如何应对老龄化带来的健康风险？

老龄化与健康、疾病模式转型 长寿是社会进步、文明的重要指标之一。但近年来，学者、公众也已基本达成共识——期望寿命高并不意味着生活质量就好。在人口期望寿命不断提高的同时，也伴随着人口类型的转变和人口健康、疾病模式的转变，尤其是老年人口健康状况的恶化，意味着老年人口带病生存的风险大大增加。庞大的老年人口规模对老年医疗保险和长期医疗服务需求将更加迫切。老年慢性病是一种长期存在的疾病状态，     

探索适合自己的居家养老模式

上海在1973年成为全国最早进入人口老龄化的城市。而截至2010年底,上海户籍老年人口331．02了了,占总人弱的23．4％;80岁以上户籍老年人口59.83万,占老年人口的18．1％。在人口老龄化、高龄化日益严峻的形势下,上海开展了深入调研,并参考国外养老服务的经验,明确了老年人家庭照顾、社区居家养老服务与机构养老为一体的“9073”养老服务格局,     

面对老年孤独

孤独,是老年生活中难以回避的问题。首先,由于离、退休,老年人脱离了工作岗位,日常的生活时间和空间都发生了很大的改变和转移,业缘关系基本消失。其次,由于城市家庭结构日益趋于小型化、核心家庭化,生活在空巢家庭的老年人越来越多,目前上海空巢老人达到100万,占老年人口的40％,子女工作压力的增大     

少子老龄化背景下的低龄老人代际负担——以上海为例

老龄化加速，高龄化显著 作为全国第一个老龄化城市，上海自1979年至今已有近三十年的“老”龄。老龄化进程中的上海人口结构近年来表现出加速老化的特征，60岁及以上老年人口和80岁及以上高龄人口逐年递增，且增速加快。“十五”期间，上海市户籍60岁及以上老年人口年平均增加近5万人，而在“十一五”初期的2006和2007年，60岁及以上老年人口年平均增加量就已超过10万人。     

日本老年护理保险对上海的启示

日本老年护理保险，又称之为介护保险，是运用社会保险机制，对失去生活自理能力的老年人实施社会化护理服务的制度，以满足由于人口老龄化所带来的巨量护理服务需求。与日本相似，上海人口老龄化程度正在不断加深，老年人口护理需求也正在大幅增加。     

上海60岁以上老年人口已达24．5％

据悉,上海是我国第一个人口老龄化的城市,老年人口比例始终高于全国8％-10％,是迄今为止我国老龄化程度最高的特大城市。截至2011年年底,该市户籍60岁以上老年人口达347．76万,占总人口的24．5％。80岁及以上高龄老年人口62．92万,占60岁及以上老年人口的18．1％。     

上海可借鉴其设计理念和运行模式

上海是全国老龄化程度最高的地区，2011年末上海户籍60岁及以上老年人口为347．76万人，所占比例为24．5％。日本老年护理保险的设计理念和运行模式等，对上海建立老年护理制度，提供了有益的借鉴。     

浙江“老协”：创新老年社会管理的抓手——“老协”：农村老人的第二家园

根据第六次全国人口普查数据,我国居住在乡村的人口占总人口的50．32％,农村居民为6．74亿人,按“我国农村老龄问题研究”课题组陈昱阳的报告“我国农村老年人口规模是城市的1．69倍,农村老年人口比重已超过18．3％”计算,目前我国农村地区60岁以上老年人口为1．23亿人,占全国1．77亿老龄人口的近七成。可以说,占全国老龄人口近七成的农村老年人生活质量如何、能否颐养天年,不仅关系到农村每个家庭的和谐,更影响到社会主义新农村建设的进展,影响到农村经济社会和谐发展。是检验我国老龄事业发展的试金石。     

政府购买服务 老人照料无忧——无锡市出台居家养老服务补贴办法

随着我国经济社会的发展，老年人的生活水平和生活质量日趋提高。同时随着人口老龄化的加速，我国老年人口的基数越来越大，且从2009年起，在新中国建国后第一个人口出生高峰期（1949年至1957年）出生的人口开始成倍地步入老年期，且这批老年人的子女大多是独生子女，越来越多的小家庭结构，越来越多的子女和老年人分开居住，传统家庭的照料功能日趋弱化，使老年人特别是生活不能自理的老年人的生活照料和护理照料，日趋成为影响老年人生活质量的主要因素。     

