Construction of Industrialization Development Model for"1+4+X"Community-Based Elderly Care in Gannan Old Revolutionary Base Area in the Context of Population Aging

In the context of controlling population development in a planned way,China entered an aging society in the early 21 st century.In this context,how to meet the needs of the elderly care and form an effective elderly care model has become a key problem to be solved urgently by local government departments.With the continuous advancement of the elderly care policy,the community-based elderly care has gradually become the mainstream and is in the stage of vigorous promotion.Taking the Gannan old revolutionary base area in Jiangxi Province as an example,this study puts forward"1+4+X"community-based elderly care model based on the policy system of community-based elderly care,the physical and mental health of the elderly,the material space and the construction of evaluation system,and explores how to promote the application of this community model efficiently in the form of industrialization,so as to drive the economic growth of the Gannan old revolutionary base area,promote the employment development and improve the community-based elderly care service.

Circumstances of falls and fall-related injuries among frail elderly under home care in China

This exploratory study investigated the circumstances of falls and fall-related injuries among frail elderly people under home care.A convenience sample of 500 frail elderly(60 e99 years old)from the Wanshoulu and Yuyuantan communities in Beijing's Haidian District during February 2013 and March 2014.Fall circumstances and related injuries were characterized by detailed interviews and questionnaires.The article reports the results of a study that the overall fall incidence was 41.5%,and higher for females than males.Falls mainly occurred in individuals who were over 80 years old(50.0%)and indoors(67.9%).The percentage of subjects who experienced a combined injury after the fall was 56.3%,whereas 19.0%fell causes a fracture.Approximately 35%of the subjects were hospitalized,and 27.6%of the subjects recovered more than 30 days.Results indicate that,falls in the frail elderly caused serious damage,and fall-related circumstances should be a great concern in this population.

The research of the community-home elderly long-term care service system

With the rapid development of the aging of the population, the demand of long-term care services in the elderly is growing. Because of family miniaturization, core, and currently limited social accumulation are difficult to meet the demand of the elderly in long-term care.Community provides the elderly long-term care services, and provides the elderly all kinds of household helping services. They just make up for the inadequacy of the family and society.And how to make the community elderly long-term care services become more suitable for the needs of the elderly at home, provide better service for the elderly, are our current problems to be solved.

Changes and Development of Home and Community Based Elderly Care Service Policies in China

This paper analyzes the current situation of the development of home and community based elderly care service in China,points out the existing problems,and puts forward improvement measures,aiming to deepen the understanding of HCBS and promote the theoretical research and practice of community home-based elderly care service.

Study of the Possible Use of a Home-Visit Nursing Interventional Lymphedema Care Program for Secondary Lymphedema in the Elderly at Home

Objective: This study aimed to clarify the possible use of and points to improve a home-visit nursing interventional lymphedema care program (plan) we developed. Methods: The subjects were visiting nurses with at least three years of home-visit nursing experience and experience with lymphedema care for the elderly at home. Semi-structured interviews were conducted, and the collected opinions were aggregated and summarized. Results: Based on interviews with nine subjects, opinions regarding the use of the program, such as “The assessment perspective at the time of introduction helps to grasp the needs for a wide variety of subjects”, and regarding points to improve, such as “It is necessary to set the duration and timing of the section considering the frequency of visits and degree of edema at the time of introduction” and “It is necessary to have a perspective concerning efforts to maintain motivation for care of the elderly and their families”, were aggregated. Discussion: The results of the interviews were generally useful for the structure and development of the program, care methods and content, and interventions for influencing factors. Consideration of setting the timing according to the degree of lymphedema, modification of the program’s development, development of a program that fully considers the degree of edema at the time of introduction and the acceptance of edema among the elderly, and the need to consider the care content that should be given priority were suggested as points for improvement.

The home healthcare nursing services provided to the elderly patients: a systematic review

Background:Home healthcare(HHC)services entail quality and transitional care offered to patients.Doctors recommend HHC to the elderly patients to manage conditions and improve outcomes outside inpatient setting.The systematic review aimed to assess the home health care nurse services to elderly patients.The question of this study is“what are the home nursing care services provided to the elderly patient.Methods:A systematic review methodology was adopted.A search was conducted on PubMed,MEDLINE,and ScienceDirect using keywords such as“home healthcare”,“nurse services”,“home nurses”,“elderly patients”.The search generated 1829 articles,but 16 were selected for qualitative synthesis for meeting the eligibility criteria.Joana Briggs Institute’s critical appraisal tools helped in the assessment of the primary studies.A data extraction matrix generated themes,while a narrative synthesis presented the studies.Results:The review found administration of HHC nursing services in different settings.The studies confirmed varied nature of HHC,types of HHC services,transitional care,challenges,or barriers of offering HHC,relationships,and decision-making process in offering care to the patients and family.The studies presented HHC as a multifaceted component with diverse impact on the patients and family.The analysis revealed that HHC nurses services served elderly persons as the main target group.HHC faces different challenges,barriers,or obstacles such as work,role conflict,organization,elderly patients,and decision-making.Conclusion and Future Research:The assessment of the HHC nursing services provided to the elderly patients reveals different facets of the healthcare process that reduce readmissions and hospital costs.Further studies could explore the provision of care to other target groups such as middle-aged patients to understand the impact of the services.

