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What does it entail for care practices when non-affiliated strangers manage your property and make critical “life-matter” decisions on your behalf? Known as “delegate children,” these legal guardians fill gaps left by the state welfare system while navigating complex moral dilemmas.
Performing Care as a “Delegate Child”
It was a snowy day in late December 2022 when I accompanied Xiao Zhang on her visit to a nursing home in the Jing-Jin-Ji region of northern China. It had been a month since her client, Granny Shi, moved into the facility. A steelworker who entered the factory at eighteen, Granny Shi was highly regarded for her mechanic skills. After her child’s death, she became one of the “elders who lost their single child (shidu laoren),” overwhelmed by the pressing concern of her late-life care. As an employee at a social guardianship organization, Xiao Zhang performs the role of “delegate children” (daili ernv) to Granny Shi. In China’s legal service market, “delegate children” is a new profession. Although “legal guardians” is the more formal term, staff members at the civil guardian organization often identify themselves as “delegate children”. This label underscores the surrogate care they provide, which is akin to the support traditionally expected from biological children. In this article, I explore the divergent perceptions and expectations surrounding care duties held by elders and their guardians. Elder care is becoming a key venue for the contestations of post-socialist China’s care regime, where market-driven care models are increasingly displacing the extensive welfare benefits once guaranteed by the work unit (dan wei) system, all occurring within a legal context that heavily favors familial rights.
China is facing a critical eldercare crisis driven by a rapidly growing aging population, shrinking family sizes, and exorbitant costs of private eldercare facilities and assisted care. The repercussions of the one-child policy are profoundly evident, as it has left numerous elderly caught in a critical predicament: they struggle to access necessary care because of the lack of a family member to act as a guarantor for authorizing their hospital and institutionalized care admissions and to make medical care decisions on their behalf. Many of my interlocutors refer to this situation as a “dead end” or “impasse.”
In Granny Shi’s case, she wished to spend her remaining years in a nursing home. However, admission to such facilities requires the signature of a relative, preferably biological children. After four years of fruitless searching for a guardian, Granny Shi left her steel city home and relocated to the Jing-Jin-Ji region. This decision was prompted by the discovery of a newly founded social guardianship organization specifically designed to resolve these childless elders’ dilemmas. At the beginning of today’s visit, Xiao Zhang showed Granny Shi a list of tasks to accomplish. She accompanied Granny Shi to a nearby bank to make payments to the notary office. They then stopped by a grocery store to shop for the daily necessities Granny Shi needed at the facility. Xiao Zhang reminded Granny Shi to buy winter gloves and offered to bring a thermos from home to avoid unnecessary expenses. On the way back to the nursing home, Xiao Zhang held Granny Shi’s hands tightly, guiding her on the icy paths. These acts and gestures underscore the informal, interpersonal facets of care that are not encapsulated by the formal legal duties of guardianship.
The 2021 Civil Code introduced multiple new articles on adult guardianship, including the provision for individuals to select their guardians when fully capable. However, the government policies fail to outline practical measures, leaving a gap in the market for exploring professional standards. During my 2023 fieldwork in China, I observed various entities—including law firms, notary offices, legal service companies, nursing homes, and household management services—attempting to fill this void. The social organization where Xiao Zhang is employed exemplifies a broader trend. In their operations, the role of delegated children extends beyond traditional “care work,” which is typically limited to daily caregiving tasks. Their responsibilities encompass navigating the constraints of established systems, collaborating with bureaucracies, bridging gaps in social services, and channeling necessary care resources. Additionally, their work often requires mediating between the client’s wishes and a legal culture that favors familial ties and the rights of biological children.
