合肥市失能老人护理服务问题研究
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摘要
老龄化问题是世界各国普遍面临的问题,老年阶段也是人生的必经阶段,随着老龄化趋势的加重,老年人口越来越多,老人由于疾病或是身体功能的老化会导致生活自理能力下降,需要他人的护理。以往我国都是依靠传统的家庭养老方式,失能老人都是在家由家人进行照顾,养儿防老的观念早已深入人心。但是家庭结构随着时代的发展而发生了变化,国家实行的计划生育政策让家庭成员越来越少,一对年轻夫妻有时要一边工作一边赡养四个甚至八个老人,各种各样的情况导致后代无法对失能的长辈进行很好的护理。长期护理服务是解决失能老人晚年生活的较佳途径。失能老人长期护理服务工作的开展完善对失能老人生活福祉,我国社会保障制度的完善与发展都具有非常重要的意义。
本文通过对我国老年人口的总体情况和安徽省老年人口基本状况的介绍,引出开展失能老人护理服务工作的必要性。合肥作为安徽省的省会,位于江淮之间,巢湖之滨,是皖江城市带的核心城市,更是长三角的重要经济中心。2010年统计的人口数据显示,失能老人占老年人口总数的19%,失能群体数量庞大。由于年龄越大,失能的概率越高,合肥在1997年就进入了老龄化社会,目前拥有一百万以上的老年人,护理服务问题亟待解决。文章分析了合肥市目前老年护理服务工作开展的情况,包括提出让大部分老年群体进行居家护理和小部分老年群体进行机构护理。居家护理服务是指政府依靠社会的力量,主要是依靠社区,为在家的老人提供护理服务。机构护理则是把这种服务形式搬到了养老机构。笔者在充分了解合肥市老年护理服务情况的基础上,借助入户调查和进入机构调查的方法,对失能老人的基本信息、护理状况、精神状况进行了实地调查,将这些结果汇总,运用spss18.0软件对调研结果进行分析总结,发现现有的护理方式、护理费用及护理服务标准不能满足失能老人的护理需求,提出通过相关措施来完善失能老人护理服务的工作。包括提出政府主导、社会参与的方式,政府应该理顺体制和机制,明确规定合肥市失能老人护理服务工作的目标、任务,支持、吸引社会团体开办护理服务机构；建立完善护理保险制度,将服务费用纳入养老保障体系当中,构建一个有效的经济保障来解决护理费用问题；培养合格的相关人才,包括专业的管理人员和服务人员,为护理服务配备最合格的人才等措施。当前正是我国社会保障事业不断完善发展的阶段,合肥市失能老人护理服务工作的完善不仅仅能更好地给老人提供生活质量和福利水平,还会推进我国社会保障事业的发展与进步。
The aging problem is a worldwide problem, old age is the necessary stage of life, with the increase of aging trend, more and more elderly population, due to disease or the aging T he elderly body functions will lead to decline in daily living, they need for the care of others. We were always relying on traditional family pension before, families take care of disabled elderly at home, the concept of raising children for old age has long been popular. But the family structure has changed with the development of the times, the country's family planning policy lead fewer and fewer family members, sometimes a young couple will support for four or even eight elderly while they have work to do, a variety of situations result that the young can't take care of their disabled parents finely. Long-term care service is a good way to help the disabled elderly in old age. Long-term care service for disabled elderly has very important significance for the disabled elderly and the improvement and development of China's social security system
The article introduced the overall situation of China's elderly population and the basic situation elderly population in Anhui Province, leads to the need to establish Long-term care service for disabled elderly. Hefei, the capital of Anhui Province, located between the Yangtze River and Huaihe River, it's the core city of the Wanjiang Zone, and the important economic center in the Yangtze River Delta. Population statistics data by2010show that the the disabled elderly accounted for19%of the total elderly population, the large number of disability groups. The greater the age, the higher the probability of disability, Hefei entered the aging society in1997, has more than one million elderly now, care issues need to be solved. The article analyzed the aged care services work in Hefei, Including let most of the older age groups take home care and the small part use institutional care. Home care services is that the government provides care for the elderly at home relies on the strength of the society, mainly relying on the community. Institutional care moves the form of service pension in to institutions. I have learned the basic situation of aged care services in Hefei plenty, through household surveys and Institutional surveys, conducted a field survey on the basic information of the disabled elderly, nursing, mental status, I summarized these results then analyzed and summarized by using spss18.0software, found that the existing care, cost of care and nursing services standards can not meet the demand for care of the disabled elderly, and put forward to establish a comprehensive disability care for the elderly. Including the pattern of government-led and social participation, the Government should rationalize the system and mechanism and define objectives, tasks of disabled elderly care work in Hefei, support to attract the public to set up care institutions; Establishing and improving the care insurance system, care costs are included in the pension system which to build an effective economic security to solve the problem of the cost of care; Training qualified personnel, including professional management and service personnel with the best qualified staff for care services. It's the constantly improving development stage of our social security, building Long-term care service for disabled elderly in Hefei not only give better quality of life and level of benefits to the elderly, but also to promote the development and progress of our social security.
