It’s around 5 o’clock in the morning as I watch the temple stir to life. The sound of bamboo clappers pierces the early morning calm and gray-haired seniors dressed in Buddhist robes quietly file into the chanting hall with their palms pressed together.

These aren’t and never will be monks. Rather, they are elderly laypeople who have chosen to spend their final years living in a temple instead of a traditional elder care facility.

Between a rapidly aging population, falling birthrates, and the emergence of the nuclear family, China is facing an elder care crisis. While some families have turned to nursing homes for help, not everyone is willing to make that decision. In a society where children are expected to care for their parents in their own homes, the idea of sending the elderly to an institution is often stigmatized as unfilial.

That stigma still exists, but the realities of home-based elder care for people in their eighties and nineties, many of them living with illnesses, have forced some families to consider alternative arrangements. Temple-based elder care is one such alternative. There were around 53 temples providing elderly care services in China as of late 2022, concentrated in the eastern provinces of Jiangsu, Zhejiang, and Fujian. Each temple houses anywhere from 30 to 500 seniors.

Buddhist temples have a long history of charitable involvement in China. Often working at the behest of the government, they offered basic services to the poor, sick, and elderly. However, prior to the 20th century, temples were mainly concerned with issues of the next life. In 1928, an influential Buddhist cleric, Master Taixu, published a critique of Chinese Buddhism in his Sound of the Tide journal. Proposing the concept of “Buddhism for Human Life” (later renamed “Humanistic Buddhism”), Master Taixu called for the faith to serve the living and engage with secular society. His spiritual heirs continued to promote the concept, and it gradually grew in popularity.

But it wasn’t until 2012 that the Chinese government gave official sanction to religious groups engaging in charitable activities and offered them preferential policies such as tax breaks, government subsidies, and water and electricity support.

In response, some temples opted to set up nursing homes for the general public. Most seniors who choose temple-based care are lay Buddhists, but there are exceptions. Dasheng Temple in the eastern province of Jiangsu, for example, has taken in many widowed and lonely seniors without requiring them to be Buddhist.

For their part, the temples do not see elder care as their primary mission. Monks, nuns, and residents all refer to it as “self-cultivation” for seniors, which just so happens to involve an element of care. Resident seniors dress in simple gray, black, and brown clothing and observe a vegetarian diet, symbolizing their observance of Buddhist precepts. They are also expected to practice Buddhist ethics in their daily lives as they accumulate merit for the next life.

This emphasis on self-cultivation over care avoids some of the traditional pitfalls of elder care in Chinese society, helping seniors feel like they are neither fragile nor a burden.

It also offers families a much-needed alternative to Confucian filial piety. Buddhism has long offered interpretations of the parent-child relationship and the concept of filial piety that differ from those of Confucianism. In his 2006 book “The Real Great Filial Piety,” the Buddhist Master Huijing provided an updated interpretation of filial piety as a three-tiered structure. The first two tiers are similar to Confucianism: being filial toward one’s parents and ancestors and honoring one’s ancestors through personal achievements. But the third level calls for guiding one’s parents to practice Buddhism and preparing them to leave the six paths of existence.

The practice of temple-based elder care bypasses the moral dilemmas that children often face when it comes to caring for the elderly, allowing them to feel as though they are doing their parents a service, rather than foisting them off on society.

In “Being Mortal,” Atul Gawande references a description of old age as “a continuous series of losses.” These losses are not limited to bodily functions, but also one’s own subjectivity. Elderly people leave the homes they’ve lived in for decades and move into nursing homes that are well-equipped but socially isolating. Their subjectivity is gradually lost and their dignity stripped away until they become little more than prisoners.

In contrast, temples put a strong emphasis on seniors taking care of themselves. Although the temples typically offer access to volunteers, seniors rarely seek help from them, in part because looking after oneself is a way to accumulate merit.

Fear of death is another common concern among those of advanced age. This is particularly true in China, where the topic is all but taboo. While modern medicine can alleviate physical pain, it’s not easy to dispel the fear and anxiety surrounding death. Although not for everyone, Buddhism provides seniors an answer to the ultimate meaning of life while encouraging them to achieve self-cultivation and mindfulness.

During one of my research visits to Bohai Shuangyuan Nursing Home, I heard a message broadcast over the loudspeaker calling seniors to attend to a resident who was in hospice. The response shocked me: The seniors appeared in high spirits as if they were going on holiday rather than a deathbed. The ward quickly filled with chanters — an unthinkable occurrence at other nursing homes, where the topic of death is studiously avoided.

Temple-based elderly care isn’t about to replace traditional nursing homes. Nevertheless, it offers us a lens to re-examine the relationships between the elderly, society, and family.

Translator: David Ball, editors: Cai Yiwen and Kilian O’Donnell; portrait artist: Wang Zhenhao.

(Header image: VCG)