Author: Li Maofu Source: The Contemporary World 2010-05-19 14:16:41
With the improvement of people's living standards, the spectrum of diseases of the population has changed, and the demand for chronic disease care has increased; people attach importance to their physical and mental health, and at the same time, their awareness of disease prevention and self-care is also increasing. On February 21, 2006, the State Council issued the Guiding Opinions on the Development of Urban Community Health Services, which intensified the efforts to improve the community health service system. In the construction of community health service system, the United Kingdom, Australia, and some Asian countries and Hong Kong, China has accumulated a wealth of experience, it is worthwhile for us to learn from and study.
Japan Japan's community health care is based on the "Regional Health Law", "Health Care Therapy" provisions, to 1994, each prefecture, special administrative regions have established health care, health care centers, the country **** there are health care 848, city streets and villages health care centers 1,241, all types of health care institutions in health care nurses to reach more than 20,000 people for the implementation of the health of the whole of the national health care work in Japan. At the same time, Japan has implemented a universal health insurance system, which provides a guarantee for the development of community health care. According to the Ministry of Health and Welfare's Population Research Institute, Japan's elderly population will account for 15.6% of the total population by the year 2000. In response to this situation, the development of community care in Japan has been relatively rapid, with health care for the elderly and health care for mothers and children being the centers of community health care in Japan, and the aging society advancing the development of health care for the elderly in Japan. According to the Ministry of Health and Welfare, in September 1994, there were 1,003 health-care facilities for the elderly of all kinds in Japan, with more than 85,000 elderly people enrolled, and the aim of the Japanese health-care system for the elderly is to maintain health and ensure medical treatment. To this end, a "health handbook" is established for community members as soon as they reach the age of 40, and basic health education and health examinations are carried out. The levels of health care for the elderly can be divided into: hospital wards for the elderly, nursing homes, health care centers for the elderly, rehabilitation facilities, special care homes for the elderly, day-care centers, and home care assistance facilities, etc. The Elderly Health Care Act was enacted in 1993, and home visit nursing care is institutionalized, with nurses from hospitals and clinics providing assistance to homebound convalescents and mental rehabilitation patients. As stated in the Maternal and Child Health Law and the Child Welfare Law, health centers in Japan provide a variety of health checkups, health care guidance and medical assistance to women in marriage, pregnancy, childbirth, perinatal women, and infants up to preschool age.
Elderly care (elderly care) --- initially originated in the U.S. With the accumulation of knowledge about the physiology, psychology, and society of the elderly, most developed countries have begun to adopt community-centered community-based elderly health care services, etc., and in economically developed countries such as Europe, the Americas, and Asia, Japan, etc., have been expanding health care facilities and welfare facilities and other social services for the elderly. In economically developed countries such as Europe, the Americas and Japan in Asia, social services such as health-care facilities and welfare facilities for older persons have been expanded in recent years. Social services for the elderly generally focus on activities that are supportive, help protect, improve physical and social functioning, and provide opportunities for personal achievement.
I. Health Care Measures for the Elderly in the U.S.
(1) Home care, home health care, home delivered meals, regular visits, telephone confirmation, and emergency call systems are provided for frail and elderly people who live at home.
1. Housekeeping services: by trained women.
2. home health care services
3. home-delivered meals
4. regular visits
5. telephone confirmation services
6. emergency call-out systems
(ii) Services and programs for healthy older people
Individual or group services for older people who are relatively healthy and able to travel on their own.
1. transportation or companionship services
2. cafeterias for the elderly:
3. legal services
4. employment services
(iii) Specialized services
1. day care centers for the elderly ---- who are unable to live independently in their own homes and do not wish to go to a nursing facility.
2. Counseling services ---- to resolve personal and family conflicts.
3. Protective services ---- protect the legal rights and interests of the elderly.
The health care measures for the elderly in Japan
(1) Healthy Elderly
1. Establishment of "Vibrant" Promotion Centers: Promoting the elderly's "Self-reliance, Participation, Self-care, Self-enrichment, and Dignity" as a principle. The Center will be a center for the promotion of "self-reliance, participation, self-care, self-enrichment, and dignity" for the elderly.
2. Establishment of the "Silver Talent" Center: Provides opportunities for employment.
3. Provide special "silver transportation": encourage the elderly to participate in society.
(2) Older People Living Alone and Frail
1. Establishment of a Complete First Aid Information System
2. Establishment of Municipal, Town, and Village Elderly Welfare Promotion Centers ---- to ensure safety, relieve loneliness, help with daily life, and promote health.