本文通过对我国老年人口的总体情况和安徽省老年人口基本状况的介绍,引出开展失能老人护理服务工作的必要性。合肥作为安徽省的省会,位于江淮之间,巢湖之滨,是皖江城市带的核心城市,更是长三角的重要经济中心。2010年统计的人口数据显示,失能老人占老年人口总数的19%,失能群体数量庞大。由于年龄越大,失能的概率越高,合肥在1997年就进入了老龄化社会,目前拥有一百万以上的老年人,护理服务问题亟待解决。文章分析了合肥市目前老年护理服务工作开展的情况,包括提出让大部分老年群体进行居家护理和小部分老年群体进行机构护理。居家护理服务是指政府依靠社会的力量,主要是依靠社区,为在家的老人提供护理服务。机构护理则是把这种服务形式搬到了养老机构。笔者在充分了解合肥市老年护理服务情况的基础上,借助入户调查和进入机构调查的方法,对失能老人的基本信息、护理状况、精神状况进行了实地调查,将这些结果汇总,运用spss18.0软件对调研结果进行分析总结,发现现有的护理方式、护理费用及护理服务标准不能满足失能老人的护理需求,提出通过相关措施来完善失能老人护理服务的工作。包括提出政府主导、社会参与的方式,政府应该理顺体制和机制,明确规定合肥市失能老人护理服务工作的目标、任务,支持、吸引社会团体开办护理服务机构；建立完善护理保险制度,将服务费用纳入养老保障体系当中,构建一个有效的经济保障来解决护理费用问题；培养合格的相关人才,包括专业的管理人员和服务人员,为护理服务配备最合格的人才等措施。当前正是我国社会保障事业不断完善发展的阶段,合肥市失能老人护理服务工作的完善不仅仅能更好地给老人提供生活质量和福利水平,还会推进我国社会保障事业的发展与进步。
The aging problem is a worldwide problem, old age is the necessary stage of life, with the increase of aging trend, more and more elderly population, due to disease or the aging T he elderly body functions will lead to decline in daily living, they need for the care of others. We were always relying on traditional family pension before, families take care of disabled elderly at home, the concept of raising children for old age has long been popular. But the family structure has changed with the development of the times, the country's family planning policy lead fewer and fewer family members, sometimes a young couple will support for four or even eight elderly while they have work to do, a variety of situations result that the young can't take care of their disabled parents finely. Long-term care service is a good way to help the disabled elderly in old age. Long-term care service for disabled elderly has very important significance for the disabled elderly and the improvement and development of China's social security system
The article introduced the overall situation of China's elderly population and the basic situation elderly population in Anhui Province, leads to the need to establish Long-term care service for disabled elderly. Hefei, the capital of Anhui Province, located between the Yangtze River and Huaihe River, it's the core city of the Wanjiang Zone, and the important economic center in the Yangtze River Delta. Population statistics data by2010show that the the disabled elderly accounted for19%of the total elderly population, the large number of disability groups. The greater the age, the higher the probability of disability, Hefei entered the aging society in1997, has more than one million elderly now, care issues need to be solved. The article analyzed the aged care services work in Hefei, Including let most of the older age groups take home care and the small part use institutional care. Home care services is that the government provides care for the elderly at home relies on the strength of the society, mainly relying on the community. Institutional care moves the form of service pension in to institutions. I have learned the basic situation of aged care services in Hefei plenty, through household surveys and Institutional surveys, conducted a field survey on the basic information of the disabled elderly, nursing, mental status, I summarized these results then analyzed and summarized by using spss18.0software, found that the existing care, cost of care and nursing services standards can not meet the demand for care of the disabled elderly, and put forward to establish a comprehensive disability care for the elderly. Including the pattern of government-led and social participation, the Government should rationalize the system and mechanism and define objectives, tasks of disabled elderly care work in Hefei, support to attract the public to set up care institutions; Establishing and improving the care insurance system, care costs are included in the pension system which to build an effective economic security to solve the problem of the cost of care; Training qualified personnel, including professional management and service personnel with the best qualified staff for care services. It's the constantly improving development stage of our social security, building Long-term care service for disabled elderly in Hefei not only give better quality of life and level of benefits to the elderly, but also to promote the development and progress of our social security.
引文
① 《合肥市承接产业转移促进服务员发展若干政策(试行)》,2012年4月。
[1]黄成礼.中国老年人口的健康、负担及家庭照料[J].中国卫生资源,2006,9(5)：208-91.
