我国社区居家养老的现状、问题与对策探析

我国已步入老龄化社会,目前全国的养老方式主要有家庭养老、机构养老、社区居家养老三种方式。社区居家养老是介于家庭照顾和社会机构照顾之间的一种运用社区资源开展的老人照顾方式,能有效弥补家庭养老和机构养老的不足。文章主要从社区居家养老的内容、各种养老模式的特点与社区居家养老的优势与不足等几个方面对国内的社区居家养老模式进行分析、总结,并提出基于社区的养老网络构建的政策建议。     

广州市社区居家养老模式探索

社区居家养老是中国社会养老保障体系的必要补充,也是解决城市养老问题的重大战略选择。近几年广州市社区居家养事业取得显著成绩,成为全国的样板。社区居家养老工作要持续、快速、健康发展,必须走政府、社会、家庭相结合的养老保障道路。     

上海市:发展社区居家养老的五大思路与举措

上海市针对社区居家养老服务结构性矛盾依然突出、服务队伍远不能满足需求、社会力量参与程度有待提升等发展瓶颈,明确提出今后一个时期内将从推动城乡社区养老服务设施网络化布局,促进社区、居家、机构养老服务融合化发展,引导社区居家养老服务社会化、市场化运营,推动社区居家养老服务组织及队伍专业化发展,提升社区居家养老服务智能化、     

居家养老服务社会组织的培育和监管研究

居家养老就是综合运用社会网络与现代信息技术,是融合个人、家庭、社区、社会组织、市场、政府共同参与的一种多元养老服务。社会组织在提供居家养老服务方面有得天独厚的优势。居家养老服务具有部分公共服务的属性,政府要充分发挥其在居家养老服务中的价值功能,对居家养老社会组织进行监管,通过政府购买服务和市场化运作,培育专业性的居家养老社会组织。     

政府温情出招 助推居家养老——解析《湖北省人民政府办公厅关于加快发展城乡社区居家养老服务的意见》

湖北省委、省政府高度重视社会养老服务工作。2012年初,省政府将"建立居家养老为基础、社区服务为依托、机构养老为支撑的社会养老服务体系"写入政府工作报告;同年6月,省政府办公厅印发了《湖北省社会养老服务体系建设"十二五"规划》。为深入贯彻党的十八大提出的"积极应对人口老龄化,在老有所养上持续取得新进展"的要求,2012年12月6日,湖北省委书记李鸿忠率领省委省政府领导及省直有关部门负责人专题调研了武汉市社区居家养老服务工作,对群众反映的养老热点问题作出安排部署。湖北省委常委、副省长张岱梨专题听取了省民政厅关于全省社区居家养老服务工作情况汇报,对加快发展城乡社区居家养老服务工作进行研究部署,省政府办公厅及时研究出台了《关于加快发展城乡社区居家养老服务的意见》。2013年1月17日,湖北省政府在武汉召开了全省社区居家养老服务推进会,会议对加快发展全省社区居家养老服务工作进行了全面部署。     

四措并举构建居家养老服务模式

之一,完善居家养老机构的设施建设。加强新的居家养老机构基础硬件设施的建设。积极为社区的居家养老事业提供必需的设施,要统筹社会资源,统一规划,新建和改建一批老年人福利服务设施和活动场所,增强社区居家养老服务功能。     

上海市《社会养老服务体系建设规划(2011-2015)》实施情况报告

"十二五"期间,上海市继续坚持"9073"养老服务格局,即通过强化社区涉老性配置标准,鼓励90%的老年人由家庭自我照顾;支持社区为7%虽住在家里但需要社会服务的老年人提供上门、日托、助餐等社区居家养老服务;由政府主导、鼓励市场参与,为3%高龄、失能(失智)老年人提供具有全托生活护理功能的机构养老服务。7%社区居家养老服务、3%机构养老服务主要面向老年人提供基本的日常照护服务,构成社会养老服务体系。从满足快速增长的、多样化的养老服务社会需求出发,"十二五"上海确立了至2015年社会养老服务人数43万人左右的发展目标(即社区居家养老服务30     

江西龙南县：探索多种形式居泉养老模式

江西龙南县根据居家、社区、机构养老的不同特点,积极探索多形式居家养老模式,不断提升居家养老服务水准。重点在社区居家养老服务方面做文章,探索性地实施多形式居家养老模式。之一：“家庭自助式”。在低保户家庭中,由乡镇、社区居委会定好标准、草拟好条件,并负责聘任有一定劳动能力、外出就业困难的家庭人员开展自助协议式居家养老服务,用这种模式来解决高龄困难老人居家养老的问题。     

建立政府购买服务制度完善居家养老服务体系

当前,我国正在建立健全以居家养老为基础、社区照料为依托、机构养老为补充的具有中国特色的养老服务体系.居家养老,由于其符合传统、适合国情、成本低廉,是当前我国破解人口老龄化难题的有效途径,也是今后我国养老服务体系建设的重点和发展方向,政府和社会必须进一步强化对居家养老的支持.     

