The suicide rate among elderly people in rural China is bad enough.

What still shocks sociologist Liu Yanwu after six-year studying the problem is the nonchalance surrounding it.

Liu, a researcher at Wuhan University, found the suicide rate among the rural elderly has jumped from 100 per 100,000 to 500 per 100,000 in two decades.

"But I was more shocked by the lack of concern in villages where the elderly commit suicide. It seems that death is nothing to fear, and suicide is a normal, even a happy end," says Liu.

Liu's research began in 2008 with a study of 10 villages in Jingshan County, central China's Hubei Province.

During a two-week stay in one village, three elderly people ended their own lives. Similar events occurred in other villages.

An old man boasted to Liu about his two sons working in the town. One lived in a big house in the town, and the other had built a new house in the village, while the father and the crippled mother lived in a mud-brick house with a leaky roof that was ready to collapse.

In the villages of Hubei's Yingcheng County, few elderly people have died of a natural death in recent years, Liu found.

When Liu visited a village there in 2011, a woman recalled how she helped retrieve the body of a relative who had thrown himself into the pond. She described the process with vivid gestures and a joking tone.

A man calmly talked about the death of his mother. The old woman, confined to bed by chronic illness, groaned about her suffering when her two sons visited her.

The younger son asked, "Why are you whining? You have medicine, don't you? Everything will be okay after you take the medicine." The "medicine" was pesticide.

The man saw off his younger brother and came back to the room, where he found his mother had drunk a bottle of pesticide.

"What should I do? Ask my brother to pay with his life? Our mother would have died sooner or later," said the man.

Liu says that attitude is common. "Their sick mother, in her 70s, would have died sooner or later. It's nothing serious."

"But in other suicide cases, paralyzed people take pesticide. How? Nobody looks into it," Liu says.

In the villages of Yingcheng and Jingshan, the children of suicides are not blamed. For the elderly, death is a relief, Liu says.

His investigation has extended across China to dozens of villages in Hubei, Hunan, Jiangsu, Zhejiang, Shandong, Shanxi, Hebei, Henan, Jiangxi and Guizhou provinces.

While the circumstances differ from place to place, the common factor is a poor quality of life, says Liu.

Filial piety was valued in old China, but many elderly people in rural areas can no longer depend on their children as a result of the great economic and social changes over the past three decades, and the pension system fails to compensate, Liu says.

His research partner, Yang Hua, revisited villages in Jingshan in 2012 and returned with the story of an old man's son, working in a city, who was informed his father was critically ill in hospital. The son asked for seven days leave to go home.

Three days after he got back, his father was still alive. The son asked his father: "Will you die or not? I only have seven days, including the time for the funeral."

So the old man killed himself, and the son conducted the funeral and went back to work.

Liu says many young villagers have a budget for treating sick elderly relatives. If it costs less than 30,000 yuan (about 4,800 U.S. dollars) and the elderly relative can live another 10 years with an annual income of 3,000 yuan, then the treatment is worthwhile. However, it's a waste of money if the elderly relative cannot live long.

In China, farmers are vulnerable, and old farmers are the most vulnerable, Liu says.

The elderly are sad that they can get no support from their children, but they also understand the heavy burden on their children. Elderly parents expect less from them; middle-aged farmers are buying pensions and health insurance; and young couples show less desire to have children.

Liu reckons the main cause of elderly suicide is the difficulty of making ends meet, especially for those who can no longer work, followed by chronic illness and lack of family support.

Both families and the government should take more responsibility, he says.

China must improve its pension and medical security systems for farmers. More support should be given to people over 70 years old, especially those losing the ability to look after themselves, Liu suggests.

"The government plays an important role," Liu says.

When he was in Yingcheng County in 2011, the new rural pension insurance had yet to be introduced there.

Elderly people asked Liu whether the pension insurance would cover their village. Told that it would, they said they'd persevere another two years before considering ending their lives.