Since the 18th National Congress of the Communist Party of China, the construction of China's rural elderly care service system has been solidly promoted, and the service capacity and development level have significantly improved. But it cannot be denied that the shortcomings still stand out. The 2024 government work report proposes to increase efforts to address the shortcomings of rural elderly care services. Recently, the Ministry of Civil Affairs, in conjunction with the Central Office for Spiritual Civilization Construction, the Ministry of Agriculture and Rural Affairs and other departments, issued the Guiding Opinions on Accelerating the Development of Rural Elderly Care Services (hereinafter referred to as the "Opinions"), making arrangements and deployments for the in-depth implementation of the national strategy of actively responding to aging population and rural revitalization, and accelerating the development of rural elderly care services. The relevant person in charge of the Elderly Care Service Department of the Ministry of Civil Affairs said in an interview with reporters that the Opinion has made a comprehensive and systematic deployment for the development of rural elderly care services at the national level for the first time. It provides important policy guidance for implementing the national strategy of actively responding to population aging, rural revitalization strategy, strengthening the construction of rural public service system, and laying a solid foundation for accelerating the maturity and finalization of China's characteristic elderly care service system. China is one of the countries with the fastest population aging development speed in promoting mutual aid elderly care, which has significant characteristics such as a large population, fast speed, and difficult response. According to the seventh national population census, there is a significant difference in the level of aging between urban and rural areas in China. From a national perspective, the proportion of elderly people aged 60 and above in rural areas is 23.81%, which is 7.99 percentage points higher than that in urban areas. According to the fifth sampling survey data on the living conditions of elderly people in urban and rural areas of China, indicators such as age structure, empty nest rate, and health status of rural elderly people are more severe than those in urban areas. There is a significant gap between rural elderly people and urban areas in terms of economic income level and ability to bear elderly care service costs. In many places, the phenomenon of hollowing out villages, aging farmers, and elderly migrant workers returning home is more prominent. The gap between urban and rural aging is constantly widening, and the degree of rural aging is higher and the situation is more urgent. Rural elderly care services are different from urban elderly care services, with a historically formed cultural tradition, social foundation, and unique and distinctive characteristics. Rural families have undergone profound changes, showing trends such as miniaturization, decentralization of housing, and weakened support functions. Traditional rural family elderly care has undergone significant changes. The aforementioned person in charge stated that the development of rural elderly care services should adhere to government guidance, social participation, collective mutual assistance, and family responsibility, and adhere to doing our best and acting within our capacity. Especially, we need to innovate the system and mechanism for the development of rural elderly care services, enhance the endogenous driving force for the development of rural elderly care services, leverage the advantages of "neighbors" and "acquaintances", promote the combination of elderly care and action, focus on the construction and promotion of services around the elderly, and strive to solve rural elderly care problems without leaving the village or hometown. For the development of rural elderly care services, the "Opinions" have set short-term and medium-term goals: by 2025, the rural elderly care service network will be further improved, and each county (city, district, banner) will have at least one county-level special impoverished person support service institution mainly for disabled care. The overall coverage rate of elderly care service centers in townships (streets) within the province will not be less than 60%, and mutual assistance elderly care will continue to be promoted according to local conditions. Outstanding service needs such as disabled care, medical and health care integration, meal assistance, visiting care, learning and entertainment will be effectively met. After a period of effort, the rural elderly care service system that integrates county-level planning, urban-rural coordination, and conforms to local conditions has become more perfect, and the sense of gain, happiness, and security of rural elderly people continues to improve. The aforementioned person in charge pointed out that strengthening the construction of rural elderly care service networks should be promoted from the county, township, and village levels. At the county level, it is necessary to expand the functions of county-level special poverty alleviation service institutions. Support county-level special care institutions to set up disability care zones or cognitive impairment care zones as needed, and strengthen the construction of nursing beds. Fully leverage the radiating and driving role of county-level poverty alleviation service institutions, actively expand their functions such as resource coordination, practical training demonstration, and technical guidance. Support county-level public elderly care institutions or other private elderly care institutions with high management and service levels, regional elderly care service centers, village level neighborhood mutual aid points, rural happiness centers, etc. to form service consortia in accordance with the law, and operate in a chain, brand, and intensive manner. At the township level, it is necessary to promote the construction of township (street) regional elderly care service centers. Promote the transformation of elderly care institutions such as nursing homes for extremely poor people in townships (streets) that meet the conditions, and build them into regional elderly care service centers with functions such as coordination and guidance, full day care, day care, home visits, and service referrals. The on-site