On April 13, the old man was discharged from the hospital and went home.
Editor's note
From the problems encountered by a disabled mother to the attention of disabled mothers in the whole society, China Real Estate News has been promoting four years of non-stop research and the People's Political Consultative Conference (CPPCC), and the State Council's pilot document on embedded service facilities has finally been released. It is very important for the family and the hospital system to correctly evaluate the physical symptoms of the disabled elderly, how to take a slightly argumentative assessment after the disability, whether to stick to the difficult road of rehabilitation or simply give up, and how to choose the right path after the second disability...... All these need to have an understanding of the meaning of the life of the elderly, and how can the family, society, and the government be linked? The whole society should use every day and every action to tell people that they should work hard for the high-level spiritual world of human civilization and progress.
Text丨He is credible
Editor丨Li Zhen and Liu Wei
The old are supported, dependent, happy, and safe, and the eugenics generation is a sign of China's prosperity. And one person is disabled, the whole family is unbalanced, one generation has fewer children, and the second generation is anxious, which may lead to social gaffes.
Since 2020, China Real Estate News has paid close attention to the situation and problems of "one old and one young", and has joined hands with the People's Political Consultative Conference Daily to conduct grassroots research for many times. According to the research results, a special report of tens of thousands of words on the construction of "one old and one small community excellent care station" was written, and more than 20 million words of post station management standard manual was sorted out, which provided a meaningful reference for decision-making.
On the eve of the National People's Congress and the National People's Congress this year, the National Development and Reform Commission, the Ministry of Housing and Urban-Rural Development and other departments issued the "Implementation Plan for the Construction of Embedded Service Facilities in Urban Communities", which was recently forwarded by the General Office of the State Council to all regions and departments for implementation. This is a major event in life and a major event for the country for thousands of elderly people, 44 million disabled people, newborn infants and young children aged 0~3 and their families.
This is a great social project, not can be overnight to fill the gap in construction, but the state vigorously promote the overall promotion, there is no turning back, all localities must be accurate, fast, effective implementation, especially all walks of life and provincial and municipal media, to vigorously follow up the report, find good practices, report on the problems that arise, promote and develop the cause of the greatest merit and the largest blue ocean, and solve problems for children, families and society.
The main recommendations of the project and practice
Through the practice of more than four years of rehabilitation and disability of a disabled elderly, the family has a total of 8 people participating all year round, 6 times of nursing and nanny rotation, and a total of tens of thousands of yuan in medical and nursing expenses.
According to our comprehensive elderly rehabilitation pilot, as well as the investigation of the situation of 0~3-year-old infants and young children without care, at present, it is the responsibility of the government, family, society and the market to do the following work, and it is also a "just need".
1. Accelerate the construction of embedded service facilities, on the basis of 50 cities this year, every city and county should have a pilot next year.
2. Explore government guidance, comprehensive coordination, and the implementation and entrusted operation of policies of various ministries and commissions. For example, the "one old and one young" service, the market operation of the Youyang Station, and the sustainable operation model of family participation.
3. Explore the introduction of fiscal, tax, financial and other support policies.
4. Establish an "authoritative excellent post station coordination group" in the country. Large central enterprises lead local state-owned enterprises and market-oriented companies to jointly establish a data-based and intelligent platform.
5. The government, family, society, and the market work together to support the policies of "one old and one young" in the community, and use a comprehensive mechanism to solve the urgent needs of the masses.
We have verified the urgency and necessity of the construction of embedded service facilities in the community from the whole process of rehabilitation and disability of a disabled elderly. At the same time, in the comprehensive linkage of catering, nursing staff learning and training, education, social welfare, treatment experiments and other work, we saw the blue ocean of healthy elderly management and business, and the work and behavior of rehabilitation nursing, which is not only a socialist merit, but also a blue ocean of the new economy.
6. The elderly need to respect life after they become disabled, and the hospital system should have a basis for evaluating the physical signs of the elderly.