社区居家养老意愿的影响因素研究——以北京市为例

人口老龄化背景下的养老问题备受关注,养老方式的选择将影响养老资源的有效配置。本文根据实地调研数据分析北京市家庭养老、社区居家养老、机构养老等方式的现状及其发展态势,使用回归分析考察了老年人意愿养老方式及其影响因素。研究结果表明,家庭养老仍是主要的养老方式,社区居家养老备受青睐,尤其是中等收入的老年人更偏好于社区养老。建议养老资源更多地向社区进行配置,促进社区居家养老的快速发展。     

Is Housing First for Mental Health Community Support Possible During a Housing Shortage?

Supported housing programmes for people with chronic mental health needs have shifted towards approaches that rely on housing first, which prioritizes access to a permanent home in the community. How do support programmes with this assumption manage the market constraints of a shortage of affordable housing? The article examines empirical mixed method data (interviews and programme data) about the experience of managing this problem in the Mental Health Housing and Accommodation Support Initiative (HASI) in New South Wales, Australia. HASI provides clinical mental health services, housing support and housing if needed, for people who are not yet living independently in the community. It found that the housing shortage affected the ability of the providers to implement the intended programme design at three early steps in the support: determining eligibility; prioritizing access between people with and without housing; and managing entry to the programme when they did not have housing. As a result, some otherwise suitable applicants were not prioritized for entry into the programme or their entry was delayed until they were housed. The providers adjusted the programme to the housing market realities, which compromised the programme intentions. The policy lessons are that programmes need strategies to provide housing for people who require it; assist people to find or apply for housing; and support people while they wait for housing. These approaches enhance the coherence of programmes, build on integration mechanisms and respond to the housing context.     

Audit of advertised housing and support vacancies for people with disabilities in Australia

The introduction of Australia’s National Disability Insurance Scheme (NDIS) has changed the way housing and support are delivered to Scheme participants. NDIS policy reform focuses on coordinated housing and support responses. These responses are guided by the Specialist Disability Accommodation (SDA) Rule, Framework and pricing and Supported Independent Living payments. To date, the National Disability Insurance Agency (NDIA) has only released limited data to understand SDA demand or inform market development. To understand changing housing and support approaches and the impact of NDIS housing policy on market responses, this research had three aims: (1) to examine the locations and characteristics of housing and support vacancies advertised for people with disability; (2) to investigate funding sources for, and providers of, these supported housing options; and (3) to examine the proportion and source of government, nonprofit and private sector funding for housing and support developments advertised. An audit was undertaken of all advertisements on the two main non‐government organisation Websites that list Australian supported housing vacancies. A total of 562 property adverts were reviewed in March 2019. Audit findings are considered in relation to the current NDIS policy context. Possible housing futures and market gaps for people with significant and permanent disability in Australia are discussed.     

廉租住房住户：社会支持网现状分析与建构策略——来自贵州省贵阳市的实证研究

随着我国廉租住房保障制度的实施,廉租住房住户作为一个特定聚居群体逐渐形成,完善的社会支持网络是他们维持日常生活、应对危机的重要保证。廉租住房住户社会支持网主要由非正式支持构成,在经济困难解决、情感宣泄和社交支持三方面起着重要作用,但该群体社会支持网较脆弱,网络规模小、结构单一,部分住户甚至缺乏基本的社会支持。这样的社会支持网现状难以有效地化解日后生活过程中可能遭遇的生活危机与困难,这既无益于个体生活状况的安定,也无益于社会秩序的稳定。因此,本文尝试提出廉租住房住户社会支持网络的建构策略,即以社区为平台,以社区服务组织和社区工作者为依托,以赋权理念为指引,以廉租住房住户需求为基础来帮助他们建构多类型、多主体介入的社会支持网络。     

代际累积与子代住房资源获得的不平等:基于广州的个案分析

本文通过"代际累积"概念探讨了父代住房支持的差异引发的子代住房不平等问题。参考以往通过"优势累积/劣势累积"两条因果路径分析社会不平等的方法和最新文献对累积过程的关注,本研究将弥补以往累积与社会不平等研究忽视代际分析的不足,从因果机制和过程分析两方面推进代际累积对住房不平等的解释。对前者的研究发现,住房制度改革拓宽了个体住房资源获得的渠道,父代家庭对子代的住房支持从无到有、由小变大,其对住房不平等的影响也日渐凸显;对后者的研究表明,代际累积这一因果机制所解释的住房不平等并非稳定不变的,受一些因素的影响,既有累积趋势可能会发生异于原初累积方向的变动,甚至是累积断裂。这一发现弥补了代际优势/劣势累积这一因果机制未能澄清累积过程中波动存在的理论缺憾。     

