Wang Qing, 93, has been bedridden since February after a fall. She couldn鈥檛 take a bath until one day in July, three nursing caregivers carried a specially made bathtub to her home.

Modeled on a Japanese practice, the new in-home care service in Shanghai is winning applause from families with disabled seniors.

The bath given to Wang at her home in Changzheng Town in Putuo District involves an elaborate procedure and takes an hour and 40 minutes.

The bathtub is in two pieces. Once assembled, it is thoroughly disinfected. The tub has various elastic belts and clasps to protect the elderly, and a skidproof pattern is embedded in the bottom of the tub.

A water pipe is connected, a disposable cover is placed over the tub, and a water thermometer is placed inside. Towels used for different parts of the body are set out in advance.

鈥淓very detail must be strictly observed to guarantee the safety of seniors,鈥� said Hua Binbin, a service provider. 

Once the initial preparation is completed, which takes about 30 minutes, Wang was carefully moved from her bed to a stretcher that can move up and down. Then she is lowered into the water. Caregivers ladle water over her all the time to keep her warm, and keep up a cheerful patter to comfort her.

After the bath, her hair and body are carefully dried, and she is moved back to her bed.

鈥淐ontrolling the water temperature is the most difficult part,鈥� said Hua. 鈥淚t is kept at 38 or 39 degrees Celsius for the initial immersion and then kept at 40 degrees.鈥�

Wang was very happy with her bath.

鈥淚 feel refreshed and comfortable,鈥� she told Shanghai Daily, with a big smile, as she rested in bed after the bath. 鈥淚 hope the next bath will be scheduled soon.鈥�

Wang lives with her son and daughter-in-law.

鈥淚n the past, she was fastidious about cleanliness and bathed frequently,鈥� said daughter-in-law Meng Ting. 鈥淭hat all stopped in February after the fall. Now she is bedridden and can鈥檛 sit up for more than five or 10 minutes.鈥�

Meng said she had been giving her mother-in-law 鈥渂ed baths,鈥� using washcloths, towels and a basin of water.

鈥淚 washed her every day, but it wasn鈥檛 the same as having a real bath,鈥� said Meng.

In Changzheng Town, senior residents account for a third of the population. More than 700 of them are 90 years and older, with 20 centenarians.

The in-home bathing program started earlier this year. A bath costs 450 yuan (US$69) a time. The town government purchases the service at a discount price from a provider. The family of an elderly recipient need pay only 10 percent of the cost.

鈥淲e visited many seniors鈥� homes to learn what they needed and what their habits were,鈥� said Gui Jiahuan, a town official in charge of the program. 鈥淲e took a year to organize the program. What was clear to us is that seniors prefer remaining in their own homes. Some initially refuse the service because of privacy concerns, but they are hooked on it after just one bath. It takes time to accept a new concept in China.鈥�

Meng said Wang did refuse the new service for a long time as well.

鈥淪he was shy,鈥� explained Meng. 鈥淏ut after she became bedridden, she agreed to give it a try. She liked it from the start.鈥�

Wang has since enjoyed the service several times. Because of big demand, the baths are usually available monthly or quarterly.

Families first must apply at their neighborhood committees, triggering an assessment of a senior鈥檚 health condition. 

Fu Shou Kang, the service provider, has bathed more than 300 seniors in a year, serving up to six a day. The service is fully booked.

鈥淭he average age of seniors we serve is 80 years old,鈥� said Lin Xueqin, a manager of the provider, 鈥渁nd we also serve the disabled, even if they are young.鈥�

The nursing caregivers are all 45 years or younger.

鈥淲e require that they have medical nursing certificates and drivers鈥� licenses, are good at communication, have a loving heart, are filial and have good physical health,鈥� Lin explained.

She added that the nursing staff has received instruction from Japanese specialists in the field, and some have gone to Japan for training.

The special bathtub, introduced from Japan, costs 60,000 yuan. Two are in service at present, Lin said.

鈥淲e have made some adjustments to the Japanese method,鈥� she added. 鈥淥ur nurses must be very patient because they need to clean every part of a senior鈥檚 body. They also do some finger-tip massaging, which promotes blood circulation of the bedridden.鈥�

Staff, she said, need good communication skills to understand how a senior is handling the bathing. 

Nie Jiyan is one of the nursing caregivers.

鈥淔amilies of seniors have never seen this kind of bathtub before and misunderstandings can arise,鈥� she said. 鈥淲e carefully explain it all. I treat the seniors like my own parents.鈥�

The job is tough, obviously.

Some old residential complexes do not have parking space, meaning the caregivers have to lug the 10-kilogram bathtub some distance. If residential buildings don鈥檛 have elevators, that means carrying it up stairs.

Similar services have also been introduced in other districts.

Shan Qinzhen, 75, who lives in Songjiang District, has been paralyzed since a fall in her bathroom. She relies on her family to feed her and can no longer take a shower twice a day, as in the past.

Taking showers alone can be dangerous for seniors.

In July, the Songjiang District Civil Affairs Bureau earmarked 600,000 yuan to start a trial of in-home bath services. In one case, it served an elderly person who hadn鈥檛 been able to take a bath for more than 20 years.

鈥淭he service is considerate, and I am happy,鈥� said Shan. 

The Songjiang trial covers 1,200 elderly and disabled people for a year.

The first bath is free, and financial support is available based on need for subsequent baths.

Bu Yousheng, 27, is the youngest caregiver on the Songjiang team.

Two years ago, he moved alone to Shanghai, looking for work.

鈥淎t first, I didn鈥檛 dare to tell my family back home what I do in Shanghai,鈥� he said. 鈥淚 didn鈥檛 think they would understand, so I told them only that I worked in senior care service. But after a while, I realized just how important this job is.鈥�

His cell phone is full of photos of the faces of seniors he has served

鈥淥ne is a grandpa who can鈥檛 speak but has gradually accepted our service,鈥� Bu said. 鈥淪ome of our clients hug me after the bathing, and a few have since passed away.鈥�

In 2019, Shanghai鈥檚 population of people 60 years or older grew 2.9 percent from a year earlier to 5.2 million, accounting for more than 35 percent of permanent residents.

The city has been operating a long-term nursing care insurance program for its elderly residents since 2018.

The program targets citizens aged 60 or older who need long-term care, no matter where they reside, as long as they are covered by public medical insurance.

鈥淭he program includes in-home baths and is in great demand,鈥� Chen Yuebin, director of the Shanghai Civil Affairs Bureau鈥檚 senior services department, told Shanghai Daily. 鈥淭his new, emerging service diversifies what we can offer and meets the personal needs of many seniors.

He said efforts are underway to safety-proof the bathrooms of the elderly, particularly those living in old residential complexes.