One
One old and one young: a major event for the stability of the country
"After four years of rehabilitation and care for disabled mothers, I realized that the most difficult bone to gnaw on the elderly is the care and rehabilitation of the elderly after disability, which is by no means capable of a family, and requires a system and a linkage mechanism. The construction of embedded service facilities in the community is fundamental. For the care of the disabled elderly and the construction of community service facilities, Li Wenzhong, director of the Social Affairs Management Committee of China Real Estate News, has deep feelings.
When I heard that the National Development and Reform Commission, the Ministry of Housing and Urban-Rural Development and other departments researched and formulated the "Implementation Plan for the Construction of Embedded Service Facilities in Urban Communities", which has been recently forwarded by the General Office of the State Council to all regions and departments for implementation, the elderly with disabilities and those who care about the 44 million disabled people across the country feel the slightest relief, and their efforts and appeals over the years have not been in vain.
A Guangxi netizen who takes care of his hemiplegic father said: "Sometimes I can't take care of the elderly, I am very irritable, I have said heavy things to my father, and after I finished speaking, I feel that he is very pitiful and I feel very guilty." There is no way, the days have to go on, and the care has to go on. "This is just a microcosm of the 44 million disabled families in the country. The situation is still changing, and the "Blue Book of China's Pension Services (2012~2021)" predicts that the total population of disabled elderly in mainland China will increase significantly by 2030.
"'One old and one young' is a common problem faced by Chinese families, and this policy was introduced before the two sessions, hoping to become a tipping point for the 'one old and one young' problem. This also makes us feel that the persistence and efforts in the discussion and practice of this topic in the past four years are worthwhile. Li Wenzhong said that China Real Estate News will continue to do a good job in news publicity and public opinion supervision and reporting, continue to pay attention to the solution of the problem of "one old and one small" in the community, and through the complete establishment of an integrated service platform, in order to truly achieve both the great merit of socialism and the new blue ocean of the new economy. ”
Two
Four years of practice and research, together with all walks of life
One person is disabled, the whole family is out of balance" is the dilemma faced by many families with disabilities, and how to do a good job in the care of disabled people is not easy.
"Through the process of caring for a disabled mother, I feel that it is almost impossible to achieve normal care with a family, children, especially now that they are all only children. This also verifies the urgency of the construction of embedded service facilities in urban communities, and we need to form a mechanism and system. Li Wenzhong said.
Because of experience, I understand. In 2021, according to the needs of social development, China Real Estate News and the People's Political Consultative Conference News launched the activity of "Attaching Importance to Community Service Areas - Promoting the Overall Construction of China's Youyang Post Station", and the research team joined hands with 100 cities across the country, 100 local party media, top 100 real estate enterprises, top 100 properties, and well-known medical and health care institutions to visit community service needs, the construction of "one old and one young", and the exploration of new consumption hotspots. The survey covered 41 large communities in 24 cities under the jurisdiction of 14 provinces, autonomous regions (municipalities) of Beijing, Tianjin, Guangdong, Henan, Liaoning, Anhui, Hunan, Jiangxi, Fujian, Gansu, Hubei, Chongqing, Jiangsu, and Ningxia, with a total of 164423 families.
After 10 months of joint investigation and research, it was found that there are two major problems in family life that need to be paid attention to: one is "the most difficult bone to gnaw in the elderly", there is a situation of "one person is disabled, the whole family is unbalanced", and the daily work and life of the young and middle-aged generation are greatly affected; second, the lack of basic facilities for infant care in the community and the lack of infant care education have led to the reluctance of some young people to have children, which affects the family happiness index. In terms of elderly care, home care is still the first choice for the elderly in China. According to the report, 44.5% of the elderly tend to live in ordinary residential communities, and they can maximize their pension needs and psychological satisfaction from community participation, while the elderly have a higher demand for professional pension services, and they need more professional services and care, with 33.2% of the elderly group aged 80 and above preferring to live in professional pension apartments. "Living alone" is also becoming the norm for the elderly, with 65.5% of the elderly living independently (alone or with their spouse), and the proportion of people living with children is gradually decreasing, even among the elderly group aged 80 and above, the proportion of independent living is still as high as 48%.
