Shanghai Community Pension Insurance for the Elderly

Original title: Shanghai: How to take care of the elderly in the country’s oldest city

China Youth Daily·China Youth Online reporter Wang Yejie Source: China Youth Daily (2017 March 09, Edition 06)

The rehabilitation therapist took the elderly in the community to do towel exercises. Photo by Wang Yejie

In the elderly care home, the bed of the elderly has just been made in the morning. Photo by Wang Yejie

The word "aging" is no longer a foreign word to China today. Aging is now becoming an unavoidable and important topic related to the sustainable and stable development of China's economy.

This is especially the case in Shanghai. Shanghai is the first city in the country to enter the aging population and has the highest degree of aging. As of the end of 2015, this modern and fashionable city has accumulated 4.36 million registered elderly people over the age of 60, accounting for 30.2% of the city's registered population.

The huge elderly population base, coupled with the elderly care service system that is slightly lagging behind compared to developed countries, has brought huge challenges to this city. Recently, reporters from China Youth Daily and China Youth Online found that a new "community elderly care" model is being rolled out across Shanghai. Compared with comprehensive elderly care institutions, it is more suitable for most elderly people and more "people-friendly."

Elderly care services that are higher than the standard of "early education institutions"

In an old community in Lujiazui Street, Pudong New District, Shanghai, there is a "hidden" one with a high reputation among the elderly. A high-end "elderly care home" - the hardware decoration is comparable to a four-star hotel, and the software services are higher than five-star standards.

China Youth Daily·China Youth Online reporter noticed that at first glance, this elderly home with a total construction area of ??1,060 square meters looks more like an "early education institution" with complete facilities.

Each step on the stairs is marked with a "number of steps" with brightly colored stickers. If you take the stairs from the first floor to the second floor, the old man will get a big reward - congratulations on completing this trip There are 24 steps in the "Journey to the High". Next to each bed, cartoon cushions and family photos that the elderly love are placed. When you need a private space, you can have a separate wooden sliding door by pulling the door. A small room; in the activity room, a small blackboard is written with the limerick "Four and Ten". This is one of the contents of today's course to help the elderly exercise their oral muscles; on the floor of the dementia elderly area, there is a sticker of 1~ The 12-step label is the "starting point" and "end point" for the elderly's daily exercise. Due to memory loss, even the most basic walking according to the label is an "exercise" for some elderly people.

If I hadn’t told you, you might not have imagined that this is a public welfare nursing home run by the government. No matter in terms of services or hardware conditions, it seems that this should not be a "government-backed" service, but more like a market-oriented "early education institution."

According to Chen Yuebing, director of the Aging Affairs Office of the Shanghai Civil Affairs Bureau, Shanghai’s elderly care goals during the “Thirteenth Five-Year Plan” period have evolved from the inclusive elderly care services in the past to a diversified direction. “In the past When it comes to government-run elderly care institutions, it feels like the level of services is very poor. Now we have the government provide the venue and invite social organizations to move in, and the elderly pay a small part of the cost themselves to provide more dynamic services. ”

Since the second half of 2014, Shanghai has successively launched "elderly care homes" like the Lujiazui Elderly Comprehensive Care Home in central urban areas. This kind of embedded, multi-functional, small community elderly care facility , which can provide the elderly with nearby, convenient and comprehensive elderly care services. Currently, there are 73 elderly care homes in Shanghai, and it is expected that by the end of 2017, they will cover all neighborhoods in central urban areas and suburban urbanized areas.

A new model is born, and the government no longer "directly manages" elderly care

During the "Twelfth Five-Year Plan" period, my country's elderly care service model can be simply summarized as "9073" - that is, family Self-care, community home care services, and institutional care services are integrated. 90% of the elderly care for themselves at home, 7% of the elderly care for themselves in the community, and 3% of the elderly care for themselves in nursing homes.

In the "Thirteenth Five-Year Plan", the new development of the elderly population has put forward new requirements for the elderly care model. In Shanghai, the comprehensive service supply system is more emphasized. The most ideal situation is that the three groups of "90, 7, and 3" groups can be provided with comprehensive services by the same service agency for the elderly.

“In the past, government-run elderly care facilities mainly met the needs of healthy and young elderly people; now, there are more and more disabled, dementia, and elderly people living alone in the community. For these urgent needs, we How to be satisfied? " Chen Yuebing said that Shanghai's solution is for the government and social enterprises to jointly set up elderly care service institutions, and the elderly will have to pay some money to enjoy the services.

Take Lujiazui Comprehensive Care Home for the Elderly as an example. The location and building where it is located were originally public facilities in the community. The local government purchased Shanghai Fuyuan through bidding. Elderly care center services. This elderly care service organization is fully involved in the construction of elderly care homes, starting from the decoration.

Yu Ling, the consulting manager of Fuyuan Elderly Care, told China Youth Daily·China Youth Online reporter that he participated in all the decoration, space utilization, consulting and planning of this venue. “In addition to the more reasonable hardware settings, the service The recruitment of personnel is also managed by us throughout the entire process.”

This elderly care home has various types of service personnel including rehabilitation therapists, nurses, social workers, and volunteers. The amount is determined by the local government based on the actual needs of the elderly in the region and in accordance with the city's unified standards.