The Nuances of “Guan” in Guardianship
What does it mean for elders to sign a contract with a guardian organization or individuals when they cannot depend on their children for support in their later years? Through conversations with elders, I have found that many view guardianship not merely as a legal arrangement but as a promise of security. This suggests a relationship that is fundamentally about care rather than simply fulfilling legal obligations. Elders frequently seek care in the form of “guan”—a term that captures both caretaking and an element of control, indicative of the nuanced interplay between autonomy and dependency. This dual meaning highlights the elders’ need for care models that respect both their autonomy and their comprehensive care needs; moreover, as the duties of guan are customarily performed by children, the term also implies a desire for emotional attachment. Elders who engage in guardianship contracts often pursue authentic care, which implies genuine relationships that extend beyond legal ties and form kin-like connections.
Notably, understandings of care are diverse and context-dependent. For Granny Shi, the guardianship organization serves as a trustworthy work unit (dan wei), reminiscent of the comprehensive welfare systems provided by state enterprises during the socialist era, ensuring care for her needs throughout her life. The guardians, in contrast, are supposed to fulfill a distinctly contractual role—adhering to the duties explicitly outlined in their agreements. In practice, many guardians strive to fulfill the role of “delegated children,” aiming to provide both professional oversight and emotional support for their elderly clients. In fact, guardians like Xiao Zhang view their work as more than merely “a job.” One guardian described it as follows: “Guardianship enables us to forge a close relationship [with the elders], grounded not in blood but in trust, commitment, and oversight.” This perspective is indicative of how most guardians view their roles: they consider themselves both altruistic caregivers engaged in “good deeds” and professional agents, providing a level of “professional care” unmatched by actual family members.
Moral Dilemmas and Constraints
The notion of “professionalism” in guardianship, however, invites skepticism. Without clear professional standards, how one performs “genuine care” while maintaining professionalism lacks clear guidance. Such questions keep presenting themselves in practice. Mr. Chen, the founder of a civil organization in the process of transitioning to a guardianship organization, often finds himself facing dilemmas. As the leader of a newly established organization, he is particularly meticulous about avoiding legal disputes and maintaining the organization’s social reputation, especially given its status as a civil organization committed to philanthropy.
During a webinar I attended hosted by a social guardianship organization, a spokesperson highlighted a recent moral quandary: An elderly client collapsed. He had signed an advance directive against any form of medical intervention. Despite this wish and the doctor’s warning about the surgery’s side effects, the guardian still chose to admit the person to the ICU. The spokesperson remarked, “If it were his son, he could decide freely. However, as an organization, we are afraid of being accused of failing to save lives.” This decision highlights the moral complexities encountered by guardians, who, despite having the legal authority to act on behalf of elders, still confront judgments within the prevailing legal culture, especially when making the aforementioned “life mattering” decisions. The guardians need to heed the rights of related kin, including spouses, parents, children, and other relatives to avoid potential charges.
These guardians’ struggles raise profound questions about the nature of good care: should guardians honor the client’s own wishes and adhere to professionalism, or should they perform acts of filiality to comply with social expectations? And how to navigate the rights of biological children or other relatives within the legal framework of China?
Bridging Welfare Gaps and Offering Hope
In summary, I contend that guardians like Xiao Zhang emerge as pivotal figures within the evolving care regime, bridging the substantial gaps created by the transition from the comprehensive Dan Wei system to a market-driven eldercare model. By meeting the urgent demand of care for elders like Granny Shi and numerous older people who age alone, these organizations offer hope to elders in desperate need of guardian service. However, this hope remains tenuous, as the legal status and rights of guardians are often questioned and subordinated to familial rights. The legal framework and prevailing distrust toward non-familial caretakers present significant barriers, inhibiting their capacity to effectively execute wills and to exercise the agency of the elderly client.
The guardians’ efforts to establish professional organizations do more than just tinkering or filling these gaps; they underscore the urgent need to develop new mechanisms that are attuned to the altered dynamics of eldercare. The dilemma of care examined in this article reflects broader questions about the definition of “good care,” raising important questions about whose will should be honored, and how China’s transitional and transforming care regime can be supported by more refined legal regulations for these crucial services.
SEAA section contributing editors Aaron Su and Jieun Cho, and incoming editors Alex Wolff and Yanping Ni, all contributed to this piece.