构建上海老年人社会服务体系的思路和政策建议

自1979全市60岁以上的老年人口占全市总人口的10．2％起至今，上海进入老龄化社会已经有二十年的历史，但上海老年事业的全面发展和老龄工作充分开拓，主要在九十年代，特别是1995年下半年，市委、市政府建立市老龄工作协调联席会议制度以后。上海的老年工作进一步纳入正常发展的轨道。     

The experience of quality of life among older people

Although quality of life has been in the focus of attention for over a decade there are few studies available investigating, how the old and the oldest old experience their quality of life or what quality of life actually means for them? To illuminate this, eleven in-depth interviews were conducted with six women and five men (80+) living in their home. An interpretative hermeneutic phenomenological analysis revealed that quality of life in old age meant a preserved self and meaning in existence. Maintained self-image meant that the older people experienced a coherent life with an intact meaning. How quality of life was valued depended on the meaning the old people attached to the areas of importance as well as how they were evaluated. Additionally, areas not generally included when measuring quality of life became discernible. The meaning of home, how life was viewed, thoughts about death and dying, and telling ones story proved to be areas of importance for their perception of quality of life. Thus, indicating that older people's view of quality of life is more complex than some of today's most commonly used quality of life instruments capture and that quality of life assessment tools needs to measure beyond pure health indices. For nursing care the use of life review in everyday care, and an open way towards existential topics as well as a family oriented care along with preventive work helping people to remain in their own homes may enhance their experience of quality of life.     

Health-related quality of life in old age: preliminary report on the male perspective

Health-related quality of life is a key element of successful aging. With life expectancy increasing, postmenopausal estrogen/gestagen replacement therapy has been under discussion for some time with the aim of achieving a higher quality of life in old age. For a long time, the relevance of hormonal aging was only discussed with reference to women; however, more recent work deals with concepts that affect both sexes. According to recent studies, numerous symptoms and complaints which may impair quality of life, can be attributed to hormonal changes in old age in both women and men. The majority of age-related complaints, such as a decline in physical performance, decreased sexual activity and a deterioration of general well-being, are strongly reminiscent of the symptoms of classical pituitary disorders in adulthood. Since the early 1990s, scientific studies have also been investigating the influence of hormone 'replacement' in elderly men, using, for example, growth hormones. However, until now there has been no suitable measure for assessing the quality of life specifically in elderly men. In a research project aimed at developing a questionnaire (the VITA? questionnaire), roughly equal numbers of elderly men and women were asked about their subjective health and quality of life. It was found that men assessed their health-related quality of life very positively in a number of different dimensions of the questionnaire. In the present article the individual aspects of the quality of life of men are described and examples of gender-related differences are presented and discussed.     

Perception of quality of life in an elderly Angolan sample / Percepción de calidad de vida en una muestra de ancianos angoleños

Increased life expectancy and the ageing of the population have made it particularly important to distinguish between the old (usually 60–79 years, or the ‘young old’) and the oldest old (80 years or more, or the ‘fourth age’). This study explores the effects of age, gender and institutionalization on perceived health and life satisfaction in 1003 elderly people from Luanda, Angola. A multivariate analysis of variance (MANOVA) was estimated to test for these effects. Results provide evidence of lower scores on life satisfaction and perceived health for the oldest old and the institutionalized. However, the higher life satisfaction among the non-institutionalized disappeared when they reach the fourth age. No differences were found by gender, although there was a slight drop in the life satisfaction of women over the age of 80.     

Financial literacy and anxiety about life in old age: evidence from the USA

This study examines whether financial literacy can help to reduce anxiety about life in old age. We hypothesized that financially literate people are more able to earn income and accumulate assets, leading them to have a less anxious life in old age. On the other hand, less financially literate people rely more on social security to secure themselves in the old age as they are not able to accumulate sufficient assets. By using US survey data, we provide evidence that assets significantly reduce anxiety about life in old age only for people who are more financially literate. For less financially literate people, social security plays an important role in reducing anxiety about life in old age. Besides these, having a child and doing regular exercise also reduced anxiety for all respondents but marital status reduced anxiety in respondents over 40 years of age. The results of our study are robust to measurement of financial literacy and endogeneity problems.     

