20 February 2026

China observations on ageing, aged care, and beyond

Lessons from a system experimenting at scale

Actress Cai Ming (center, in red) looks at a humanoid robot modelled on her likeness during the comedy sketch at the 2026 Spring Festival Gala

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Article summary (by AI)

• Older people are highly visible in daily life, supported by culture, family structures and public spaces designed for sustained social use.
• Deep demographic pressure from the one-child policy is reshaping expectations around family care and exposing workforce gaps.
• Technology is treated as essential infrastructure, with government subsidies accelerating adoption of AI, robotics and home-based supports.
• Older citizens adopt digital systems readily because platforms are integrated, practical support is available, and tools solve real problems quickly.
• The scale, speed and policy ambition shaping aged care sit within a broader national push for infrastructure, automation and rapid system delivery.

At this year's Spring Festival Gala, China's biggest annual broadcast, watched by hundreds of millions in China and around the world, humanoid robots took centre stage. What is usually a night of songs and comedy became a showcase for the country's booming robotics industry. But it was the very first comedy sketch (pictured above) that caught my attention. In it, four humanoid robots serve as emotionally supportive home assistants for an older woman whose grandson rarely visits. The twist, revealed partway through, is that the grandmother herself is also a humanoid, which spirals into a series of comic misunderstandings before the real grandson and grandmother reunite on stage, with the grandson promising to be more present in her life. It was funny, affectionate, and pointed; a joke that only lands in a country where aged care and AI are already part of the same conversation.

I spent five months living in China, based across two cities: Xi'an, a metropolis of 13 million, and Jingdezhen, a tier-five city of under two million. I visited many other cities, went to expos, spoke with technology and aged care providers, toured residential care facilities, and lived daily life alongside a population that is ageing rapidly and responding to it in ways that look very different from what we do in Australia.

These are my observations.

Ageing in plain sight

One of the first things you notice in Chinese cities is how visible older people are. Not in care settings, but rather in parks, on streets, in restaurants, raising grandchildren. Every morning, public parks fill with groups doing tai chi or using the public gym equipment. By late afternoon, the same spaces are occupied by mahjong and Chinese chess tables, music circles, and sharing snacks on benches arranged in clusters rather than rows. This continues well into the evening, when I saw groups dancing around to portable karaoke machines. In Shanghai, where I stayed for two weeks next to a small park, I saw the same groups of older citizens there every time, clearly living a significant part of their social lives in that space.

It reflects something cultural. In China, public space functions as an extension of domestic life in a way that does not really have an equivalent in Australia, where parks tend to be used for a specific activity (e.g. a morning walk) and then vacated. But the culture is supported by design, and that part is easy to overlook. Chinese public parks are well maintained and deliberately equipped for extended visits. Toilets are plentiful and clean. Clusters of food and drink carts are available, whereas bigger parks have coffee shops and restaurants built in. Seating is arranged around tables and under shelter, designed for groups rather than solitary contemplation. Lighting makes evening use comfortable and safe. Public transport connections mean that access does not depend on owning a car, which matters enormously in a country where traffic seems to be a daily nuisance.

The result is a space that genuinely invites people to stay for hours. For older residents, that infrastructure supports a daily social life that in Australia would require joining a club, booking a venue, or driving somewhere. It is difficult to know how much of China's visible culture of older people thriving in public space is cultural and how much is simply good park design. The honest answer is probably that neither works without the other.

Older people, some wearing traditional dress, dance under the winter sun in one of Xi'an's central squares.

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The demographic pressure underneath

Underlying this visible, active culture of ageing is a deep expectation, cultural and legal, that families care for their elderly relatives. China's Elderly Rights Law formally requires adult children to visit and support their parents (though enforcement is lax). The family unit remains the primary aged care mechanism for most of the population. But that model is under serious strain. China's one-child policy, in place from 1980 to 2015, means that a single adult child may now be responsible for two parents and four grandparents simultaneously. Many of those only children grew up during China's economic boom with dual parental incomes, pursued professional careers, and now live in cities far from their home regions. There are fewer people available to provide informal care, and fewer still willing to work in formal care roles.

Formal residential aged care exists, but as in Australia, demand is outpacing supply. The demographic imbalance created by the one-child policy has produced intense workforce pressures across the economy, and aged care is no exception. China is staring down a structural gap between the number of people who need care and the number of people who can provide it.


Technology as essential infrastructure

This is the context in which China treats technology not as an enhancement to aged care, but as essential infrastructure. The approach is innovation-first: deploy at scale, then refine regulation based on evidence. Provincial governments subsidise aged care providers specifically to accelerate AI and technology adoption. Privacy concerns are acknowledged and managed within existing legal frameworks rather than used as a reason to delay rollout. AI is already in widespread use, with AI-generated content clearly labelled.

Hundreds of companies now manufacture humanoid robots in China, with more entering the market constantly. The pace has prompted China's National Development and Reform Commission to issue a warning about "highly similar" models overwhelming the market and crowding out space for meaningful research and development. I feel this is a problem born of excess momentum.

On the consumer side, China provides direct subsidies of up to RMB 20,000 per person (roughly $5,000 AUD) for ageing-friendly technology and home modifications, with no assessment required. The subsidy covers smart monitoring devices, AI voice assistants, adaptive equipment and home upgrades, and family members can claim it on behalf of older relatives. The policy frames assistive technology as core ageing infrastructure, intended to delay residential care entry and reduce hospital admissions and crisis costs.


