【作者】 修宏方；

【导师】 唐钧；

【作者基本信息】 南开大学 ， 人口学， 2013， 博士

【摘要】 随着老年人口比例的上升,老龄化社会问题愈.显突出,如何解决社会老龄化问题显得尤为重要。尤其是现在老年人绝大多数是居住在家中，如何以社区为依托,整合各种社区资源,建立一种介于老人家庭照顾和社会、机构照顾之间、并运用社区资源开展的老人照方式,形成正规服务、社区志愿者及社会支持组成的的综合服务网络,兼有护理、医疗保健、家务服务、应急救援的综合性服务。实践表明,社区居家养老服务既是目前破解养老难题最经济、最可行的途径之一,也是发展社区服务业、推动社区就业再就业新的着力点,足促进家庭和谐、代际和谐、建设和谐社区的重要举措。根据研究的内容,确定了以公共社会学为研究的价值取向,定性研究与定量研究结合的研究方法。对老年人的养老服务需求采用了定量的研究方法,对居家养老服务需求及影响因素,运用定性研究的的方法进行深入的分析。定性研究过程中采用了深度访谈和话语分析的方法。调查工具为哈尔滨市60岁以上老年人居家养老服务需求调查表。深度访谈的对象分为五类,老年人、老年人家属、民政部门领导、养老机构领导、社区干部。主要探讨了社区服务对居家养老服务的支持状况,分析存在的问题及产生的原因。我国老龄化呈现出老龄化加速、高龄化加速、空巢化加速和失能老人增多的现象。并且对经济、政治、社会、文化的影响越来越重,对养老保障、社会服务和医疗卫生等方面形成了巨大的需求压力。老年人的生理变化和心理变化对他们的居家养老服务需求产生了很大影响。老年人的养老服务需求内容很多,异质性很强。主要有日常照料需求、医疗保健需求、精神慰藉需求和社会参与需求。健康状况下降导致了老年人对养老服务的刚性需求,但是老年人对养老服务的有效需求还受到经济状况、消费观念和,子女消费意愿的影响。老年人的的养老服务需求很多,而社区居家养老服务体系尚未建立。目前社区居家养老服务存在诸多问题。如,养老服务供需矛盾,养老服务员不专业,居家养老服务覆盖面窄,居家养老服务宣传不够,居家养老服务投入不足,居家养老服务缺乏监管等。国外和我国港台地区的社区居家养老服务都发展比较早,已经形成体系。但是,无论从老年人口的规模和老龄化的速度都与我们目前的状况有差距,因此,在学习具体的服务经验的同时,要积极思考适合我国具体情况的居家养老服务的模式,构建本土化的社区居家养老的服务体系,以适应不断加剧的老龄化形势。要整合居家养老服务各个主体的资源,适当引入市场机制,实现投入多元化。要建立一支稳定、专业、多元参与的居家养老服务队伍,注重专业人才的培养和使用,倡导老年人之间的互助服务。要扩充居家养老服务内容,使其更丰富、规范、符合老年人的身心需求。要建立居家养老与机构养老的衔接机制,形成可持续发展的体系,提高服务水平。要建立养老服务评估机制,包括服务需求评估、服务质量评估,发展中介性评估机构,促进评估人员职业化。要大力发展老年社会工作与专业服务,帮助老年人获取资源,争取权益,正确认识自身价值,提高适应能力,促进老年人的社会参与,帮助老年人适应老年期的角色变化。更多还原

【Abstract】 With the increase in the proportion of the elderly population, an aging society has become more prominent, how to solve the problem of an aging society is particularly important. Especially now that the vast majority of older people living at home, how to rely on community, integrating a variety of community resources, the establishment of a range of family care for the elderly and social, institutional care and use of community resources to carry out the elderly take care of the way the formation of regular services, community volunteers and social support comprehensive service network, both care, health care, domestic services, emergency rescue service. Practice shows that the community home-based care services both crack pension problems most economical, the most feasible way, is one of the development of community services, promote community employment and reemployment new focal point, is to promote family harmony, intergenerational harmony and building a harmonious community an important measure.According to the study it’s established for the study of public sociology value orientation and combined qualitative and quantitative research methods. Demand for elderly care services uses quantitative research methods. Demand for home care services and influencing factors use qualitative research methods for in-depth analysis. Qualitative research process uses in-depth interviews and discourse analysis methods. Survey tool is Harbin60years or older home care service needs survey. Depth interview subjects were divided into five categories, the elderly, the elderly family members, civil affairs department heads, the pension agency leadership, community leaders. The paper focuses on community service support for home care services, and analyzes problems and causes.China’s aging showing accelerated aging, aging acceleration, acceleration and number of disabled elderly empty nest phenomenon. And the economic, political, social and cultural impact of the increasingly heavy, old-age security, social services and health care and other aspects of the formation of a huge demand pressure. Elderly physiological changes and psychological changes had a significant impact on their demand for home care service. The elderly pension service needs a lot of content, strong heterogeneity. Daily care needs, health care needs, spiritual comfort needs and social participation needs. Declining health led to a the elderly pension services rigid demand, the elderly pension services effective demand is also affected by the state of the economy, the impact of consumer attitudes and children’s willingness to consume.The elderly pension service needs a lot of community home care service system has not yet been established. Community home-based care services, there are many problems. Such as the pension service supply and demand contradiction, pension unprofessional waiter, narrow coverage of home care service, home care service is not enough publicity, inadequate investment in home care services, home care services to a lack of supervision.Community home-based care services for foreign and China’s Hong Kong and Taiwan have developed earlier, has formed the system. However, no matter the size of the elderly population and the rate of aging with our current situation there is a gap, while learning specific service experience to positive thinking mode suitable for the specific situation of home care service, build localization community home care service system, in order to adapt to the the aging situation escalating.To integrate the main resources of home care service, the proper introduction of market mechanisms to achieve investment diversification. Want to build a stable, professional, pluralistic and participatory home care service team, focusing on the training of professionals and to promote mutual service among the elderly. To expand home care services, to make it richer and regulations in accordance with the mental and physical needs of the elderly. Home care and institutional pension bridging mechanism to establish a system of sustainable development, the level of services provided. To establish the pension service evaluation mechanisms, including the service needs assessment, quality of service assessment, the development of intermediary assessment bodies to promote the professionalization of the evaluators. We must vigorously develop the old social work and professional services to help older people access to resources, to fight for their rights, a correct understanding of their own values, to improve the ability to adapt, promote social participation of the elderly, help the elderly to adapt to the changing role of old age.更多还原