And once "people are disabled, it's important that medical and care needs are met in the community." A person who understands the needs of the disabled said that it is difficult to stay in the hospital for a long time, it can be said that it is unrealistic, and the hospitalization in large hospitals can only be two or three months, because of the problem of beds, many hospitals are unwilling to admit the disabled elderly.
In the research activities of China Real Estate News and the People's Political Consultative Conference Daily, the surveyed families have a strong demand for community medical facilities, due to the aging of physical functions, limited activity capacity and range of activities, the elderly have more prominent needs for the community and surrounding environment and facilities, among which outdoor exercise, sitting and chatting and grocery shopping are the daily high-frequency activities of the elderly in the community. They have a strong demand for the construction of the Youyang Station, and they are more willing to pay for the services of the Youyang Station, and the average monthly cost is more than 1,500 yuan. Judging from the survey results, because most of the community supporting projects are self-selected projects, the Youyang Post Station has become the most needed but most scarce livelihood project in the community. Among the surveyed communities, only 1 community has a special care station and can provide some day care services for the elderly, the number of communities with no planning at all is 10, and 7 communities have set up activity centers for healthy elderly people but do not have day care services for the elderly.
Relatively speaking, Li's mother, who was disabled after an illness, was lucky and happy.
Four years ago, she suddenly fell ill and was sent to the hospital for timely treatment, leaving a serious sequelae - loss of freedom of movement. The burden of care falls on two generations of the family. During the home rehabilitation stage, in addition to the four children who were accompanied by them in shifts day and night, professional nursing staff and male relatives with greater strength were also invited to assist. Over the past four years, after the efforts and careful care of doctors, nurses, nurses and family members, the elderly have been practiced day after day in accordance with scientific rehabilitation design standards and nursing standards.
The rehabilitation of the disabled elderly is a systemic issue involving the government, society and family. As for how to improve the dilemma of difficult care for the disabled elderly, Li Wenzhong said that from the perspective of care experience, families need at least one full-time caregiver to take care of a disabled or partially disabled elderly, and a completely disabled elderly generally needs more than two caregivers, and also needs to have life support personnel. "Therefore, taking care of the disabled and partially disabled elderly is a heavy economic, human and mental burden on families. In particular, many families of the elderly over 60 years old in urban areas are single-child families, and they basically do not have the ability to solve the problem of nursing and rehabilitation of the disabled and partially disabled elderly. ”
Three
The disabled elderly, infants and children need to work together
According to the 2020 survey results of the China Health and Elderly Care Tracking Survey (CHARLS), more than 95% of disabled or semi-disabled elderly people are cared for by family members, and children are no longer the main caregivers, and more than half of the disabled elderly are cared for by their spouses independently. Because of the poor ability to respond to emergencies and the low degree of professionalism of care, this type of care often faces various difficulties and even has a negative impact on caregivers.
The problems don't stop there. Three scholars, Ai Jingyi and Feng Jin of Fudan University and Yu Yangyang of Shanghai University of Finance and Economics, found that caring for a spouse increases the likelihood of depression, physical pain and other health problems in caregivers, and the length of care has a significant negative impact on health.
This exposes the shortage of embedded services and their facilities in the community. After the investigation of China Real Estate News and the People's Political Consultative Conference Daily, in the "Report on the Status and Future Trend of Community Home Care for the Elderly", they deeply analyzed the hardware supporting needs of the elderly living communities.
At present, more than 60% of the elderly "live independently", and community rehabilitation facilities need to be improved. For example, the elderly have a strong demand for community medical services, such as health monitoring, medical delivery, and family doctor programs.
In addition, community services for the elderly have become the biggest "rigid need", and the survey report shows that 44.5% of the elderly tend to live in ordinary residential communities, and they can obtain maximum pension needs and psychological satisfaction from community participation.
The reality is that the current allocation of various community services does not match the actual needs of the elderly.
