China, as the world's most populous country, is also the world's largest aging population, social security and health care pressure is enormous. According to the international common interpretation, if the proportion of people over 65 years old exceeds 7% of the total population, it is an aging society; if it exceeds 14%, it is an aging society. At present, most developed countries belong to an aging society, such as France, the United States, the United Kingdom, Japan and so on. According to statistics, from the proportion of people over 65 years of age over 7% of the total population rose to 14%, France used 114 years, the United States used 65 years, the United Kingdom used 45 years, Japan used 24 years, and our country only used 20 years, it is expected that China's aging population will reach one-third of the country's population by 2050.
There are two main reasons for the aging problem: one is the prolongation of life expectancy, along with the improvement of people's living standards and health care, China's life expectancy has more than doubled from 35 years in 1949 to 75 years now, reflecting the social changes of the motherland, which is a symbol of the country's wealth and strength; the other is the imbalance of births, before the implementation of family planning policy, China's "multiple births in one family", "multiple births in one family". Before the implementation of the family planning policy, China had a serious phenomenon of "multiple births in one family", and the family planning policy since 1983 has slowed down China's population growth.
How to solve the problem of aging in China, based on the above two reasons, different countermeasures are proposed. The aging problem caused by longer life expectancy is unavoidable, and the resulting consequences are usually insufficient pensions and mismatched pension security measures, which can only be solved by delaying retirement and strengthening pension security measures; the aging problem caused by unbalanced births can only be dealt with by balanced births, which, according to the results of the 2010 census, show that China's population has increased by more than 70 million people over the past decade, and that the fertility rate is lower than 1.5 percent. But the fertility rate is lower than 1.5, that is, each negative rate of less than 1.5 children on average, far below the replacement fertility rate of 2.1, which means that China's next generation will be 30% fewer than the number of the previous generation, not far in the future, China's population will enter a period of negative growth, and the problem of population aging will be more prominent.
The current situation of the urban elderly
(1) Basic family situation
In the 30 years since the implementation of the family planning policy, the first two generations of only-children have already entered the age of marriage and childbirth, and in this context, the "four-two-one" family model has become commonplace, i.e., a family model with four elderly people, one couple and one child. That is, four elderly people, one couple and one child. Four elderly people need two only children to support, and at the same time also have to raise a child, coupled with the serious dependence of the only child itself, in the rapid development of society, the pressure of competition increased dramatically today, often overwhelmed, not enough to take care of.
In addition, "empty-nest families" and widows and widowers are gradually increasing, for a variety of reasons: (1) the elderly wish to live independently and are reluctant to leave the environment in which they have lived for a long time; (2) the elderly wish to live with their children, but due to differences in lifestyles and values, they choose to live independently in order to avoid conflicts; ((3) children are busy with work and housing constraints; (4) children have to live with their children, so they are often unable to take care of their children. (3) Children's busy work, housing tension, objective conditions do not allow; (4) due to children's marriage to leave their parents to start a family in a different place; (5) unwilling to support their parents and so on.
(2) Economic Situation
Compared with the rural elderly, the urban elderly basically have pensions after retirement, coupled with the prevalent habit of saving, so the economic income and consumption level is higher. According to statistics, the main source of income for 85% of the urban elderly after retirement is their pensions, while 13% rely on their children's financial support. This shows that the main source of income for the elderly is their pensions. However, there is a marked difference in the pension entitlements of retirees from different organizations, with the entitlements of retirees from organizations and institutions being much higher than those of retired persons from enterprises.
(3) Health Condition and Medical Needs
With the continuous improvement of medical standards, the life expectancy of the urban elderly has been extended. However, the prolongation of life span does not mean the prolongation of health condition. At present, the health condition of the urban elderly in China is worrying, only 1/3 of the elderly are in good health, the remaining 2/3 of the elderly are suffering from different degrees of disease, and the diseases they are suffering from are mostly chronic diseases, of which the more common ones are hypertension, hyperlipidemia, diabetes and so on, and half of them are suffering from a variety of diseases at the same time, and the ability of self-care and the health condition of the urban elderly groups are not as good as they should be.
The greatest difficulty encountered in the medical needs of the elderly is the economic factor, followed by cumbersome procedures, and then mobility and transportation difficulties. In addition to the above factors, elderly people in different areas have different difficulties. Those in urban areas also often face inconvenient reimbursement, difficulties in registering and hospitalization, while those in the suburbs face the main problem of not having good hospitals around them, and are often unable to seek timely medical treatment. Surveys have shown that chronic non-communicable diseases have become the biggest killer of the health of the urban elderly, but one third of the sick elderly do not go for treatment, and one quarter of them are unable to seek medical treatment for various reasons. Therefore, medical services for the elderly are characterized by individualization and diversification.