Older Women in Poverty: The Impact of Midlife Factors

This study investigates the factors contributing to older women's economic well‐being from a life course perspective, assessing the effects of both midlife characteristics and later life events on women between the ages of 66–70, and 71–85. Using the 1968–1997 Panel Study of Income Dynamics, the findings suggest that midlife characteristics such as workforce participation, income, and rural residence are strongly related to economic outcomes in old age. Late‐life events and characteristics, however, also contribute significantly to economic outcomes even when midlife factors are incorporated into analyses. In addition, both midlife and later life characteristics contribute to the persistence of poverty in old age, with many groups of ever poor women finding themselves in poverty for over 50% of their old age years.     

Unexpecting age

This essay argues that how we view our own old age is highly influenced by socially pervasive, though never explicit, expectations regarding old age as a generic category. I idenfiy four key expectations - the right to an old age; the idea that being old means being endowed with certain (positive or negative) characteristics; the fragmented relationship between the phases of life; and the assumption of the a-social nature of the aging process - and explore the sometimes contradictory ways in which these impact upon our own journeys through the life course.     

Elder self neglect: A geriatric syndrome or a life course story?

AimsTo explore the unique aspects of the elder self-neglect phenomenon and to achieve phenomenological understanding of self-neglect through the eyes of self-neglecting elders.MethodA qualitative study based on a sample of 16 self-neglecting elders. Data collection was performed through in-depth semi-structured interviews, followed by content analysis.FindingsFour major themes emerged from the older participants: “I was unlucky:” a life course of suffering; “That's the way it is:” self-neglect as a routine of life; “They tell me that I'm disabled:” old age as exposing situations of self-neglect; “My empire:” how do I perceive my old age.ConclusionsSelf-neglect is not necessarily an issue of old age, but is related to the person's life history. Self-neglect as a way of life accompanied the participants into old age, but it was not originated or created there. The overall message of the self-neglecting elders was to see them as human beings and not as old neglected people; not to label them as an “age syndrome” but to perceive them in a holistic and humanistic manner.     

Parental Conflict During Divorce as an Indicator of Adjustment and Future Relationships: A Retrospective Sibling Study

We assessed parental conflict during divorce and divorce stories, quality of relationship among siblings during divorce, and attitudes about romantic relationships later in life. Thirty-two undergraduate female participants (18–23 years old) whose parents divorced during the 7 to 13 year old age range completed the Sibling Relationship Questionnaire and an adapted version of the Adult Divorce and Sibling Relationship Interview. Older sibling participants endorsed higher levels of dominance toward younger siblings, more caretaking behavior, and higher levels of parental conflict than younger siblings. Analyses revealed overt conflict exposure related to less confidence in relationship sustainability as young adults. Content analysis demonstrated relationship formation problems and trust in partners.     

Narratives of age and uprootedness among older Cambodian refugees

This article examines Cambodian refugees' beliefs and traditions about age from the perspective of the cultural life course. Drawing on a study of 39 Cambodians between the ages of 50 and 79, the article explores the process of life reorganization from the standpoint of social liminality. The narratives of these refugees illustrate how cultural traditions shape views of who is old. Moreover, these narratives illustrate how gender roles and their loss, as well as factors that mitigate role loss, shape the experience of old age. It is concluded that (1) subscribing to the traditional cultural template for the Cambodian life course provides a sense of continuity in the face of disruption, and (2) the Cambodian family, as a central social institution, serves as a vehicle for role continuity, role loss, and the management of conflict. The extended family thus continues to be a primary source of meaning as elders reorganize their lives in old age.     

Minding the gap: The construction of old age and oldness amongst peers

While ‘oldness’ is a state of being that people in Western cultures agree exists, and ‘old age’ is a category which is readily used in daily discourse and upon which decisions are made in daily life, what old age is and who is old nevertheless remain problematic categories. Social scientists have acknowledged such complexity and sought ways of framing old age that are flexible enough to take the heterogeneity of ageing into account. What has not been considered as closely however are intragenerational dynamics in the construction of old age. Based on ethnographic research on the experiences of ageing and selfhood in the north of England, and using a processual and interactive approach to self-making, I explore here criteria that older people employ to monitor and adjudicate on the manifestation of oldness in their peers, as well as the distinctions they make between ‘normal’ ageing and ‘real’ old age.