In 2021, the community will start the upgrading and transformation of the "old community", although there is a building space that can be transformed into a "one old and one young" excellent care station, but after the community transformation, it would rather build this space into a "bicycle parking shed" and rent it to department stores and supermarkets, rather than build the "one old and one young" excellent care station with the rigid needs of residents in the community.
Over the years, China Real Estate News has conducted a lot of research and suggestions on the construction of community embedded service facilities such as Youyang Station. For example, it is suggested that in the work plan for the renovation of old urban communities, it is clear that the community can transform and use the internal idle property for use, or set aside rooms and ground to build houses, and open "elderly care centers" and "community elderly care medical care stations" with an area of 200~600 square meters, so as to provide policy support for the legitimacy of the use of community elderly care space and venues, and provide policy support for the participation of social resources and even socialized operation; Encourage social forces to participate in the pilot of the market-oriented chain operation model of community elderly care, etc.
In China, most elderly people who need long-term care actually live in their own homes or with their children. Since the vast majority of disabled elderly people in mainland China are in a state of home care, we need to integrate institutional care, community care and home care to form an organic system, so as to do a good job in elderly care services.
"In the process of renovating the community, set aside 200 square meters to 600 square meters of space to achieve community pension, and also plan and configure in the new community, so that the future 'post-50s', 'post-60s', 'post-70s', 'post-80s' and even 'post-90s', after their parents are old or some of the elderly are disabled, it will be the most favorable system and mechanism guarantee. Li Wenzhong said that after the previous experience, China Real Estate News will continue to promote this matter, hoping that in all communities and the future community development and construction process, people will work together to do the meaningful thing of community pension. Zhang Yang, a famous host of Beijing TV, couldn't help but say after watching the feature film shot by China Real Estate News that this is the best gift for mothers all over the world!
Four
The greatest merit, the best blue ocean
In the next decade, the aging of the mainland will continue to deepen. Therefore, it is the general trend to manage the life and consumption of healthy elderly people aged 60 to 78 in an all-round way, and they are the main group of people in the development of the new economy. In the community, design and organization have become a must.
The Ministry of Housing and Urban-Rural Development has made new arrangements in accordance with the division of labor among ministries and commissions.
"The goal of building a complete community is consistent with the implementation of the construction of community embedded service facilities. In order to do a good job in connecting the two tasks, we have taken measures such as focusing on community service facilities for the construction of complete communities, coordinating the construction standards of community service facilities, and establishing an efficient working mechanism. Zhang Yan, deputy director of the Department of Building Energy Efficiency and Science and Technology of the Ministry of Housing and Urban-Rural Development, said that in the next step, multiple measures will be taken to cooperate with the National Development and Reform Commission to do relevant work.
First, comprehensively carry out urban physical examinations to find out the shortcomings of community facilities. Starting from 2024, the urban physical examination work will be carried out in cities at and above the prefecture level, and the community, community, and block will be listed as the basic unit of urban physical examination, and the shortcomings of community elderly care service facilities, infant care service facilities, public activity venues, cultural activity centers and other facilities will be found to be substandard, imperfect in function, and inadequate in service, and the problem ledger will be listed, entered into the information platform and dynamically updated, so as to provide strong support for the scientific planning, reasonable layout, and accurate embedding of community service facilities.
Second, the implementation of urban renewal actions, the construction of community facilities according to local conditions. In the renovation of old urban communities, we will carry out the "corridor revolution", "environmental revolution" and "management revolution", and improve the supporting facilities through reconstruction, purchase, replacement, leasing and transformation. In the construction of complete communities, we will focus on the shortcomings of "one old and one small" service facilities, implement a number of construction projects such as elderly service stations, nurseries, and kindergartens, connect the 15-minute living circle, promote the overall construction and linkage transformation of adjacent communities and surrounding areas, and strengthen the co-construction and sharing of facilities. In the construction of dynamic blocks, the implementation of old commercial areas, pedestrian streets, old factories and other renovation, the vacated space resources are prioritized for the construction of public service facilities.
