China Youth Daily Zhongqing Online Reporter Wang Source: China Youth Daily (2065438+March 09, 2007, 06 edition)
The rehabilitation teacher takes the elderly in the community to do towel exercises. Wang Yujie/photo
The nursing home just made the bed for the elderly this morning. Wang Yujie/photo
The word "aging" is not a strange word in China today. Nowadays, aging is becoming an important topic related to the sustained and stable development of China's economy.
This is especially true in Shanghai. Shanghai is the first city with the highest aging population in China. By the end of 20 15, this modern and fashionable city has accumulated 4.36 million registered elderly people over 60 years old, accounting for 30.2% of the registered population in the city.
The huge elderly population base, coupled with the slightly lagging old-age service system compared with developed countries, has brought great challenges to this city. Recently, an interview with China Youth Daily and Zhongqing Online reporter found that a new model of "community pension" is being rolled out all over Shanghai. Compared with comprehensive old-age care institutions, it is more suitable for most elderly people and more "close to the people".
Pension service higher than the standard of "early education institution"
In an old community in Lujiazui Street, Pudong New Area, Shanghai, there is a "nursing home" with a high reputation among the elderly-the hardware decoration is comparable to that of a four-star hotel, and the software service is higher than the five-star standard.
China Youth Daily Zhongqing Online reporter noticed that this nursing home with a total construction area of 1.060 square meters looks more like an "early education institution" with complete facilities at first glance.
Every step on the stairs is marked with brightly colored stickers. From the first floor to the second floor, the elderly will get a big reward-congratulations on completing this "climbing trip". 24 steps in the whole process; Next to each bed are cartoon cushions and family photos that the elderly like. When you need private space, you can have an independent small room by pulling open the wooden movable door. There is a doggerel in the activity room, and the words "four and ten" are written on the blackboard, which is one of the courses to help the elderly exercise their oral muscle strength today; On the floor of the demented elderly area, there is a step label of 1 ~ 12, which is the "starting point" and "end point" of daily exercise for the elderly. Due to the decline of memory, even the most basic walking according to the label is a kind of "exercise" for some elderly people.
If I don't tell you, I'm afraid you can't imagine that this is a public welfare pension institution run by the government. No matter from the service or hardware conditions, it seems that this should not be a "government-supported" service, but more like a market-oriented "early education institution".
According to Chen Yuebing, director of the aging work department of Shanghai Civil Affairs Bureau, the goal of providing for the aged in Shanghai during the 13th Five-Year Plan period has developed from the past inclusive old-age services to diversification. "I used to say that the government is at the bottom, and the government runs an old-age care institution, which feels like a poor-level service. Now we are provided with venues by the government, inviting social organizations to settle in, and providing more dynamic services by the way that the elderly pay a small part of their own expenses. "
From the second half of 20 14, Shanghai has successively launched "home care for the aged" similar to Lujiazui's comprehensive home care for the aged. This embedded, multifunctional and miniaturized community pension facility can provide nearby, convenient and comprehensive services for the elderly. At present, there are 73 parents' care centers in Shanghai, and it is estimated that by the end of 20 17, they will cover all blocks in the central city and suburban urbanized areas.
With the birth of the new model, the government no longer "directly" provides for the aged.
During the "Twelfth Five-Year Plan" period, China's old-age service model can be simply summarized as "9073"-that is, family self-care, community home-based old-age service and institutional old-age service are integrated. 90% of the elderly care at home, 7% in the community and 3% in the old-age care institutions.
In the "Thirteenth Five-Year Plan", the development of the new aging population puts forward new requirements for the old-age care model. In Shanghai, the comprehensive service supply system is emphasized. Ideally, the "post-90 s, post-7 s and post-3 s" groups can be provided with comprehensive services by the same elderly service institution.
"In the past, government-run pension facilities were mainly to meet the needs of healthy and young elderly people; Nowadays, there are more and more disabled, demented and elderly people living alone in the community. How can we satisfy this part? " Chen Yuebing said that the solution in Shanghai is that the government and social enterprises jointly provide old-age care services, and the elderly can enjoy the services and pay for themselves.
Take Lujiazui Comprehensive Nursing Hospital as an example. Its location and buildings were originally public facilities in the community. The local government purchased the service of Shanghai Fuyuan Pension Service Center through bidding. This service institution for the aged has participated in the construction of nursing homes for the aged since the transformation.
Yu Ling, manager of Fuyuan Pension Consulting Department, told China Youth Daily and Zhongqing Online reporter that the decoration, space utilization and consulting planning of this venue are all involved. "In addition to the more reasonable hardware settings, the employment of service personnel is also managed by us."
This old-age care institution has various types of service personnel, such as rehabilitation workers, nurses, social workers and volunteers. The number of service personnel is required by the local government according to the actual needs of the elderly in the region and the unified standards of the whole city.