renovation and upgrading project does not adjust the planned use or occupy additional construction indicators. If the infrastructure equipment is aging, the fire protection facilities are not up to standard, the occupancy rate is low, and the conditions for rectification are not met, the merger and relocation shall be carried out according to local conditions. At the village level, increase the number of village level elderly care service points. Incorporate the construction of mutual aid elderly care service facilities such as village level neighborhood mutual aid points and rural happiness homes into village planning. Establish a sustainable development model with government support and guidance, village collective organization construction, mutual assistance for elderly people who voluntarily move in, and widespread social support. Encourage grassroots elderly associations to participate in service management, and widely carry out mutual assistance and assistance activities such as purchasing and handling, seeking medical treatment and drug delivery, visiting and caring, learning and exchange. Based on practical needs, it is possible to rely on village level neighborhood mutual aid points, rural happiness centers, etc. to establish elderly canteens and elderly meal assistance points, explore neighborhood mutual aid, establish "central households" for multi household pairing, and provide flexible and diverse meal assistance services. Combining the improvement of village appearance, we will carry out the construction of accessible environments in rural areas, and implement aging friendly transformation for families of elderly people in special difficulties. Promote the integration of elderly care and education, and encourage rural elderly care institutions with conditions to build learning points for elderly education. Carry out cultural activities that are popular among elderly people in rural areas, and improve their health and lifestyle literacy. Support pastoral areas to explore and carry out mobile services on horseback, better solving the service difficulties of elderly people in emergency and medical assistance during the nomadic process. In addition, it is necessary to guide and improve the efficiency of resource utilization in county-level elderly care institutions. We will take measures to optimize and integrate the resources of public elderly care institutions, reform the operation and management mechanism of public elderly care institutions, and further improve the operational efficiency of public elderly care institutions in the county. We will gradually relocate concentrated elderly care recipients to high-quality and efficient care facilities (nursing homes) according to their wishes. For public elderly care institutions that are idle or have low operational efficiency, social forces can be introduced through methods such as public and private construction, public and private operation, and commissioned operation in accordance with regulations. If the average occupancy rate of public elderly care institutions in the county is lower than the overall average occupancy rate of public elderly care institutions in the province where they are located in the previous year, the county-level civil affairs department should formulate specific work plans and take effective measures to improve the efficiency of bed utilization in public elderly care institutions. The person in charge of improving the quality level mentioned above stated that the key to improving the quality level of rural elderly care services is to adhere to goal orientation, highlight problem orientation, and focus on solving the bottlenecks and difficulties that hinder the high-quality development of rural elderly care services. On the one hand, we need to strengthen service security supervision. Strengthen the main responsibility for safety production and fire safety in rural elderly care institutions, implement safety bottom line requirements for construction, fire protection, medical and health, food, and services, and strengthen the construction of internal management rules and regulations. Innovate comprehensive regulatory mechanisms and encourage the use of information technologies such as intelligent positioning and video surveillance to strengthen quality and safety supervision. The civil affairs department shall implement industry management and safety supervision responsibilities in accordance with the law, and guide the safety production and fire safety work of rural elderly care service institutions. The civil affairs department and market supervision department shall strengthen the food safety management of rural elderly care service institutions in accordance with their responsibilities. The emergency management department and the fire department are responsible for guiding the emergency management and fire safety work of rural elderly care services, improving fire prevention and emergency rescue capabilities. On the other hand, we need to promote the integration of medical care, health and wellness. Strengthen the signing and cooperation mechanism between township medical institutions and rural elderly care service institutions, and establish a green channel for medical treatment. Support medical institution practicing physicians and rural doctors to visit village level neighborhood mutual aid points, rural happiness centers, and elderly families for home visits, providing health monitoring, medical care, rehabilitation guidance, and other services. Implement grassroots health talent training projects, with a focus on enhancing the health management capabilities of rural doctors for major chronic diseases. In addition, it is necessary to improve the level of elderly care services in relocation sites for poverty alleviation. Based on factors such as the population size, aging degree, and accessibility of services in the relocation area, reasonably set up elderly care service facilities in resettlement sites, and plan and construct them in conjunction with public service facilities in the relocation area. Funds such as east-west cooperation and targeted assistance can include the construction of elderly care service facilities in resettlement sites in the scope of support. Strengthen the construction of the elderly care service personnel team in the resettlement areas, especially in large and medium-sized centralized resettlement sites, and promote the employment of elderly care nurses and other talents in the resettlement sites. (Lai Xin She)