Third, strengthen and improve the management of residential properties to help improve the level of community services. Give full play to the advantages of property service enterprises close to residents, develop community pension, childcare, housekeeping, meal assistance and other life service businesses, and explore the "property service + life service" model. Promote property service enterprises to accelerate the development of online and offline life services, improve the level of smart property management services, make up for the shortcomings of community services, and better meet the diversified and multi-level life needs of residents.
In addition, we should pay attention to the market mechanism and scale effect, scientifically select the construction and operation modules such as public construction and private construction, private office assistance, and government procurement of services, and provide low-cost facility space to service operators. Advocate the embedded service model of chained and managed operation community, and build a "street-community-community" service system. Support all localities to actively build and cultivate community service "leader" enterprises and service brands.
Liu Ming, director of the Social Development Department of the National Development and Reform Commission, also said that all localities should give priority and focus on providing services urgently needed by the masses in accordance with the requirements of precise services, and focus on promoting and giving priority to the construction of community embedded service complexes (community service centers) with complex and integrated functions to provide one-stop services for residents.
In addition to community-based embedded services, insurance services should also be supported to address the long-term care of the disabled. Li Wenzhong suggested that in view of the aging population and the declining birthrate, it is necessary to increase one insurance - insurance for the elderly and children. It is necessary to further expand the scope of the "long-term care insurance" pilot project, find a solution to the problem in line with the actual situation of the mainland, establish a long-term care insurance system as soon as possible, and reasonably distribute the responsibility for old-age care and childcare among individuals, units, the state and society. "If long-term care insurance can cover half of the market price, and the other half is paid in pensions, supplemented by social assistance and charitable donations, it should not be a problem for the totally disabled elderly to be admitted to skilled care facilities. ”
In the survey of China Real Estate News and the People's Political Consultative Conference Daily, 91.3% of the respondents hope to be able to provide health care services and health examination consultation for the elderly and infants, 69.6% of the families hope that the post station can provide rehabilitation care for the elderly, 78.3% of the elderly hope to provide psychological counseling and companionship services, 95.7% of the elderly hope that the post station can open up home appliance maintenance, regular volunteer scissors service content, 91.3% 47.8% of the elderly hope that the post station can regularly hold legal consulting services for the protection of the rights and interests of the elderly, such as the establishment of a will, etc., and 78.3% of the elderly hope that the post station can have a special person responsible for the payment of water and electricity property fees and the supermarket purchase and purchase services.
A caregiver of a disabled mother said she returned to the family to take care of her mother "full-time" because she wanted her mother's old age to be "not just alive, but also quality".
One respondent hopes that his father will be relieved from the plight of caring for his mother. His desire represents the voice of the families of the disabled elderly: they hope that the disabled elderly can receive more attention and social support.
They are society and should be seen. Doing a good job in the rehabilitation and care of the disabled elderly, as well as taking care of infants and young children, will undoubtedly be the greatest merit and the best blue ocean.
"Now is the time. Li Wenzhong said that this road has been highly valued by the party and the state, and at the same time the social recognition is higher, for breaking the problem of "no filial son before the bed of a long illness", promoting young people to dare to have children, and solving the problem of "one person is disabled, the whole family is unbalanced." One generation has fewer children, and two generations are anxious", all of which make people see hope.
News scene
Dr. Qing Song from the Department of Neurosurgery of Beijing Shijingshan Hospital and the patient's family explored the road to secondary disability recovery.
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Dr. Ma and Dr. Shao Pengfei, Director of the Department of Neurosurgery of Beijing Shijingshan Hospital, and Dr. Shao Pengfei, Deputy Director of Qingsong, performed hydrocephalus surgery for the second rehabilitation of the disabled elderly after four years.
The last time the elderly were disabled and were able to walk after recovery, the second disability brought more difficulties, the picture shows the nurse Huang Sijuan (first from the right) and her family sent to the hospital.
The family is fully engaged in the hospital, participating in nursing and feeding nutritious meals.