This morning, China Youth Daily Zhongqing Online reporter saw in the non-disabled area on the first floor that old people were doing daily towel exercises with rehabilitation teachers. This simple towel twisting exercise is said to effectively exercise the finger movement ability of the elderly.
Here, there are only 32 beds and 30 bunks ("bunks" are aimed at the reception ability of the elderly-reporter's note), and in a community, which old people can live and which old people can't live is a big issue related to fairness.
Aunt Zheng, an elderly person living alone, registered through the WeChat platform "Lujiazui Online" and successfully stayed in a comprehensive care home. 14 days ago, she was hospitalized for surgery because of a broken leg. After leaving the hospital, she went straight to a two-room nursing home. Living here for one day, she needs to pay about 150 yuan's nursing expenses, plus meals. This charging standard is unified throughout the city.
Every night, the aunt on duty will help her go to the toilet at night. "Attitude is very good. Some old people give up four or five times a night, and aunts have no complaints. " This is much more cost-effective than spending five or six thousand yuan a month to hire a live-in nanny. "Nanny doesn't care about salary. Many people have heard that they have to take care of the elderly and left without looking back. "
Aunt Zheng introduced that during her stay in the hospital, she submitted her application through the Internet. Later, the street social worker went directly to the hospital to evaluate her condition, and she was admitted to the nursing home only after passing the evaluation.
According to Chen Yuebing, this evaluation system is unified in the whole city. Its full name is "Municipal Elderly Care Unified Needs Assessment Information Management System". Through various meticulous standards, the elderly in different situations are divided into six grades. Some people can fully enjoy the government's "bottom-up" service, but more people can enjoy the service "at their own expense and by the government" after the evaluation. All applicants' information is stored in the system, which is convenient for finding, supervising and uniformly allocating resources.
Serving the "disabled" and "demented" elderly well is the ability to "cover the bottom"
One of the basic requirements of Shanghai for these nursing homes for the aged is to provide services for the disabled and demented elderly. Chen Yuebing said that in the past, public pension institutions could never find a suitable "marketization road", but now with the national policy gradually allowing private pension service institutions to enter, public institutions have also found a suitable marketization road. "In addition to non-governmental organizations, we also encourage responsible enterprises to participate in operations."
Whether it can provide services for the disabled and demented elderly has become a focus of "competition".
In the process of population aging in China, the most prominent problem at present is the rapid increase in the number of disabled and demented elderly people. The latest statistics show that there are more than 40 million disabled and demented elderly people in China, and their pension and medical problems directly affect more than 654.38 billion families.
In Shanghai, Aunt Xu, a white-haired old lady with mental retardation, got lost many times. Recently, her family sent her to a community nursing home for evaluation. During the evaluation, the nursing home allowed her to stay here temporarily and receive care.
"This is really a crowd that the government needs to cover, which has helped a lot." Xu Jiaren told China Youth Daily and Zhongqing Online reporter that for the custody of Mrs. Xu Lao, the whole family ran away 10, but none of them ran away, and all of them were confiscated. "The risk is too great to accept."
Then, in such a high-risk situation, how can the nursing home jointly organized by the government and social organizations help the disabled and demented elderly?
Yu Ling told reporters that in the past, it was not that institutions were unwilling to take care of the disabled and demented elderly, but that they were "afraid to touch" this group. "From a management point of view, as long as management is in place, the risk is not great. But on the one hand, everyone is afraid of emergencies, on the other hand, they are unwilling to pay high management costs, so they all love to' grab' the health of the elderly. " Yu Ling introduced that the current situation is that if an old-age care service agency wants to cooperate with the government to provide for the elderly, then in addition to accepting the health of the elderly in a community, the disabled and demented elderly are also "standard".
Compared with the past, the elderly with service disability and dementia are more "insurance".
It is reported that since 20 15, Shanghai has implemented the policy of "rewarding the elderly with awards instead of compensation", and rewarded qualified old-age service institutions from three aspects: the establishment of medical institutions, the recruitment of professional and technical personnel, and brand chain operation. In order to help the old-age care institutions guard against operational risks, Shanghai has also launched the "Comprehensive Liability Insurance for Old-age Care Institutions", with the premiums borne by the cities, districts and old-age care institutions.
By the end of 20 15, 87% of the old-age care institutions were insured, and the incidence of 100-bed cases showed a downward trend.
From 20 17 to 1, Shanghai has also launched comprehensive insurance for community-based aged care services covering the responsibilities of service personnel, clients and third parties, helping community-based aged care services reduce operational risks.
Every pension service institution will have a "score" in Shanghai Civil Affairs Bureau in the future. At present, more than 200 old-age care institutions in Shanghai have been evaluated in terms of facilities, equipment, management level, service quality and social reputation. According to the plan, it will take two to three years to achieve full coverage of the rating of the old-age care institutions in Shanghai.
References:
News reports of Zhongqing Online
Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.