中国未来老年贫困的风险研究

伴随社会经济发展,未来老年人的收入形式呈现出多元化趋势,经济和心理自立能力呈增强趋势。但是,即将经历老龄化和高龄化最快时期的未来老年人中相当一部分人目前处于贫困或贫困的边缘。这种状况一方面会通过非正式支持对上下两代贫困风险产生影响,另一方面会影响到他们老年期无论是来自自身的,还是外部的支持情况,表现出老年期资源累积不足的倾向。因此,延续性贫困可能是未来老年贫困的一大原因。     

中老年家庭灾难性医疗支出的测度及影响因素——基于CHARLS数据的实证

基于2011-2015年三期平衡面板数据,对中老年家庭的灾难性医疗支出进行测度并分析其影响因素。研究发现:我国中老年家庭灾难性医疗支出发生率在考察期内进一步扩大,差距也进一步上升。以家庭可支付能力的40%为灾难性医疗支出的界定标准,则在2015年其发生率依然高达25.4%,平均差距为0.069,相对差距为0.272。引入安德森医疗服务利用模型对影响因素进行分析,结果显示家中有住院、门诊及残障人员更容易发生灾难性医疗支出,经济状况对灾难性性医疗支出发生起着显著作用,总体而言灾难性医疗支出具有"亲贫"效应,越是贫困的家庭越容易发生灾难性医疗支出。据此,文章提出应该采取分类管理的措施,通过发放免费医疗服务券、强化医疗费用控制等政策建议来切实降低灾难性医疗支出的发生。     

Formal Social Participation and Utilization of Community-based Services among Urban Elderly Chinese Living Alone in Shanghai,China

This research examined formal social participation among elderly Chinese adults living alone and the association between utilization of community-based services and formal social participation, which refers to participation in employment, volunteer jobs, and social groups. Using a secondary analysis on a survey data from a simple random sample of 228 adults aged 60 and older living alone in a Shanghai neighborhood, it was found that only small percentage of older adults living alone were involved in formal social participation. Hierarchical multiple regression analysis showed that use of community-based services is significantly associated with formal social participation among elderly Chinese living alone. Thus, future policies and programs should focus on strengthening community-based services for elderly Chinese, to more effectively promote and facilitate their social participation.     

“The Persistence of Parent Repayment” and the Anticipation of Filial Obligations of Care in Two Thai Provinces

With an accelerated and sustained decline in fertility and an increase in life expectancy, Thailand has entered its aging phase at a rapid pace. This raises an important question of who should care for the increasing elderly population. Using a survey of adults aged 16–64 years (n = 742) in two provinces in the north‐east (Kalasin) and south (Phang Nga) of Thailand, this paper explores the expectations that individuals have from their children when they become very old. Only one‐third of the respondents expected to live with their children in old age and only one‐fifth anticipated financial assistance. Less than half of them expected personal care and practical care from their children (43% and 38%, respectively). The expectations varied substantially by the number of children and income, with those with higher income reporting lower expectation. Those living in Kalasin, a much poorer province than Phang Nga, had greater expectations from their children in old age. This suggests that, for those with less financial resources, children remain the main care provider for the elderly.     

社区老年学习社团发展的支持策略研究

社区老年学习社团,是推动社区教育发展的重要主体,也是老年人继续社会化的主要形式。但多数社区老年学习社团的发展,由于缺少专业师资,活动平台有限,管理模式单一等问题存在,制约着社区教育的发展。新形势下,社区老年学习社团的发展,要立足于专业化,从发挥老年人自身主动性出发,优先为老年学习社团建立导师工作室,引导社团成员开展志愿服务,培育社团实践基地,组织社团成果展,为社区老年学习社团搭建“以学促学”的可持续发展路径。     

Are there differences in standard of care for the elderly? A comparative study of assistance decisions in Stockholm

According to Swedish law, an elderly dependent person is entitled to public services in the form of home help in ordinary housing or a place in special housing — i.e. sheltered housing, a residential home or a nursing home. There are no explicit rules for how much home help a person is entitled to given dependency and other factors, nor are there any explicit criteria to guide the admission to special housing. A study was performed in ten districts in Stockholm in order to determine whether there were systematic differences between the districts with regard to the allotment of care and services to the elderly. It was found that there were in fact significant differences that could not be explained by variations in dependency or other factors of importance for the allotment decision. A minor part of these differences was connected to the different background and experience of the assessing person.     