This morning, a reporter from China Youth Daily and China Youth Online saw that the elderly in the non-disabled area on the first floor were doing daily towel exercises with the rehabilitation therapist. This simple, simple exercise Twisting the towel around is said to be effective in exercising the elderly's finger mobility.

There are only 32 beds and 30 care places in total ("care spaces" refers to the reception capacity of the elderly in day care - reporter's note). In a community, which elderly people can stay? , which elderly people cannot stay is a big issue related to fairness.

Aunt Zheng, an elderly person living alone, registered through the WeChat platform "Lujiazui Online" and successfully moved into a comprehensive care home for the elderly. She was hospitalized for surgery 14 days ago due to a broken leg. After being discharged from the hospital, she moved directly into a two-person room in a senior citizen home. To stay here for one day, she needs to pay about 150 yuan in nursing fees, plus food expenses. This charging standard is uniform across the city.

Every night, the night watch aunt will help her get up and go to the toilet at night. "The attitude is very good. Some old people relieve themselves four or five times a night, and the aunt has no complaints." This is five or six times more than what she spends every month. It is much more cost-effective to hire a live-in nanny for 1,000 yuan. "Nannies do not have nursing qualifications. Many people hear that they have to take care of the elderly and leave without looking back."

Aunt Zheng introduced that she was in the hospital While she was hospitalized, she submitted an application online. Later, the street social worker went directly to the hospital to evaluate her condition. After passing the evaluation, she was admitted to the elderly home.

This assessment system, according to Chen Yuebing, is unified across the city. Its full name is the "Municipal Unified Elderly Care Needs Assessment Information Management System". Through various detailed standards, the elderly in different situations are divided into There are 6 levels. Some people can fully enjoy the government's "covered" services, but more people, after evaluation, can enjoy the services at their own expense and partly subsidized by the government. All applicant information is stored in the system, making it easy to search, supervise, and allocate resources in a unified manner.

Only those who serve the "disabled" and "demented" elderly people well can be said to be able to "cover everything"

One of Shanghai's basic requirements for these elderly care homes is that they can serve the disabled, Services are provided for elderly people with dementia. Chen Yuebing said that in the past, public elderly care institutions could never find a suitable "market path." But now, as national policies gradually begin to allow private elderly care service agencies to enter, public institutions have also found a suitable market path. "In addition to private Non-organizations, we also encourage responsible enterprises to participate in operations.”

Whether it can provide services for the urgent needs of disabled and demented elderly people has become a focus of “competition”.

In the process of population aging in my country, the most prominent problem currently is the rapid increase in the number of disabled and demented elderly people. The latest statistics show that there are more than 40 million disabled and demented elderly people in the country, and their elderly care and medical problems directly affect more than 100 million families.

In Shanghai, Aunt Xu, an old lady with dementia and white hair, got lost many times. Recently, her family was unable to provide care and sent her to a community elderly care home to await evaluation. During the evaluation period, the elderly home allowed her to live here temporarily and receive care.

“This is really the group of people that the government needs to take care of, and it has been a big help.

"The Xu family told reporters from China Youth Daily and China Youth Online that for Mrs. Xu's custody issue, the whole family went to no less than 10 elderly care institutions, but none of them accepted her. "The risk is too great, and they are not willing to accept her." ”

So, under such a high-risk situation, what confidence does an elderly home jointly run by the government and social institutions have to protect the elderly who are disabled or have dementia?

< p> Yu Ling told reporters that in the past, it was not that institutions were unwilling to take care of the disabled and demented elderly, but that they “did not dare to touch” this group. “From a management perspective, as long as the management is in place, there will basically not be too much risk. However, on the one hand, everyone is afraid of the unexpected, on the other hand, they are not willing to pay high management costs, so they all like to 'rob' healthy elderly people. "Yu Ling introduced that the current situation is that if a senior care service institution wants to cooperate with the government in providing senior care, in addition to accepting healthy seniors in a community, disabled and demented seniors are also "standard."

< p>Compared with the past, it is now more "safe" to serve the disabled and demented elderly.

It is reported that Shanghai has implemented the "reward instead of subsidy" policy since 2015, starting from the establishment of in-house medical institutions and recruitment. In order to help elderly care service institutions prevent operational risks, Shanghai has also launched "Comprehensive Liability Insurance for Elderly Care Institutions", which is provided by municipalities, districts and elderly care institutions. The three parties jointly bear the premiums.

As of the end of 2015, participating elderly care institutions accounted for 87% of the city's total, and the 100-bed case rate has been on a downward trend.

Since 2017, Starting in January, Shanghai has also launched comprehensive insurance for community elderly care services that covers service personnel, service objects and third-party liabilities to help community elderly care service institutions reduce operational risks.

Every elderly care service institution will be in the future. The Shanghai Municipal Civil Affairs Bureau has "a score." Shanghai has currently evaluated more than 200 elderly care institutions, and the evaluation will be completed in two to three years from aspects such as facilities and equipment, management level, service quality, and social reputation. Full coverage of the rating of elderly care institutions in Shanghai

Reference: News reports from China Youth Online

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