“Care That Respects Individuality” Provided to Elderly People with Dementia as Perceived by Japanese Dementia Carers Qualified

The objective of this study was to clarify the contents of “care that respects individuality” provided to elderly people with dementia living in group homes as perceived by dementia carers qualified. We interviewed 21 dementia carers qualified working at group homes in Prefecture A about the practical contents of and their thoughts on “care that respects individuality”. The data obtained from the interviews were analyzed using the modified grounded theory approach (M-GTA). As a result, 14 concepts regarding the contents of “care that respects individuality” provided to elderly people with dementia living in group homes as perceived by dementia carers qualified were generated in the following 4 categories: “placing emphasis on the individual”, “respecting feelings”, “eliciting strengths”, and “close mutual relationship”.

The Experiences of the Elderly and Caregivers in Respect of Caring for the Elderly in Windhoek and Rehoboth Namibia: An Exploratory and Descriptive Study

In many instances, care for the elderly, especially in long-term care institutions, is provided under minimal supervision by caregivers who are lay people. This can lead to poor quality care or neglect of the elderly. The research question was: “How competent are lay caregivers for the elderly in old age homes, who often lack the opportunity for training to improve their knowledge and skills, in delivering care to the elderly? The aims of the study were to explore and describe the experiences of both the caregivers and the elderly in respect of caring for the elderly in old age homes. The objectives of the study were to explore and describe the experiences of the caregivers and the elderly with respect to caring for the elderly and in respect of nursing care they received. A qualitative, explorative, descriptive, contextual and phenomenology design was used to perform this study. In the situational analysis, the experiences and needs of the caregivers were described. Themes in terms of interpersonal relationships that could be positive or negative regarding the elderly were identified. These included lack of regular in-service training sessions for caregivers. Likewise, sub-themes like communication, support and caring for elderly people were revealed. Inadequate knowledge of caregivers in caring procedures, a shortage of staff, equipment and absence of policies which should support and guide the work of caregivers impacts negatively on the care of the elderly. From the experiences of the elderly and caregivers, the competencies under scrutiny emerged and were measured qualitatively by the perceptions of the elderly, in respect of the caring they were exposed to.

Cultural Sensitivity of a Community-Based Falls Prevention Program Targeting Older Arab American

Falls are a frequent and costly cause of injuries and functional decline in the elderly. Tai Chi is a cost-effective strategy for preventing falls in older adults. Many senior centers have introduced Tai Chi programs to increase mobility and decrease the risk of falls. However, the practice has yet to be widely disseminated to ethnic minorities who are not culturally connected to Tai Chi. This paper describes implementation barriers and recruitment and retention challenges of Arab American participants in a Tai Chi intervention-based health promotion program, including issues related to community organization and staffing, recruitment and retention, need for building relationships, need for translation and interpreters, and cultural barriers & misconceptions. Understanding and paying adequate attention to these challenges may help facilitate in planning other health promotion interventions targeting Arab American population.

Sleeping Conditions of Older Adults with Delirium Receiving Home Care

We aimed to clarify the sleep status before delirium onset among older adults receiving home care. The sleep status of 21 participants aged ≥65 years was monitored while they slept with a sensor placed under their bedding, after ruling out insomnia and dementia. The incidence of delirium was 28.6%;delirium onset occurred within an average of 2.7 (SD = 12) days after the start of home care among those whose care environment was changed due to hospital discharge or moving. Increased interrupted sleep and activity during sleep indicated that sleep fragmentation occurred before delirium onset. In conclusion, individuals aged ≥65 years and those whose care environment has changed should be screened for delirium because the time to delirium onset is short. Further, interventions to monitor the sleep status and prevent delirium onset should be implemented from the day home care begins.

