Change for the better

But what he observed in Yangquan in 2014, after introducing the concept of hospice care from the United States, suggested that things were changing for the better.

"The habits and customs of the rural elderly have improved," he said. "There's been a mental transformation."

The elderly have received better care as their needs have begun to be taken more seriously in the community and in wider Chinese society.

Miller and his wife pioneered palliative care in Shanxi province, and they have labored to localize hospice services.

They envision a community-based system in the future to ease the way for the terminally ill.

"Their arrival broke through the bottlenecks in our hospital," said Li Youquan, founder of Yangquan You'ai Hospital."Dr Miller helped us improve the technology of cancer screening and introduced the concept of palliative care."

According to the National Bureau of Statistics, there were more than 176 million people over age 65 in China at the end of last year. Earlier, the National Health Commission had found that more than 180 million seniors over age 60 had chronic diseases. Nearly 40 million were disabled or partially disabled.