(3) Long-term Bedridden Elderly
1. Establishment of Geriatric Thermal Service Terminals
2. Establishment of Home Care Support Centers
3. Establishment of Home Care Centers
4. Establishment of Comprehensive Centers for Welfare Instruments
(4) Demented Elderly
1. Establishment of Demented Elderly Day Care Stations
2. Establishment of a joint system of comprehensive care for the demented elderly
(v) Establishment of a team of collaborators
3. Health care measures for the elderly in China
China entered an aging country in 2000, and the elderly have become an important group of social concern.
(A) There are three main systems for the elderly in China's urban communities:
1. All state-owned enterprises, collective enterprises and most other ownership components have been included in social pension insurance.
2. Most business and administrative units still follow the original pension system.
3. Elderly people who have no formal job or who are not working are not enrolled in social health insurance, and live mainly on their spouses' wages or their children's support.
(2) Our government pays great attention to the work of the elderly
Strengthening leadership, manpower, policy guidance, institutional development, domestic and international exchanges, and training of talents have been given care and support.
(3) The development of China's nursing care system in 1977
1. Geriatric care in hospitals
2. Establishment of hospitals specializing in geriatrics
3. Establishment of geriatric hospitals
4. Establishment of nursing care centers in the streets
5. Nursing homes and apartments for the elderly.
Section III: Health and Care for the Elderly in the Community
I. United Nations Principles of Health Care for the Elderly
On February 6, 1991, the United Nations General Assembly adopted the United Nations Principles of Health Care for the Elderly. It emphasizes the independence, participation, care, self-fulfillment and dignity of older persons. The principles are as follows:
(1) Independence
1. Older persons should be able to enjoy adequate food, water, shelter, clothing and health care through the provision of income, family and social support and self-help.
2. Older people should have access to work or other income-generating opportunities.
3. Older persons should be able to participate in deciding when to withdraw from the labor force.
4. Older people should be able to participate in appropriate education and training.
5. Older people should be able to live in environments that are safe and appropriate to individual choices and changing abilities.
6. Older persons should be able to live at home for as long as possible.
(ii) Participation
1. Older persons should remain integrated in society, actively participate in the development and implementation of policies that directly affect their well-being, and pass on their knowledge and skills to future generations.
2. Older persons should be able to seek out opportunities for service to society and should serve as volunteer workers in positions well suited to their interests.
3. Older persons should be able to organize movements or associations of older persons.
(iii) Caregiving
1. Older persons shall enjoy the care and protection of their families and communities by virtue of the cultural value system of the society.
2. They shall have access to health care services to help them maintain or recover to their optimal level of physical, Chilean and emotional well-being and to prevent or delay the onset of disease.
3. They shall have access to social and legal services to enhance their autonomy and enable them to receive better protection and care.
4. To enjoy human rights and fundamental freedoms while living in any residence, hospice or treatment facility.
(iv) Self-enrichment
1. to be able to seek opportunities to realize their full potential
2. to have access to the educational, literary, spiritual and recreational resources of the community.
(v) Dignity
1. to live with dignity, security and freedom from exploitation and physical and mental abuse.
2. They should be treated fairly regardless of their age and gender, racial or ethnic background, disability or other status, and respected regardless of their economic contribution.
II. Fitness and Recreation for Older People
(1) The World Health Organization's Five Guiding Principles of Fitness for Older People
1. Special attention should be given to exercise that contributes to cardiovascular health.
2. Weight training should be emphasized.
3, pay attention to maintain the body movement "balance".
4, the elderly and the frail should participate in sports.
5. Pay attention to the psychological factors related to exercise.
(2) Exercise for the Elderly
(3) Precautions for the Elderly to Adhere to Moderate Exercise
1. Walking should not be too fast
2. Turning one's head should not be too fast in activities
3. The amount of exercise should not be too large
4. Exercise time is not more than 2 hours a day
5. Self-detection of exercise intensity
Three, the elderly dietary care
(a) a reasonable diet, nutritional balance
(b) reasonable cooking soft and rotten
(c) three meals a day reasonable arrangement, to develop good eating habits
(d) pay attention to dietary hygiene
(e) the appropriate way of eating
four, the elderly rest and sleep
(I) Rest
(II) Sleep
V. Safety and Protection of the Elderly
(I) Protection against Falls Anti-skidding Facilities
(II) Prevention of Choking and Choking
(III) Prevention of Falling out of Bed
(IV) Attention to Safety of Medications
(V) Prevention of Cross-infection
Section 4 Common Psychosocial Health Problems and Prevention in the Elderly
I. Retirement Syndrome
II. Depression in the Elderly Suicidal Tendencies
III. Hypochondriasis in the Elderly Characteristics
IV. Widowhood
Summary: Through the study of this chapter, we will master the factors affecting the health of the elderly, the assessment of the health status of the elderly, the common health problems of the elderly in the community, and master the community health problems of elderly with different health conditions. The course is designed to help students understand the current situation and trend of population aging in the world and China, and the physiological and psychological changes of the elderly.