China's ageing society is creating a new workforce: The hospital companion

China's ageing crisis and overburdened hospitals have given rise to a new service industry of paid companions who assist elderly patients through daunting medical routines

In China’s packed hospitals, a quiet new workforce is taking shape. Young people — equipped with patience, smartphones, and not necessarily medical degrees — are earning a living by escorting elderly patients through the country’s vast healthcare system. This service, born from an ageing society and a growing digital divide, is expanding across China’s major cities.

 

They help older patients navigate a maze of forms, kiosks, and departments. It is part of a new “companion economy” that has emerged from China’s rapidly greying population. These companions stand in line, book appointments, collect test results, and, at times, simply offer company, according to a report by The New York Times.

 

 

An ageing Chinese society meets a stressed hospital system

 

China’s rapidly ageing population lies at the heart of this shift. By the end of 2024, more than 300 million people — about 22 per cent of the population — were aged 60 and above. That proportion is projected to exceed 30 per cent by 2035, according to China Daily.

 

Older adults often face multiple chronic illnesses, with one hospital estimating that three in four elderly patients suffer from at least two conditions. Yet most of them must seek treatment in crowded tertiary hospitals alongside younger patients.

 

Under China’s three-tier hospital system, Tier-3 hospitals dominate, handling more than 60 per cent of all patient visits. For seniors, these complexes can be overwhelming and disorienting. When family members are unavailable, many elderly patients face the ordeal alone — and that is where companions step in.

 

The rise of China’s “companion economy”

 

What began informally has evolved into a recognised niche within China’s growing “companion economy,” which also includes home nurses and daily-living aides. Industry groups estimate that more than 80 per cent of seniors living at home lack timely family accompaniment during hospital visits.

 

Once viewed as optional help, these services are now considered “rigid demand,” a term used by the China Association of Social Welfare and Senior Service (CASWSS) to describe essentials for the elderly.

 

Companions charge around RMB 200 (approximately $30) for a half-day in smaller cities, and more in major urban centres, according to Xinhua. Some work independently, while others operate through agencies or list their services on platforms such as WeChat and Xiaohongshu.

 

What do hospital companions actually do?

 

A typical day for a hospital companion starts early. They book appointments, register at kiosks, and guide patients from one department to another. They handle payments, collect reports, and sometimes communicate with doctors on a patient’s behalf.

 

Although they do not perform medical procedures, companions offer both practical and emotional support — from holding a frail patient’s arm through a crowded hallway to helping decode post-visit instructions. Their goal is to reduce stress for elderly patients and their families while helping hospitals run more efficiently.

 

Why this industry is growing now

 

Several factors are driving the growth of hospital companionship. As China’s population ages and more seniors live alone, the demand for accompaniment has surged. Nearly half of older adults are estimated to live without a nearby child.

 

Additionally, China’s best hospitals are located in major cities, forcing rural and small-town patients to travel long distances to navigate unfamiliar systems. Self-service machines, QR-code registrations, and multi-department procedures can be especially challenging for those unfamiliar with smartphones.

 

With the job market tightening, many middle-aged workers are turning to flexible, purpose-driven roles like hospital companionship, viewing it as both socially meaningful and economically sustainable.

 

What it means for patients and workers

 

For elderly patients, companions provide reassurance and remove barriers that often deter them from seeking care. Many say they feel more confident visiting hospitals when someone is by their side.

 

As quoted by The New York Times, a woman in Shanghai whose daughter works in another city described her escort as “a blessing” who made her appointments less intimidating.

 

Some companions have built loyal client bases and stable incomes, though the sector still lacks formal certification and long-term career structures.

 

The bigger picture: Adapting to an ageing China

 

The rise of hospital companions mirrors a broader transformation in China’s healthcare and social structure. The state is investing heavily in geriatric medicine, but structural challenges persist — from overburdened tertiary hospitals to low digital literacy among the elderly.

 

In this gap, the companion industry has emerged as an adaptive bridge — helping older citizens navigate a healthcare system designed for speed and efficiency rather than empathy.