中国城市失能老人社区居家照护服务工作优化研究

发布时间：2019-02-19 19:32

【摘要】：“失能”是指日常生活自理能力部分或完全缺失的情况，包括行走、吃饭、穿衣、洗澡、如厕、洗衣、做饭、服药、理财、使用交通工具等能力[1]。丧失生活自理能力的老年人称为“失能老人”。失能老人问题是近年来日益凸现的社会问题，也是人口老龄化过程中暴露晚、解决难度大的问题。中国是未富先老的国家，人口老龄化超前于现代化，失能老年人口的迅速增长始料不及，相应的服务发展严重滞后，不能有效满足失能老人的多元需求。根据2013年《中国老龄事业发展报告》蓝皮书可知，截至目前，我国老年人口数量已突破2亿大关，占全国总人口的14.8%，并且每年还将增长100万人。失能老人有3750万人，比2011年底增加400万人。预计到2015年，我国部分失能和完全失能老年人将达4000万人，占总体老年人口的19.5%。其中完全失能老年人会有1240万人，占总体老年人口的6.05%[2]。如何有效解决其日常生活和照护问题，不仅牵涉到每一位失能老人和他们的家庭，也是关系到我国社会稳定和发展的大事。社区居家养老是以家庭为核心，以社区为依托，，以老年人日间照料、生活护理、家政服务和精神慰藉为主要内容，以上门服务和社区日托为主要形式，并引入养老机构专业化服务方式的居家养老服务体系[3]。它的提出是当前人口老龄化发展的客观要求，是人们基于家庭养老功能的急剧弱化和机构养老的不成熟性而做出的必然选择。这种养老方式既满足了城市失能老人在居住地养老的生活习惯，又避免了在机构养老亲情淡泊及传统家庭养老存在的诸多问题。鉴于目前我国农村社区正在逐渐形成、发展之中，而城市社区发展态势良好、日趋完善，倡导社区居家照护服务方式更有条件。因此，本文结合城市社区失能老人的自身实际，探讨提升城市失能老人社区居家照护服务工作质量的相应对策。运用需求层次、社会嵌入、市场失灵和新公共管理等理论，通过问卷调查、个案访谈等方式，分析了我国城市失能老人的生存现状和养老需求，将失能老人的需求归结为生存照料需求、医疗康复需求以及精神慰藉需求三点，囊括了失能老人居家照护服务需求的各个方面。与此同时探讨了完善城市社区居家照护服务工作的必要性，同时指出了现阶段发展城市社区居家照护服务存在的相关问题，并在此基础上提出推进城市社区居家照护服务工作发展的对策建议，即从政府和市场角度做好资金支持、健全政策管理、大力发展医疗卫生服务、加强服务人员队伍建设以及扩大宣传教育这五个方面予以提高城市社区居家照护服务工作的发展水平，进而在完善和充实社区居家照护服务的政策基础上逐步提升社区居家照护服务工作质量，为各级政府出台相应城市失能老人社区居家照护服务的政策建言献策。
[Abstract]:"disability" refers to situations in which the ability to take care of oneself in daily life is partially or completely lacking, including walking, eating, dressing, bathing, toilet, laundry, cooking, taking medicine, managing finances, and using transportation [1]. Old people who lose the ability to take care of themselves are called "disabled old people". The problem of the disabled elderly is a social problem that has become increasingly prominent in recent years, and it is also a difficult problem to solve because of the late exposure in the process of population aging. China is an old country before the rich, the aging population is ahead of modernization, the rapid growth of the disabled elderly population is unexpected, the development of corresponding services is seriously lagging behind, and can not effectively meet the multiple needs of the disabled elderly. According to the Blue Book of the report on the Development of China's Aging cause in 2013, the number of the elderly population in China has exceeded the 200 million mark, accounting for 14.8% of the total population of the country, and it will increase by 1 million people every year. There were 37.5 million disabled people, 4 million more than at the end of 2011. It is estimated that by 2015, the number of partially disabled and totally disabled elderly people in China will reach 40 million, accounting for 19.5% of the total elderly population. Among them, totally disabled elderly people will have 12.4 million people, accounting for 6.05% of the total elderly population [2]. How to effectively solve the problem of daily life and care not only involves every disabled old man and their family, but also relates to the social stability and development of our country. The family as the core, the community as the support, the elderly day care, life care, domestic service and spiritual comfort as the main content, home service and community day care as the main forms. And the introduction of professional services of pension institutions home pension service system [3]. It is the objective requirement of the current aging population and the inevitable choice based on the sharp weakening of the family pension function and the immaturity of the institutional pension. This way of providing for the aged not only satisfies the living habits of the urban disabled elderly in their residence, but also avoids the problems existing in the institutional care for the aged and the problems existing in the traditional family pension. In view of the fact that the rural community is gradually forming and developing in our country and the development of urban community is good and perfect day by day, it is more suitable to advocate the way of community home care service. Therefore, combining with the reality of the disabled elderly in urban communities, this paper discusses the corresponding countermeasures to improve the quality of residential care services for the disabled elderly in urban communities. Based on the theories of demand level, social embedding, market failure and new public management, this paper analyzes the existing situation and pension demand of urban disabled elderly in China by means of questionnaire survey, case interview and so on. The needs of the disabled are reduced to the needs of survival care, medical rehabilitation and spiritual comfort, which include all aspects of the needs of residential care services for the disabled. At the same time, it probes into the necessity of perfecting the work of home care service in urban community, and points out the problems existing in the development of home care service in urban community at the present stage. On this basis, the author puts forward the countermeasures and suggestions to promote the development of residential care services in urban communities, that is, to do a good job of financial support from the perspective of the government and the market, to improve policy management, and to vigorously develop medical and health services. Strengthening the construction of service staff and expanding publicity and education to improve the development level of residential care services in urban communities, Then, on the basis of perfecting and enriching the policy of community home care service, the quality of community home care service can be improved step by step, so as to provide suggestions for the government at all levels to issue the corresponding policy of community home care service for the disabled elderly in cities.
【学位授予单位】：重庆大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：D669.6

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