[2]陈雪萍.以社区为基础的老年人长期照护体系构建[M].杭州：浙江大学出版社,2011.
[3]叶芳.浅析失能老人的社会保障[J].社会,2011,(3)：145-147.
[4]张瞳,赵富才.失能老人主要居家照顾者的照顾评价、社会支持与心理健康的关系[J].中国健康心理学,2011,19(5)：563-564.
[5]张勘.失能老人长期照料的现状分析和政策建议[J].上海医药,2010,31(1)：8-11.
[6]戴卫东.台湾地区人口老龄化下长期护理政策及走向[J].人口学刊,2011,(4)：61-67.
[7]伍小兰主编.台湾老年人的长期照护[M].北京：中国社会出版社,2010,34.
[8]陈晶莹.老年人之长期照护[J].市场与人口分析,2002
[9]陈杰.日本的护理保险及其启示[J].市场与人口分析,2002,8(2)：69-73.
[10]Knickman J,Snell E.The 2030 problem:caring for the aging baby boomers. Health Serv Res,2002,37 (4):849-84.
[11]Susan C.Reinhard, Heather M. Young. The nursing workforce in long-term care. Nurs Clin N Am 44 (2009):161-168.
[12]Schoenmakers B, Buntinx F, Delepeleire J. Supporting the dementia family caregiver:The effect of home care intervention on general well-being. Aging and Mental Health,2010,14 (1):44-56.
[13]Hancock PJ, Jarvis JA, L'Veena T. Barriers to respite:A case study of a sub-group from an older cares program in Western Australia. Australian Journal of Primary Health,2010,12 (2):113-123.
[14]荆涛.长期护理保险：中国未来极具竞争力的险种[M].北京：对外经济贸易大学出版社,2006.
[15]戴卫东.长期护理保险制度理论与模式构建[J].人民论坛,2011,(10)：31-34.
[16]唐仲勋,叶南客.当代都市老年事业的依托与载体——南京市老年社区服务的个案研究[J].南京社会科学,2002,(4)：74-79.
[17]赵芳,许芸.城市空巢老人生活状况和社会支持体系分析[J].南京师大学报(社会科学版),2003,(5)：61-67.
[18]龚静怡.居家养老——社区养老服务：符合中国国情的城镇养老模式[J].河海大学学报(哲学社会科学版),2004,(4)：72-74.
[19]何芸,李建权.家庭结构的变迁对养老模式的影响[J].社会工作(学术版),2007,(1)：33-35.
[20]韩振燕,辛天霞.从温州移民老人公寓看我国老年福利机构的发展[J].广西社会科学,2005,(12)：170-172.
[21]蔡驎.城市日托养老需求分析[J].上海师范大学学报(哲学社会科学版),2007,(5)：118-125.
[22]高磊,许琳.居家养老服务研究综述[J].法制与社会,2011,11：191-194.
[23]尹章海.我国人口老龄化发展特点、影响及对策[J].人口及计划生育,2009,6：22-23.
[24]谢益聪.人口老龄化背景下西安市老年残疾人护理体系的研究[D].西安：西北大学,2010.
[25]曹煜玲.中国城市养老服务体系研究—以大连市为调查分析样本[D].大连：东北财经大学,2011.
[26]郑晓婷.我国城市社区养老研究分析[D].武汉：武汉科技大学,2008.
[27]徐建伟,高雅略.论建立老年护理保险制度的必要性及相应对策[J].政治与公共管理,2007,(3)：6-8.
[28]魏玉.中国养老福利服务的社会化供给模式研究[D].北京：清华大学,2002.
[29]彭佳平.上海市老年护理供需现状及对策研究[D].上海：复旦大学,2011.
[30]潘金洪.江苏省机构养老床位总量不足和供需结构失衡问题分析[J].南京人口管理干部学院学报,2010,26(1)：15-20.
[31]北京市政协社会和法制委员会,北京市政协提案委员会.促进本市养老机构建设[J].北京观察,2010,(9)：28-31.
[32]戴卫东.国外长期护理保险制度：分析、评价及启示[J].人口与发展,2011, 17(5)：80-86.
[33]世界卫生组织主编.积极老龄化政策框架[z].北京：华龄出版社,2003,3.
[34]段昆.美日长期护理保险制度比较[J].消费导刊,2007,11：78.
[35]周海珍.长期护理保险产品设计浅析[J].兰州学刊,2010,10:129-134.
[36]林菊英主编.社区护理[M].北京：科学出版社,1998：234-242
[37]丁兰.日本的护理保险简介[J].中国全科医学,2004,(6)：801-802
[38]侯立平.发达国家(地区)的老龄人口长期护理体系及其启示[J].城市问题,2012,1：89-95.
[39]王语甜.中日老年护理保险制度比较研究[D].兰州：兰州大学,2009.
