In China, care of the elderly is shifting its focus from the physical to the spiritual, report Sun Li in Shaxian, Fujian province and Zheng Jinran in Yanjiao, Hebei province.
Guan Hehua never imagined that a visit to Jixiang Temple in Shaxian county, Fujian province, would result in her bidding farewell to normal family life and moving to the temple to live with 100 other seniors.
"The easy access to Buddhist sutras and daily prayers allows elderly people like me to find inner peace, which we were not able to achieve at home," said the 78-year-old who began living at the temple in 2010 and is the only Buddhist in her family.
Situated on a verdant mountain and nurtured by fresh springs, Jixiang Temple is the first and so far only temple in Fujian to operate as a nursing home. Although 120 beds are available, there are only 100 senior residents, whose ages range from 71 to 102. The accommodation is shared, with two or three people to each 10 to 15-square-meter room equipped with an air conditioner, a private toilet and a hot water boiler.
To enable the residents to look after each other, comparative youngsters are paired with older inhabitants, according to Shi Nengqing, 77, a senior nun who acts as the nursing home's administrator.
Before moving to the temple, Guan lived alone in the county of Shaxian because her sons had moved away on business. She described the temple as "heaven", and said she can immerse herself in Buddhism while her sons are confident in the knowledge that she's being cared for correctly.
Yin Suqing, a 78-year-old who moved to the home in 2008, expressed her satisfaction with life at the temple. "Before I moved in, I dared not perform morning prayers. Although my family supported my religious beliefs, I was worried I would disturb them," she said.
Shi said most of the residents are Buddhists who are pursuing inner peace in later life and gaining a spiritual satisfaction the material world can't provide.
Neighbouring provinces, such as Zhejiang and Jiangsu, are home to at least 21 temples-cum-nursing homes. Although they mainly provide accommodation for Buddhists, they are also home to many elderly non-believers, according to the statistics of State Administration of Religious Affairs.
Other provinces, such as Sichuan and Shanxi, will adopt a similar model in the future.
China has an aging population; in 2012, those aged 60 and older accounted for 14.3 per cent, reaching 194 million of the 1.34 billion total at the time, and by the end of this year, the number will exceed 200 million, accounting for 14.8 per cent, according to the China National Committee on Aging.
Some experts said more nursing homes are needed to provide basic physical services for seniors, but also stressed the importance of greater emphasis on the spiritual and psychological needs of the elderly.
"The government should encourage nursing homes to provide more diversified services for them," said Du Peng, a professor at the Institute of Gerontology at Renmin University of China in Beijing, who added that it is a sign of great progress that nursing homes have spaces in which seniors can pray.
He said a variety of organisations should be encouraged to build nursing homes for seniors, including religious institutions, but it is vital that they abide by the regulations in terms of construction and management.
Jixiang Temple employs two assistants and a cook to help care for the old people. The monthly per-person cost for food, utilities and medical care, is approximately 1,000 yuan (S$209), which is covered by government funding and donations from businesses and private individuals, said Shi.
"Most of the residents are Buddhists. Initially, there were a few who didn't believe, but they all turned to Buddha after living in the home for a short while," she said.
After almost three years, Guan Hehua is still proud of her decision. "I was right to move. The home is a place of harmony and kindness. We have a really warm-hearted administrator. At dinnertime, Shi Nengqing is never in a hurry to eat. She takes a head count and if anyone is absent, she goes to the dorm to check on them," Guan said, placing her palms together in a Buddhist gesture of respect.
In terms of Buddhist practice, Guan regards the routine in the temple as "highly systematic".
"Not every temple in the county holds morning prayers, but at Jixiang Temple it's taken very seriously. We pray every morning, come rain or shine."
The regime has been adapted to take the ages of the residents into account, according to Yin.
"In some temples, morning prayers begin at 3:30 am, but here it's 4:30 am in deference to the advanced age of some residents. It's all very considerate," she said.
"We have three dishes and a soup. The menu changes every day, so it's a little like a self-service cafeteria where you can eat as much as you like."
When she's not practicing Buddhism, Yin is free to take walks, exercise or read and meditate in her shared room.
"Everything is free here. The experience has filled a spiritual void, so how could I ever feel unhappy here?" she asked.
Cao Jinji is one of the resident who turned to Buddhism after living in the home for awhile.
The 93-year-old said her vegetarian diet and Buddhist meditations have given her a sense of inner peace and she has been amazed by her daughter-in-law's change of attitude toward her.
Cao said she moved to the home more than a decade ago, because her son and daughter-in-law paid her little respect and often quarrelled with her. Her daughter-in-law hadn't called her "mother" for several decades.
"But, one Spring Festival when my daughter-in-law visited me here, her expression betrayed her surprise. She had never thought that people would treat an elderly stranger so well," Cao said.
"She felt guilty and asked me to stay with the family for a short time", she said, adding that she initially thought the offer was some kind of "plot".
After Shi assured Cao that would be picked up three days later, the elderly lady paid a short visit to her old home. Her daughter-in-law treated her with respect and even started calling her "mother" once again.
"Although our relationship has softened, I still prefer to live in the nursing home because this place was the key factor that changed my daughter-in-law's attitude," Cao said.
Li Laifeng, a retired doctor at a hospital in Shaxian, has served as the home's voluntary medical officer since it opened in 1999.
A Buddhist herself, Li offered her services in accordance with the concept of mercy highlighted by the religion. She believes that the surrounding environment promotes longevity.
"The temple sits on these green hills. The air is fresh and the water is clean. Those factors make a major contribution to the good health of the residents," she said.
Li conducts checkups on the residents every week and said most of the octogenarians retain their mental faculties, and she usually only has to treat common ailments such as coughs and the occasional bout of flu. If a resident becomes seriously ill, they are sent to the county hospital.
At present the home's sickbay consists of just one room and Li is hoping to find more space for medical care to allow her to isolate patients with infectious conditions, such as flu, and prevent the spread of the illness.
Jixiang Temple was established by the Shi Zhaochan, the abbot, as a result of his falling ill. In 1994, he was diagnosed with bone cancer, which the doctor said was incurable.
In great pain, the abbot prayed every day and pledged to build a nursing home for 100 people if he was cured. A few months later, the cancer miraculously disappeared and so Shi Zhaochan and Shi Nengqing travelled to Shanghai, Guangzhou and Hong Kong to raise funds and fulfil his promise, a process that took several years.
"Shi Nengqing and I are getting older, so I plan to ask monks from other cities to come to the county and run the nursing home. We are planning to expand and so we are raising funds to pave a smooth path for our successors," said Shi Zhaochan.