Why older people actually adopt it

An assumption that many Australians bring to this topic is that older people resist new technology. In China, that assumption does not hold. I saw it daily; older people making transactions on their phones (cash is nearly obsolete), booking train tickets, navigating app-based payment systems with no hesitation. Research confirms this: 83% of Chinese respondents view AI products and services as more beneficial than harmful, compared to 44% per cent of Australians. This is just a reflection of lived experience. Technology rollouts are paired with practical support, including public kiosks that help older people set up and use digital tools.

Part of the explanation is how China builds its digital ecosystem. Rather than requiring users to re-enter personal and payment details with every new app, the major platforms share a unified ecosystem. I experienced this within my first week: I needed a metro card, opened my banking app, and had one issued instantly because my details were already stored. Setting up Didi (China's equivalent of Uber) took seconds for the same reason. Food delivery, the same. For older users, this dramatically lowers the barrier. You learn one system, and everything else works.

China also pursues vertical AI applications(*) rather than betting primarily on general-purpose models. The difference matters because vertical applications deliver visible benefits quickly. As an example, a national AI-supported complaints system using DeepSeek now routes citizens to the correct department in an average of 42 seconds with 98.7% accuracy. When people can see AI solving real problems at speed, trust follows.

China’s high-speed rail connects major cities at speeds of up to 350 km/h. (Photo source: Nikkei Asia)

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A country in motion

Aged care does not exist in a vacuum, and neither does China's approach to it. What became clear over five months is that the speed and ambition visible in aged care technology is not an outlier. It is consistent with what is happening across virtually every sector. China is a country visibly in motion. You feel it in the infrastructure, the health system, the streets, and the pace at which things get built, replaced, and upgraded. Understanding the aged care story requires understanding the environment it sits inside.

High-speed rail connects cities at roughly 300 kilometres per hour. I chose to travel primarily by train during my five months in the country. Punctual, clean, and efficient – a first-class fare of around $70 AUD covered a 47-minute journey between Guangzhou and Hong Kong, that would take longer than 2 hours by road. Subway systems in major cities are increasingly driverless, and in most cases the easiest way to navigate a city. Airports and major train stations are pristine, and even smaller city stations are either being rebuilt or well maintained. Traffic arteries and expressways are in excellent condition. The first time I spent considerable time in China was in 2008, and the progress since then does not feel like a different country –  it feels like a different planet.

The city of Shenzhen in particular demonstrates what large-scale, everyday deployment of robotics and automation looks like in practice: driverless taxis, service robots, drone deliveries and more, as normal urban infrastructure.

The health system operates with a speed that will surprise most Australians. I experienced this firsthand when I needed to visit a public hospital during my stay. You register by paying a small fee online – typically $2.50 to $5 AUD depending on the doctor’s specialty – and from there, the process is largely self-directed. The doctor issued requests for tests and imaging, I made payments online, completed the tests, walked back with the results, and had a diagnosis and treatment plan within a few hours. A consultation, blood tests, imaging, and a course of medication collectively cost the equivalent of a couple of hundred dollars (before insurance). In Australia, the same sequence would have taken days, possibly weeks, across multiple appointments. It was not a luxury experience, but it was efficient, no-frills, and remarkably fast.

Street safety is genuinely notable. Violent crime rates are low, and daily life reflects it. People leave doors unlocked, cars unattended with engines running. A visitor to China notices the camera infrastructure immediately on arrival – the country has some of the highest CCTV density in the world – but what struck me more was how relaxed daily life felt as a result. Whether you find surveillance reassuring or uncomfortable probably depends on your starting point, but the practical effect on street-level safety is hard to argue with. Visible homelessness is also rare, managed through a combination of state-run facilities, extremely low-cost accommodation, and local government intervention – a structural approach with no real equivalent in Australian cities.

Finally, I cannot write an article about China in 2026 and not mention electric vehicles, which have completely reshaped the streetscape. Chinese-made EVs start from around $8,000 AUD for a basic model, with a standard sedan costing roughly $20,000. They are everywhere, and the effect is tangible: cities are noticeably quieter without engine noise, and air quality is markedly better than what I experienced on my first visit nearly two decades ago. Several Didi rides I took were in EVs with high-quality navigation and entertainment screens, heated massage seats, and built-in fridges, and these were not made to be “luxury vehicles”, but just standard mid-range cars. The build quality would surprise most Australians who still associate "Made in China" with compromise.

Four Chinese singers (middle, in red) perform "Made in China" at the 2026 Spring Festival Gala

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What this means from the outside

And on that note, during the Spring Festival Gala, alongside the robotics showcase, performers sang a number called "Made in China" (picture above) – a knowing, tongue-in-cheek celebration of the country's manufacturing output that played directly with the idea that the phrase's connotations are shifting. In my opinion, it worked well because it was no longer aspirational, but rather a statement of fact.

China's scale enables experiments that are simply not possible elsewhere – hundred million-patient health datasets, tens of millions of older people accessing services, provincial subsidies that can reshape an entire sector's technology adoption within years. Infrastructure investment creates the foundation, and vertical AI applications are addressing the cost and capacity problems that continue to plague Western service sectors including aged care.

For Australian aged care providers and policymakers watching from the outside, the takeaway is not that China has solved aged care. It has not. But it is moving with a speed, scale, and willingness to invest that should prompt serious reflection on the pace at which we are willing to move ourselves.

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(*) A vertical AI application is one built to solve a specific problem within a specific industry (such as routing complaints, diagnosing medical images, or managing aged care rostering) rather than a general-purpose model designed to do many things across many contexts. The trade-off is narrower capability for faster, more accurate results in the domain it was built for.