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"Doorstep" pension: how to make the elderly more at ease and more comfortable?

There are 297 million elderly people aged 60 and above in mainland China, and more than ninety percent of the elderly choose to care for the elderly at home.

In the face of such a huge demand -

"Doorstep" pension happiness comes like this

"We are not around, and we are constantly worried about what to do if the elderly feel lonely, and what to do if they fall and faint. I still don't feel at ease about hiring someone to take care of it. Ms. Li, who lives in Fengtai District, Beijing, told reporters about her concerns about home care for the elderly.

Ms. Li's mother, who is in her 80s, lives alone in Xining, Qinghai Province, and is physically strong enough to take care of herself, and her three meals a day are provided by the community canteen. However, the mother's growing age and the distance of more than 1,600 kilometers still made Ms. Li feel at ease.

Home care is a realistic choice for the vast majority of elderly people in mainland China. In order to allow the elderly to live happily at the "doorstep", various regions and departments continue to launch home and community elderly care services such as meal assistance services for the elderly, renovation for the elderly, and family care beds. However, on the whole, there is still a gap between the supply of home-based and community-based elderly care services in mainland China and the actual needs of the elderly. In some places, the old-age care services provided can only meet the daily needs of the elderly, but cannot solve the spiritual needs of the elderly. The total number and professionalism of pension service talents also need to be improved.

How much support is needed behind home care? How to make home care more reassuring and comfortable for the elderly? The reporter conducted an interview and investigation.

What the elderly want

-- Pension services should meet diverse needs

"The elderly in the family are sick and bedridden, unable to eat independently, and daily care is a big problem. Since I retired, I have been taking care of the elderly, and I feel that my ability to take care of them is insufficient, and sometimes I have to take care of my granddaughter, which is really unbearable for a long time. Ms. Ren, a resident of Bindong Community, Pingyang Road Street, Xiaodian District, Taiyuan City, Shanxi Province, said that many families are most worried about when taking care of the elderly - "one person is disabled, and the whole family is out of balance."

"Sometimes I also want to send the elderly to a professional nursing institution, but after consulting several elderly care institutions, the cost of taking care of the disabled elderly is about 10,000 yuan per month, and the financial pressure is difficult to bear. If you ask a nurse to come to the door, the cost will be at least 6,000 yuan per month, and the better nurses can't grab it at all without opening a high price, so now they can only carry it themselves. Ms. Ren said helplessly.

Solving this problem means providing more refined care services for the disabled elderly in home care. In recent years, in order to make home care for the disabled elderly more at ease, the Ministry of Civil Affairs has guided all localities to continue to promote the renovation of homes for the elderly with special difficulties around the blocking points and pain points of home care for the disabled, and by the end of 2023, a total of 1,482,800 households have been renovated across the country.

The home care service for the elderly is also more standardized. In 2023, the first national standard for home-based elderly care services, "Basic Specifications for Home-based Elderly Care Services", will be released, reasonably defining the scope of services, standardizing the qualification conditions of the supply entity and the content requirements of the supply process. The "Specification for Home Rehabilitation Services for the Elderly" regulates the basic requirements, service content, service process, service evaluation and improvement of home rehabilitation services. The "Specification for Bathing Service for the Elderly" regulates the basic requirements, service process, risk control and accident handling of household bathing.

In Weishuiyuan Community, Maying Town, High-tech Zone, Baoji City, Shaanxi Province, Hui Life Elderly Care Service Center is quite popular with the elderly nearby. Chen Qiaoyan, the person in charge of the center, introduced that the first floor of the center has a reading area, a chess room, a table tennis room, a dance room, a calligraphy room, a painting room and other activity venues, the yard can play badminton, and there are elderly people here every day. Many elderly people said that after staying at the center, they didn't want to leave."

Grandma Zheng, 72, is a member of the Weishuiyuan Community Choir, and she often performs at the center with her teammates. "I think the meaning of the name 'Hui Life' is particularly good, which is to remind us that the elderly should 'know how to live'." Grandma Zheng said.