Community-based elderly care services in China: an analysis based on the 2018 wave of the CLHLS Survey

Community-based elderly care services play an important role in dealing with popu-lation aging.Based data from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey,we found that overall there was high demand for community-based elderly care services,but insufficient supply,resulting in unmet needs.The greatest demand was for medical care and nursing services and these were gener-ally more accessible compared to other services.The imbalance between available supply and elderly demand was greatest for personal care and psychological con-sulting services.Additionally,there were obvious imbalances of supply and demand for particular groups of the elderly population.In terms of demand,the young-old living in eastern and western China or urban areas had stronger demand for com-munity-based elderly care services.Elderly people with serious disabilities or low income,or living in rural areas and towns had more demand for home visit medical services,while the elderly with the ability to care for themselves or high incomes needed more social and entertainment services.With respect to inadequate supply,the demands for community-based elderly care services of the low-income elderly living in rural areas and towns or in western China were more likely to be unmet.Our results indicated that appropriate services should be provided by government agencies and institutions to meet the needs of various groups.It is also important to increase accessibility to community-based elderly care services as well as to guaran-tee an equitable distribution of supply.

中国老年人口健康状况及其家庭照料需求预测

中国人口老龄化快速发展,失能、半失能老年人口规模迅速扩大,老年照料需求快速增加。科学预测不同失能状况老年人口规模及其照料服务需求是推动老年照护服务体系建设的重要基础。文章基于中国老年健康影响因素跟踪调查(CLHLS)数据,使用Markov模型测算中国分性别、分年龄段老年人口健康状况转移矩阵,运用队列要素预测法、多元回归法等预测得到2020—2035年中国不同失能状况老年人口规模及其照料服务人员需求规模、家庭照料经济成本。预测结果显示:中国失能老年人口规模呈现增长态势,从2020年的1946万人增至2035年的3424万人,失能老年人口的比例从2020年的7.4%小幅增至2035年的7.9%,且中重度失能老年人口增幅更快,2035年时轻度失能老年人口规模相比2020年增加66%,中重度失能老年人口规模相比2020年增加92%。女性失能老年人口规模增速快于男性,80岁及以上老年人口失能比例增长更快,2035年男性70~79岁、80~89岁、90+岁三个年龄组失能老年人口规模分别为2020年的1.53倍、1.92倍、1.94倍;2035年女性三个年龄组失能老年人口规模分别为2020年的1.72倍、2.29倍、2.52倍。老年家庭照料需求将呈现快速增长态势,家庭照料服务人员需求量从2020年的2795万人增至2035年的4863万人,增长74%。2020—2035年健康老年人口的照料服务人员需求量占总需求量的比例在57%左右,中重度失能老年人口需求量占比在24%左右,轻度失能老年人口需求量占比在19%左右。60~69岁老年人口所需的照料服务人员占比最高,90岁及以上年龄组对照料服务人员的需求量增长更快。老年人口家庭照料经济成本从2020年的3027亿元增至2035年的11676亿元,将增长近3倍。中重度失能老年人口所需的家庭照料现金成本相比2020年增长3.1倍,轻度失能老年人口所需的家庭照料现金成本相比2020年增长2.6倍。男性老年人口所需家庭照料现金成本低于女性老年人口,且增速也低于女性老年人口。本研究基于定量预测结果提出积极推进健康老龄化,加大促进生育的政策支持力度,尽快推广长期照护保险制度,以赋能家庭为着力点加强失能老年人口的支持体系建设,大力发展老年护理服务业,大力发展养老护理职业教育等政策建议。

‘Smart Homes’May Help Care for Infirm, Elderly

伟大的21世纪正含笑向我们走来。科技已经并正在改变人类的生活。上文告诉我们所谓E-Books将要走入我们的学习,本文告诉我们Smart Homes也有了雏形。随着当今社会老年人的增多,这种Smart Homes前景看好。孤独,不仅仅是美国老人的痛苦。而Smart Homes能一扫此痛:It s a computer-aidedsystem,with about 30 sensors,that can talk and negotiate with the tenant.

interRAI家庭照护评估工具在社区居家老年人综合评估与照护需求分析中的初步应用

目的 ：使用inter RAI家庭照护评估工具分析社区居家老年人的健康状况与照护需求,同时验证该工具在我国老年人社区居家照护方面的可行性。方法：采用便利抽样方法抽取北京市西城区120例接受居家照护服务的老年人,使用inter RAI家庭照护评估工具进行调查,并使用inter RAI家庭照护评估工具所对应的临床评估协议分析老年人面临的主要健康问题及照护需求,与目前接受的照护服务进行对比分析。结果 ：老年人存在的健康问题涉及生理、心理、社会等多维度。每位老人存在的问题数目从1~5个不等,平均存在2个问题,且随着年龄的增长（rs=0.45,P=0.03）、患有慢性病种类的增加（rs=0.34,P=0.04）,老年人所伴有的健康问题也随之增多。老年人在心血管呼吸系统问题、疼痛、ADL受限、非正式社会支持不足、压疮风险等问题所接受的服务率相对较高,均达到70%以上;以健康促进不足、家庭环境优化、IADL受限、尿失禁、营养不良、身体活动不足等问题所接受的服务率相对较低,均未达到40%。结论：inter RAI家庭照护评估工具可以从老年综合评估的角度发现老年人存在的需要重点关注和干预的问题,为社区居家照护服务提供了具体的干预方向。未来可以进一步尝试使用该工具,并对社区居家照护的效果进行动态监测。