A marketization process in dispute: An analysis of serviced housing for the elderly in Finland, 2000–14

Marketization can be viewed as a potential response to the economic challenges of the public sector. The present study is focused on the development of marketization in serviced housing for the elderly in municipalities within Finland. Marketization is approached by asking the question: What kind of municipality‐level factors are associated with marketization and its development? The data consist of 290 municipalities and cover the years 2000–14. According to the study, the size of the municipality, the political distribution of the municipality council, and the economic situation of the municipality are found to be associated with marketization. More preciesly, the municipality size was found to be a kind of prism, which creates two different realities when it is linked with political distribution and transfers. In the case of big municipalities, the big share of Green‐Left council members on municipality councils has been associated with a low level of marketization. However, in the case of small‐ and medium‐sized municipalities, the low level of marketization has been associated with the government statutory transfers between the state and municipalities, which has helped smaller municipalities to avoid fiscal stress. In a policy context, the present study suggests that the marketization process can be slowed down by supporting the economically weakest municipalities to avoid fiscal stress. On the other hand, the marketization process can be supported by creating bigger municipalities which are then attractive enough to create an effective market mechanism.     

Depression and Suicide Among Community Elderly

Abstract

The phenomena of hopelessness, depression and, suicidality among the elderly have been long recognized as a social problem. It is commonly agreed that the rates of depression, sense of hopelessness and, suicidality in that age group are higher among older people. Due to its sensitive nature, the gerontological literature has been paid more theoretical and empirical attention to the understanding of such phenomena at the last two decades.

The present study concerned hopelessness, depression and, suicidality among an elderly community population. It aimed at providing a demographic profile of factors contributing to depression and suicidality among old people. At five senior citizen centers at the north of Israel, 316 old people living in the community were randomly selected. Subjects were administered the Beck Depression Inventory (BDI), the Beck Hopelessness Scale (HS), and the Scale for Suicidal Ideation (SSI). The data suggest that four main demographic variables contributed to the explanation of suicidality, depression, and hopelessness among the elderly. Practical implications are discussed.     

Filipinas as Residential Long-Term Care Providers

Summary

This exploratory study investigated reasons why Filipinas in Hawai'i have become the primary caregivers of elders in residential care homes and if they thought their children would follow them in this profession. A random sample of 173 Filipina care home operators (CHO), of which 95% were first-generation immigrants, was interviewed using telephone survey methods. Data were collected: to profile caregivers; to identify motivations for becoming a care home operator; and to gauge if they or their children would continue in this line of work. The sample was composed of middle-aged Filipina CHO with training and experience in elder care who concurred that the job fit their cultural values. About a third also felt that this job was open to immigrants and helped them buy a house. Twenty percent or less felt discriminated against because of this work. Although half the sample felt that women were better caregivers than men, only 38% felt that caregiving was primarily the responsibility of women. Almost 90% planned to continue with this work, but only 12% said it was likely that their children or grandchildren would become CHO, supporting the notion that choosing this profession had less to do with cultural values and gender expectations than with economic opportunities available to the current cohort of CHO. Given these findings, Hawai'i's capacity to meet future residential long- term care needs is discussed.     

Advance Care Planning with Residents in Nursing Homes in Singapore

With an aging population, the government is allocating more resources in the care of the elderly. Hospitalization may not be a natural desire of the sick nursing-home resident. Advance care planning is explored as a strategy to promote the right site of care, defined here as the most appropriate place that patients can receive treatment by medically competent teams at the lowest possible cost (Khaw, 2007). Advance care planning, when practiced with residents in nursing homes, comes with unique challenges, which this paper will illustrate. This paper also presents the multiple roles of a social worker in advance care planning and concludes with factors that contributed to effective advance care planning facilitation.