Three, the old age model analysis
(A) family old age model
At present, the most suitable for China's national conditions and the lowest economic cost of the old age model is family old age. At this stage, many elderly people are supported by their children, and eat and live with their children, and healthy elderly people usually help with the children, and even buy groceries, cooking. But there is also a part of the elderly suffering from diseases, need to be taken care of by their children, especially those who suffer from paralysis, paralyzed in bed, can not be no one around to take care of, which is undoubtedly adding to the economic and living conditions of ordinary citizens.
In order to improve the status quo of the family old-age model, we propose a specialized family old-age model: 40% of the population in urban China belongs to the low-income group, for this group of people, can be given the option of early retirement to take care of their own family old people, the government allocates a special fund to pay a social wage. These workers, who go home to care for the elderly, are required to participate in a variety of professional training and sign agreements with their communities, and are remunerated through regular evaluations of their home care by social work agencies in the community. In this way, not only can the elderly receive attentive care, but also solve the problem of work for the low-income group, killing two birds with one stone.
(2) Community-based Elderly Care Model
The community-based elderly care model is an elderly care model that takes the children, relatives and friends of the elderly as its core, relies on the community as its backbone, and relies on a specialized service team to provide life care, medical care and legal assistance to the elderly living at home in the city. This model is characterized by the fact that the elderly live in their own homes and are cared for by their children, while at the same time being provided with on-site services by community-based service agencies and professionals, which is beneficial to the physical and mental health of the elderly, and at the same time makes up for the fact that children are unable to take care of the elderly for a variety of reasons and saves, to a certain extent, the funds required for the construction of nursing homes. The community pension model is different from the family pension model, its essence is the family pension model in the community; compared with the institutional pension model, the pension service in the social institutions introduced into the community, absorbing the advantages of the family pension model and the institutional pension model, it is in the social transition period of China in the face of the aging problem put forward a new type of pension model.
The main service group in the community-based elderly care model is social workers, and the current development of social workers in China is not satisfactory, due to the following reasons: (1) China's lack of awareness of the profession of social worker, there is no specialized institution to train social workers, and most of the universities in the Mainland do not have a major in social work, whereas in Hong Kong and abroad, this profession is already maturely developed; (2) insufficient investment by the government in the social service, resulting in the lack of good wages for social workers; and (3) insufficient investment by the government in social services. As a result, social workers do not have a good salary and welfare system, and their social status is not high; (3) Chinese people have serious traditional concepts, and they are usually reluctant to employ social workers to solve family problems because of the idea that "family scandals should not be disclosed to the outside world".
(3) Institutional Elderly Care Mode
The main bodies of the institutional elderly care mode are nursing homes, welfare homes, hospitals, and various rehabilitation centers, where the elderly are centrally supported and housed in nursing homes, welfare homes, and other elderly care institutions, with specialists responsible for taking care of their daily lives. To a certain extent, this model of old-age care reduces the burden on children, and at the same time avoids conflicts in life caused by living habits, values and other issues. Secondly, to a certain extent, it disperses the family's old-age risk and realizes the ****consolidation and ****enjoyment of old-age resources.
The community-based model of old-age care is very costly, and at the same time fails to satisfy the elderly's desire for affectionate communication and provide spiritual comfort. Most of China's nursing homes were established in the early days, their service facilities and professional service level is difficult to keep up with the development and needs of the community, the equipment conditions of the nursing institutions are generally very poor, the level of professional service personnel is not high, the management model is lagging behind, and can not meet the standardization and standardization of the management.
Four, some thoughts on the issue of old age
In terms of living, can the government method of living allowance for the elderly, 300 yuan per month, independent of pension insurance. As of 2013, China has an aging population of about 200 million, 2 x 12 x 300 = 720 billion, while our 2013 GDP is expected to reach 10 trillion dollars, will not be a great burden on our finances.
In terms of healthcare, can the government open up free healthcare to the elderly. Although universal healthcare is not realistic by now, free healthcare just for the elderly is not unfeasible.
In terms of spiritual needs, the government's cultural department should often organize cultural activities for the elderly, organizing activities such as watching movies and plays for the elderly, as well as building universities for the elderly and facilities for their recreational activities.
V. Concluding Remarks
At this stage, the author believes that the government should strengthen the investment in the elderly problem, and take the family elderly model and community elderly model as the main, supplemented by the institutional elderly model, so as to make the elderly medical services professional, rationalize the allocation of resources, systematize the scale of the community, and standardize the management, and to build a model of the elderly with Chinese characteristics, so as to better meet China's basic demand for the elderly problem. The demand for the elderly in China.