日、韩公共住宅制度的改革与发展

为低收入阶层供给公共住宅是政府的职责。公共住宅制度包括供给租赁住宅、供给出售住宅以及提供政策性金融支持。本文通过分析日本和韩国的公共住宅制度,指出,日、韩两国以政府为主导,设立了专门的住宅管理机构和租赁住宅供应制度等特点,在实施过程中也取得了较好的社会效果。中国正处于房价快速上涨阶段,建立完善的公共住宅制度具有很强的现实意义。     

Effective personalised housing support for people with disabilities – case study analysis

International policy trends favour personalised approaches to housing support for people with disabilities. Previous research is inconclusive about whether these approaches are effective compared to group home support in the way they use government resources and benefit clients, partly because it does not usually consider the experiences of people who use the support. In this research we compared six new, innovative case studies of personalised housing support to previous research about group home support. We included qualitative data about client experiences, in particular regarding social networks, decision making, community service use and participation in domestic tasks. We found that client outcomes were positive in all four categories, while the financial costs to clients and government were similar to group home support. The results offer evidence that current, personalised approaches to housing support can be an effective policy option that allows people with disabilities to make choices about how to live and participate in their communities, without increasing the cost to government.     

Challenging the exclusion of people with mental illness: the Mental Health Housing and Accommodation Support Initiative (HASI)

Without appropriate support, people with mental illness can be excluded from stable housing and social and community participation. Transitional models of support for people with acute mental illness have addressed clinical symptoms and hospitalisation, but they have not facilitated stable housing and community integration. In contrast, individualised housing models aim to improve mental health, housing and community outcomes. These programs are costly and require collaboration between agencies. This article discusses the evaluation findings of one such program – the NSW Mental Health Housing and Accommodation Support Initiative (HASI). The longitudinal mixed‐method evaluation assessed whether HASI supported people with high levels of psychiatric disability to improve housing, mental health and community participation. We discuss the challenges clients within the program faced prior to joining HASI and the changes experienced while in HASI. We conclude by drawing policy implications for programs supporting people with mental illness to live in the community.     

Senior Services that Support Housing First in Metro Vancouver

Housing First is a model and philosophy for housing homeless people in immediate and permanent housing. In order to implement and deliver Housing First, research is essential to understand the system of support services as they currently exist. Guided by principles of community-based participatory research, this paper presents the findings from a senior-focused deliberative dialogue workshop in Metro Vancouver, Canada. Participants (16 service providers and 1 service recipient) identified services and resources available to support seniors in maintaining housing and barriers and facilitators for accessing services. Broadly, data were organized into seven themes: (1) Housing; (2) Home support; (3) Transportation; (4) Information availability, accessibility, and navigation; (5) Cultural diversity; (6) Discrimination; and (7) Funding and financial support. Results found that affordable housing that adapts to changing health conditions, income supports, health services, homecare, transportation, and culturally appropriate and nondiscriminatory informational resources are among the supports most needed for persons as young as 50 years old to succeed under the Housing First model in Metro Vancouver. Barriers to Housing First service provision, including rigid eligibility criteria for chronically and episodically homeless, should be revised to better support the growing number of older adults who are newly entering homelessness in Metro Vancouver.     

“It's hard work,believe me!”: Active efforts to optimise housing by people who live with mental illness and access housing assistance

Secure and appropriate housing is critical for the well‐being of people living with mental illness (consumers). Yet it is often difficult to achieve. Housing assistance is available, but is often difficult for consumers to access and negotiate. While the need for support is well‐recognised, little is known about the active part consumers play in finding and keeping appropriate accommodation. This paper addresses the research question: How do consumers who use housing assistance actively manage their housing situations? In‐depth interviews were conducted with 18 consumers who had used housing assistance within the past five years. These were analysed using constant comparative analysis, based on a grounded theory approach. Participants engaged in a range of activities to address six major concerns: working toward my home; following the rules to keep what I have; managing and improving my accommodation; working with housing services; living within my current situation; and finding and using supports. All participants described times when their mental health negatively affected their ability to do these activities. The findings highlight the need for housing services and mental health services to collaborate to develop policies and protocols that place reasonable demands on consumers and support their abilities to actively manage their housing situations.