has served more than 2,000 people.

To alleviate the immense pressure on families dealing with a disabled member, a challenge often described as "one person disabled, the whole family imbalanced," Hunan has incorporated the construction of nursing beds and specialized "Time Guardian" beds for cognitive impairment into its key provincial livelihood projects. During the "14th Five-Year Plan" period, the province completed home accessibility modifications for 165,100 households of seniors with special difficulties, established 33,000 home care beds, and delivered over 2 million home-based care visits. Rural mutual-aid models are also flourishing. Xupu County has established over 300 village-level mutual-aid care stations, combining neighborly help with professional services and volunteer efforts to energize rural care. Miluo City is exploring a "small-scale centralized" mutual-aid model based in village courtyards, leveraging peer support, policy subsidies, and community goodwill to bridge the care gap in rural areas effectively.

Pioneering Reform to Reduce Financial Burden: Ensuring Affordable Care

In response to challenges like inefficient management in some township nursing homes and insufficient supply of affordable care services, Hunan is using institutional reform to lower costs and broaden access. At the Huangshi Central Nursing Home in Leiyang City, the grounds are lush and green. Xiao Nianhua, 79, a long-term resident, reflects on the positive changes: "When I first arrived, the facilities were quite basic. Now, the environment is clean and tidy, and the care is professional and thorough. My daily life is much more comfortable." This improvement is largely thanks to a reform placing township nursing homes under direct county-level management. Before this change, Leiyang's 32 township homes struggled with staffing shortages and a lack of professional expertise. Since 2023, the city has consolidated low-efficiency sites, creating a new structure anchored by one central city nursing home, supported by four regional centers, and supplemented by nine township homes. This new system features unified personnel, finance, and asset management, alongside standardized certification, care protocols, and digital supervision. Liu Ren, Director of the Leiyang Civil Affairs Bureau, explained the benefits: "With centralized staff deployment and unified service standards, we've significantly reduced vacant beds and directed resources to the seniors who need them most." Across the province, over 720 township nursing homes have undergone this county-level consolidation, and occupancy rates in public institutions have risen by 19 percentage points since 2020.

The benefits of these reforms are reaching individual families. Grandma Zhao from Yuhu District, Xiangtan City, happily shared her experience: "The hearing aid originally cost 7,000 yuan, but after the subsidy, I only paid 5,000 yuan." Last year, Hunan launched the "Huanxin Huilao" campaign offering subsidies for aging-friendly home modifications, with an annual cap of 12,000 yuan per person, benefiting over 40,000 households. In another case, 88-year-old Grandpa Wu from Yuhua District, Changsha, who cares for his disabled wife, learned about the province's policy on service vouchers for moderately to severely disabled seniors. Their family applied through the "Minzhengtong" mini-program, and after a professional assessment, they received vouchers. Professional caregivers now provide regular in-home services like cleaning and rehabilitation, with monthly expenses reduced by up to 800 yuan, significantly easing their burden. As of the end of August, the province has precisely identified 217,300 seniors with moderate to severe disabilities, distributed 658,300 service vouchers, and stimulated 1.113 billion yuan in senior care consumption. Furthermore, Hunan is actively cultivating diverse senior care business models to enrich affordable service offerings and steer prices back to reasonable, inclusive levels.

Empowering Through Innovation and Talent: Delivering High-Quality Care

Building on the foundation of accessible and affordable services, Hunan is leveraging its natural beauty and cultural heritage to elevate care from "having basic services" to "providing excellent services." This is being achieved through a focus on digitalization, professional talent development, and enriched care scenarios, thereby strengthening the province's reputation for quality senior living. Accelerating digital transformation is key to reshaping service delivery. "Hunan is developing the 'Sanxiang Yiyang' smart elderly care platform, which includes 'one bed, one code' for dynamic facility supervision and user-friendly features like remote medical consultations, smart meal ordering, and emergency call systems," the plan states. An example is Chenzhou City's "Chenxin Huilao" smart platform, which streamlines processes by allowing seniors to apply for subsidies, book services, initiate emergency alerts, and track work orders all online. Li Hongjun, Director of the Chenzhou Civil Affairs Bureau, noted, "Digitization makes our services more targeted and efficient, providing strong support for the well-being of our senior citizens."

High-quality services depend on a skilled workforce. Hunan has established a three-tiered talent development system at the provincial, city, and county levels, enforcing certification requirements for care workers, offering skill-level-based subsidies, and holding regular professional competitions to enhance both competence and job satisfaction. In a pioneering move, Wangcheng District of Changsha has introduced a "Credit + Elderly Care" mechanism, building a reputation system for institutions and practitioners that invigorates the sector. Zhu Shiyi, a caregiver at the Wangcheng District Senior Care Center, received the top prize in the nursing category at the provincial industry skills competition and, thanks to her excellent credit rating, was promoted from a frontline caregiver to a care manager, opening up a clear career path. Dedicated rural care teams are also making a difference on the ground. In Pingjiang County, a group of trained caregivers travels between villages, providing services like housekeeping, errand running, medical companionship, and emotional support to the elderly.

Drawing on regional strengths, the province is also diversifying its health and wellness offerings. Hengyang City, for example, has created specialized wellness tourism routes centered around the "Longevity Culture" of Nanyue Hengshan Mountain, allowing seniors to enjoy the scenery and immerse themselves in the local cultural heritage. Changde City is developing a silver economy industrial park and an exhibition hall for wellness products to complete its industrial chain. To ensure safety and security, a total of over 1 billion yuan in government funding was invested at the provincial, city, and county levels during the "14th Five-Year Plan" period to upgrade the fire safety facilities of all 1,800 care institutions. By tackling the pressures of an aging society and addressing supply imbalances head-on, Hunan, under the banner of the "Sanxiang Yiyang" brand, is integrating its senior care resources both vertically and horizontally. This concerted effort is turning the vision of high-quality, local care from a blueprint into the everyday reality of a happy retirement for its elderly population.