Jin Li, a member of the National Committee of the Chinese People's Political Consultative Conference (CPPCC) and vice president of Southern University of Science and Technology, believes that in order to better realize home and community care, the most fundamental thing is to allow the elderly to enjoy high-quality elderly care services without leaving the familiar living environment, and promote the elderly to "enjoy old age". However, at present, the development of home and community elderly care services still faces many challenges. Taking the "combination of medical care and elderly care" as an example, many elderly people at home suffer from chronic diseases and need more detailed care, but often, the community only has information such as the number of elderly people at home and the status of family members, but ignores the health status and medical status of the elderly at home. As a result, the elderly at home will face the risk of untimely delivery to the hospital, and the government still needs to actively take the lead in exploring diversified service models.

In this regard, the relevant person in charge of the Department of Pension Services of the Ministry of Civil Affairs said that the form of home and community pension services will be further enriched. At the community level, focus on the development of short-term care, day care, health management, psychological support and other services, vigorously develop meal, cleaning, bathing, walking, medical, emergency and other home-based elderly care services, encourage and guide chain operation, standardized management of elderly care service institutions rely on the community to provide life care, rehabilitation care, spiritual comfort, emergency rescue and other professional services to the elderly at home, to provide support for the elderly at home.

The talent gap remains

-- The construction of the senior service talent team needs to be strengthened urgently

In interviews with reporters, many elderly people said that they hope to receive professional care whether they are at home or in nursing homes.

Grandpa Zhao, who is over 80 years old, has been suffering from Alzheimer's disease for 3 years, and finding professional and suitable caregivers has always been the top priority for Grandpa Zhao's family.

After learning that the Jinzhong Street Elderly Care Service Center in Dongli District, Tianjin can provide professional services for the elderly with dementia, the family sent Grandpa Zhao here. "Grandpa Zhao likes to be alone, fiddling with old things, and he can sit alone for an afternoon." Wang Shuying, a nursing staff at the center, said that for elderly people with dementia like Grandpa Zhao, the nursing staff will help them improve their cognitive function by playing games and touching objects.

"Thank you so much for your kindness, not only volunteering to help my wife with rehabilitation physiotherapy and psychological counseling, but also cleaning the air conditioner for us for free." A few days ago, Aunt Zhao, who lives in R&F Community, Danzishi Street, Nan'an District, Chongqing, held the hand of social worker Xiao Zhuo tightly to express her gratitude.

It turned out that Aunt Zhao, who was nearly seventy years old, was paralyzed by her wife's cerebral infarction and needed to be taken care of by her husband's side 24 hours a day.

After learning of the situation, Chongqing Jishan Social Work Service Center formulated a service plan of "rehabilitation physiotherapy + life care", organized professional rehabilitation therapists, nurses, and social workers to intervene, regularly provided emotional counseling and housekeeping services for Aunt Zhao's wife, and also helped her recover some physical and speech functions. Today, he is able to stretch his arms and legs slowly, and is even able to stand on his own with the help of a walking aid and express himself in simple words. Aunt Zhao's psychological pressure and care pressure have also been greatly relieved.

In recent years, thanks to the efforts of various localities to open up the career promotion channel of elderly care talents and continuously improve the overall level of the elderly care service industry, the development environment of elderly service talents has been improved to a certain extent. However, pension service personnel still face many practical problems when they are employed: low salary, low social status and recognition, and family support. "People around me always say that you have hands and feet, what are you doing, isn't it a shame to feed the old man? Similar biases deeply hurt everyone's enthusiasm for work. An elderly care worker said helplessly.

