农村高龄失能老年人居家照护现状、发展困境与政策体系优化

Current Status,Development Dilemmas and Policy Optimization of Home Care Services for Oldest-old Rural Adults with Disabilities

失能老年人是整个养老服务体系中社会需求迫切、对技术要求高、服务难度大的群体之一。在人口老龄化趋向高龄化、失能风险加剧背景下,如何加强失能老年人照护服务有效供给日益成为重要的社会议题。本文结合民政部政策研究中心2020年8至9月在山东和浙江两省针对农村失能老年人采集的调查数据,分析农村高龄失能老年人居家照护现状和发展困境,为积极应对人口老龄化、改善该群体照护效果提供参考依据。研究发现,九成以上的农村高龄失能老年人愿意在家接受照护服务,但该群体医疗护理服务、精神慰藉服务“需求-供给”缺口较大。长时间、高强度的照护工作使得重度失能家庭照护者承受身心健康、经济方面、社会生活维度的多重负担,而我国尚未建立起成熟完善的居家和社区照护服务体系。基于此,本文认为,未来养老服务体系优化应以破解农村高龄失能老年人照护服务筹资瓶颈为重点,探索打造多元协同、可持续的失能照护服务保障机制。

Older adults with disabilities are one of the most challenging groups within the entire elderly care service system,having urgent societal demands and requiring high-skilled and high-level services.Against the backdrop of the oldest-old population tending to grow with increased risk of disability in an aging society,how to effectively enhance the provision of care services for elderly individuals with disabilities is becoming an increasingly significant social topic.We analyzed the current status and development dilemmas of home care services for oldest-old rural adults with disabilities using the survey data regarding the care status of older rural adults with disabilities in Shandong and Zhejiang provinces collected by the Policy Research Center of the Ministry of Civil Affairs between August and September 2020,aiming to provide a reference for actively addressing population aging and improving care services quality for rural older adults with disabilities.Results showed that more than 90%of rural oldest-old adults with disabilities preferred to receive care services at home,and there existed significant gaps between the demand of this group for medical care and mental consolation services and the provision of these services.Due to long-term and highintensity care work,caregivers of rural oldest-old adults with disabilities often bear physical and mental health,economic,and social life burdens,yet China has not established a well-rounded home and community care services system for oldest-old rural adults with disabilities.Thus,the optimization of elderly care services system for this group should be targeted at breaking the financing bottleneck and building a sustainable multi-faceted care service guarantee mechanism.