[40]乔楠.上海中心城区老龄人口居家养老服务研究[D].上海：复旦大学,2009.
[41]陆宏筝.日本护理保险的发展及对我国的启示[D].北京：首都经济贸易大学,2008.
[1]黄成礼.中国老年人口的健康、负担及家庭照料[J].中国卫生资源,2006,9(5)：208-91.
[2]陈雪萍.以社区为基础的老年人长期照护体系构建[M].杭州：浙江大学出版社,2011.
[3]叶芳.浅析失能老人的社会保障[J].社会,2011,(3)：145-147.
[4]张瞳,赵富才.失能老人主要居家照顾者的照顾评价、社会支持与心理健康的关系[J].中国健康心理学,2011,19(5)：563-564.
[5]张勘.失能老人长期照料的现状分析和政策建议[J].上海医药,2010,31(1)：8-11.
[6]戴卫东.台湾地区人口老龄化下长期护理政策及走向[J].人口学刊,2011,(4)：61-67.
[7]伍小兰主编.台湾老年人的长期照护[M].北京：中国社会出版社,2010,34.
[8]陈晶莹.老年人之长期照护[J].市场与人口分析,2002
[9]陈杰.日本的护理保险及其启示[J].市场与人口分析,2002,8(2)：69-73.
[10]Knickman J,Snell E.The 2030 problem:caring for the aging baby boomers. Health Serv Res,2002,37 (4):849-84.
[11]Susan C.Reinhard, Heather M. Young. The nursing workforce in long-term care. Nurs Clin N Am 44 (2009):161-168.
[12]Schoenmakers B, Buntinx F, Delepeleire J. Supporting the dementia family caregiver:The effect of home care intervention on general well-being. Aging and Mental Health,2010,14 (1):44-56.
[13]Hancock PJ, Jarvis JA, L'Veena T. Barriers to respite:A case study of a sub-group from an older cares program in Western Australia. Australian Journal of Primary Health,2010,12 (2):113-123.
[14]荆涛.长期护理保险：中国未来极具竞争力的险种[M].北京：对外经济贸易大学出版社,2006.
[15]戴卫东.长期护理保险制度理论与模式构建[J].人民论坛,2011,(10)：31-34.
[16]唐仲勋,叶南客.当代都市老年事业的依托与载体——南京市老年社区服务的个案研究[J].南京社会科学,2002,(4)：74-79.
[17]赵芳,许芸.城市空巢老人生活状况和社会支持体系分析[J].南京师大学报(社会科学版),2003,(5)：61-67.
[18]龚静怡.居家养老——社区养老服务：符合中国国情的城镇养老模式[J].河海大学学报(哲学社会科学版),2004,(4)：72-74.
[19]何芸,李建权.家庭结构的变迁对养老模式的影响[J].社会工作(学术版),2007,(1)：33-35.
[20]韩振燕,辛天霞.从温州移民老人公寓看我国老年福利机构的发展[J].广西社会科学,2005,(12)：170-172.
[21]蔡驎.城市日托养老需求分析[J].上海师范大学学报(哲学社会科学版),2007,(5)：118-125.
[22]高磊,许琳.居家养老服务研究综述[J].法制与社会,2011,11：191-194.
[23]尹章海.我国人口老龄化发展特点、影响及对策[J].人口及计划生育,2009,6：22-23.
[24]谢益聪.人口老龄化背景下西安市老年残疾人护理体系的研究[D].西安：西北大学,2010.
[25]曹煜玲.中国城市养老服务体系研究—以大连市为调查分析样本[D].大连：东北财经大学,2011.
[26]郑晓婷.我国城市社区养老研究分析[D].武汉：武汉科技大学,2008.
[27]徐建伟,高雅略.论建立老年护理保险制度的必要性及相应对策[J].政治与公共管理,2007,(3)：6-8.
[28]魏玉.中国养老福利服务的社会化供给模式研究[D].北京：清华大学,2002.
[29]彭佳平.上海市老年护理供需现状及对策研究[D].上海：复旦大学,2011.
[30]潘金洪.江苏省机构养老床位总量不足和供需结构失衡问题分析[J].南京人口管理干部学院学报,2010,26(1)：15-20.
[31]北京市政协社会和法制委员会,北京市政协提案委员会.促进本市养老机构建设[J].北京观察,2010,(9)：28-31.
[32]戴卫东.国外长期护理保险制度：分析、评价及启示[J].人口与发展,2011, 17(5)：80-86.
[33]世界卫生组织主编.积极老龄化政策框架[z].北京：华龄出版社,2003,3.
[34]段昆.美日长期护理保险制度比较[J].消费导刊,2007,11：78.
[35]周海珍.长期护理保险产品设计浅析[J].兰州学刊,2010,10:129-134.
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