The reporter contacted a student who had graduated from a school majoring in elderly service and management, and he told reporters: "The average salary we can get in this industry is low, the work intensity is very high, and dealing with the elderly often requires more patience, so many of my classmates have chosen to engage in other jobs after graduation, and only a small number of students will insist on working in the front line of pension." ”

It is gratifying that in recent years, the relevant departments have realized that the construction of the pension service talent team needs to be strengthened urgently, and have accelerated the pace of training related talents. For example, in 2023, the Ministry of Civil Affairs will organize and hold a national pension service work commendation and senior service talent team construction promotion conference, awarding 99 units the title of "National Advanced Unit of Pension Service" and 195 comrades the title of "National Advanced Individual of Pension Service", further stimulating the enthusiasm, initiative and creativity of promoting the construction of pension service talents in various places; Jiangsu Province issued the "Jiangsu Provincial Elderly Care Professional and Technical Qualification Conditions (Trial)", and took the lead in establishing a provincial-level professional and technical title system for elderly care on a pilot basis in the country. In addition, many regions also provide entry subsidies and post allowances to elderly care workers with secondary vocational education or high school education, college degree or above......

Dang Junwu, deputy director and researcher of the China Research Center on Aging, suggested that to solve the problem of the supply of pension service talents, the government, society, schools and other parties need to work together. On the one hand, it is necessary to improve the talent incentive policy and broaden the way of talent training; On the other hand, it is necessary to encourage local governments to explore the shortage of industries and high-skilled pension service practitioners into the talent catalog, points settlement, citizen treatment and other policy scopes for preferential treatment.

Aggregate into old service resources

——Better build a "quarter of an hour" pension service circle

In November 2021, the "Opinions on Strengthening the Work on Aging in the New Era" issued by the Central Committee of the Communist Party of China and the State Council proposed to innovate the home-based community elderly care service model. On the basis of home-based elderly care, through new construction, renovation, leasing and other means, improve the capacity of community elderly care services, focus on the development of street (township), urban and rural community two-level elderly care service network, relying on the community to develop home-based diversified elderly care services.

In recent years, all localities have focused on strengthening the construction of home-based community pension service networks, developing regional pension service centers with comprehensive functions such as full-day care, day care, door-to-door service, and regional coordination and guidance at the county (city, district) and township (street) levels, supporting and cultivating community pension service institutions with chain, branding, and large-scale operation, and innovating and developing service models such as community meal assistance, elderly dining tables, community day care, family pension beds, and pension consultants, so as to better build a "quarter of an hour" pension service circle.

The interviewed experts said that the construction of a "quarter of an hour" pension service circle means that various high-quality service resources will be gathered around the elderly, at home and around. Within a quarter of an hour's time frame, it can meet the daily life, medical care, social and other pension needs of the elderly. This type of elderly care service not only retains the advantages of home care, but also expands the scope of elderly care services.

At noon, the elderly canteen of the Lidong Community Happiness Home in Dali Town, Nanhai District, Foshan City, Guangdong Province was already full of elderly people dining, and they were eating delicious meals while discussing the afternoon's activities. The Happiness House is equipped with a community hospital, a happiness canteen, a cultural activity room, etc., which can provide rehabilitation physiotherapy and various cultural and entertainment programs for the elderly.

At present, there are more than 200 such community happiness homes in Nanhai District. According to the relevant person in charge of the Nanhai District Civil Affairs Bureau, at present, Nanhai District will present various resources such as pension platforms, service outlets, health and happiness stations, home care services, and social enterprises to create a "quarter of an hour" pension service circle, providing more than 10 kinds of services for the elderly, such as education, sports and entertainment, rehabilitation and health care, volunteer service, spiritual comfort, and day care, so that the home life of the elderly is richer and more convenient.

"In the next step, we will strengthen the construction of home and community elderly care service network. Guide all localities to build a number of demonstration home-based community old-age service networks with clear levels, institutional cohesion, complementary functions and regional linkage at the district and county levels according to population distribution, aging level, development trend and resource layout, so as to achieve full coverage of home-based community old-age care services for the elderly in the jurisdiction, and build a 'quarter-hour' home-based and community-based old-age care service circle, so that old-age care services can gather around, at home and around the elderly, and improve the accuracy, convenience and accessibility of services. The relevant person in charge of the Department of Pension Services of the Ministry of Civil Affairs said.

Editor: Li Kexin