老年人对社会照顾方式偏好的影响因素分析——以浙江省为例

本文利用浙江省老龄科学研究中心2004年4月对浙江省5个城市老年人养老意愿做的调查数据,对老年人对生活照顾方式的偏好做分析。采用多变量logistic模型分析个人特征、家庭状况、身体状况、经济状况四个因素对老年人照顾方式选择的影响作用。家庭状况对老年人照顾方式的选择最为显著,身体状况和经济状况也有比较显著的影响,但个人特征对老年人对照顾方式的选择没有明显的影响。在此基础上笔者对未来老年人的照顾方式作预测,发现非正式照顾的选择有所下降,正式照顾以及居家养老逐渐得到老年人的青睐。

失智老人照护需求模式及影响因素分析

自行设计问卷,对失智老人的主要照护者进行面对面调查,分析失智老人的照护需求模式及其影响因素。结果显示,失智老人照护需求以专业照护机构为主(占75.76%);失能老人及其照护者的部分特征会影响照护模式的选择意愿。失智老人的照护需求模式呈多元化态势,建议大力发展失智老人专业照护机构,加大专业照护对社区—居家照护的支持,分级、分类为失智老人提供照护服务。

城乡失能老人社区居家照护服务的差异及对策

随着人口老龄化进程的加快,我国失能老人比例不断攀升。城乡失能老人社区居家照护服务发展不协调。在调查的基础上通过对比分析,发现城乡在社区居家照护服务方式、主体、内容以及基础条件等方面均存在较大差异,总体来看城市较之农村有明显优势。应从加大健康教育培训力度和政府照护资金投入、缩小城乡照护服务内容差距等方面统筹推进城乡失能老人社区居家照护服务体系建设,推动社会公共养老服务均等化,改善失能老人的生活质量。

当前城市民办养老服务机构发展中的问题及相关政策分析

目前我国城市养老服务机构的运营发展当中存在的主要问题一方面是当前养老机构数量还远远不能满足未来需求,另一方面是现有养老服务资源未能充分发挥其作用。问题的深层原因在于养老服务机构在服务能力和服务质量方面存在不足,并由此而导致低价格—低质量—低入住率的恶性循环。本文认为,各级政府和公众应该进一步重视民办养老服务机构的建设,坚持数量与质量并重的原则,通过政府和社会的支持而形成"质量提升—入住意愿加强—养老服务机构数量增加和经营状况改善—服务质量进一步提升"的良性循环。

机构养老与孝道:南京养老机构调查的初步分析

三十多年来计划生育政策的一个后果是我国人口结构的变化,特别是老龄人口的增加。城市中机构养老的方式开始成为家庭养老的一种补充。由于这一养老方式与中国传统文化中与家庭养老方式密切相关的孝道观念形成了一定的冲突,因此它所带来的人们对"孝道"认知的改变值得特别关注。通过对南京养老机构中老人及其子女的个案访谈资料,初步分析和探讨了与机构养老有关的养老方式及其孝道问题。结果发现,城市老人选择机构养老的原因包括子女工作忙、家中无人照料、住房紧张、与子女关系不好、长期生病等。对于机构养老的态度既有满意的,也有观望不定的,还有消极抵触的。而其子女的态度也是既有积极的,也有矛盾的。但无论老人还是子女,都不认为老人进机构养老是子女不孝顺的表现。

社会转型期农村养老的主体模式:社会保险抑或家庭保障

20世纪80年代以来,制度性社会养老保险成为构建中国农村养老体系的核心议题,但20多年来的农村社会养老保险改革目前尚未实现预期目标。社会转型期农村家庭结构的变迁对家庭养老功能带来双重影响,表现出结构性特征。与社会养老相比,家庭养老的低成本、精准化等特征使其在经济扶持、生活照料、精神慰藉方面仍具优势。在目前甚至较长期的社会转型期,家庭养老应当成为我国农村养老的主体模式。构建政府支持的家庭支持计划对于稳定、拓展家庭养老功能不可或缺,而社会养老保险值得长期建立。