How to improve the quality and efficiency of rural elderly care services by addressing weaknesses and strengthening motivation
2025-03-13
According to the data of the seventh national population census, there are about 267 million elderly people aged 60 and above in China, of which the number of rural elderly people is about 120 million. These rural elderly people generally have problems such as limited income, lack of care, and emotional deficiency. The aging of rural areas before becoming wealthy is a major challenge facing China's pension security. In June 2024, the Ministry of Civil Affairs, together with 21 departments including the Central Office of Spiritual Civilization Construction and the Ministry of Agriculture and Rural Affairs, issued the "Guiding Opinions on Accelerating the Development of Rural Elderly Care Services" (hereinafter referred to as the "Opinions"), which is the first overall and systematic deployment of rural elderly care services at the national level in China. The Opinion requires the idea and principle of rural elderly not leaving the village and hometown, and the promotion of the construction of rural elderly care service system at the county, township, and village levels, to promote the work of providing elderly care and services. The main weakness of rural elderly care services is accompanied by the deepening of China's population aging, and the problem of rural aging is significantly higher than that of urban aging. According to a survey conducted by the China Social Science Survey Center at Peking University, there is a clear phenomenon of "urban-rural inversion" in the aging population. Compared to urban areas, elderly people in rural areas have weaker purchasing power, lower levels of social security, higher levels of disability at an advanced age, and heavier caregiving burdens. After years of construction, the rural elderly care service system still faces difficulties. Firstly, there is a mismatch between welfare supply and demand. One issue is the regional imbalance in the supply of elderly care services. There is a significant gap in the investment and supply of elderly care service resources between economically developed and underdeveloped areas. Developed areas have more complete elderly care service facilities, while underdeveloped areas have relatively insufficient supply. The second issue is insufficient and asymmetric supply and demand information. The service provider has an inaccurate grasp of the real needs of rural elderly people, with a focus on basic living care and insufficient supply of diversified needs such as medical care, spiritual comfort, and cultural entertainment. The third is the prominent contradiction between consumption concept and payment ability. Some elderly people have conservative consumption concepts, and their willingness and ability to pay for high-quality elderly care services are far from market prices. The fourth issue is the unreasonable planning of service facilities. The layout and planning of elderly care facilities have not fully considered the living habits and actual needs of rural elderly people, resulting in a situation where elderly care facilities are idle and in short supply. Secondly, excessive marketization. One reason is that there is relatively insufficient investment in elderly care services in rural areas, and insufficient guidance for market-oriented elderly care services. Some elderly care institutions in certain regions excessively pursue market-oriented commercial profits, resulting in excessively high service prices that far exceed the actual affordability of the elderly, increasing their economic burden and reducing their accessibility to elderly care services. Secondly, market-oriented competitive behavior may lead service providers to lower service standards or quality in order to control costs, resulting in a failure to provide high-quality and specialized service support in areas such as home care and long-term care services. Thirdly, excessive market-oriented profit seeking behavior may lead to excessive concentration of elderly care resources on high profit and high profit service projects, while neglecting the inclusive supply of rural elderly people. Thirdly, take care of hollowing out. With the rapid advancement of urbanization, a large number of young and middle-aged people from rural areas are flocking to cities for employment, which has given rise to a special social group, namely the elderly left behind in rural areas. The elderly, disabled, dementia, living alone, and extremely poor elderly in this group are particularly lacking in long-term care resources. A study has found that over 90% of elderly people in rural areas, including those who are elderly, disabled, or have dementia, have a prominent contradiction between their "poor demand" and "poor utilization" in terms of home care, medical care, and mental comfort services. There is a large gap, and there are many problems due to unstable economic sources, such as insufficient self-care ability, lack of daily care, lack of mental comfort, insufficient medical security, poor living environment, and unwillingness to accept socialized elderly care services. The biggest hidden danger among them is the risk to life safety caused by sudden illnesses. Fourthly, there is a shortage of voluntary service resources. In recent years, the voluntary service mutual aid elderly care model that originated in rural areas has been widely promoted, relying on the advantages of mutual aid in familiar communities. However, the effectiveness varies in different regions due to differences in social capital and social network support endowments. One is the shortage of human resources. Many young people in rural areas go out to work, and the left behind population is mainly composed of elderly and children, resulting in a shortage of personnel participating in voluntary elderly care services. Secondly, the service content is single. At present, volunteer services are mostly focused on daily care and simple material assistance, with insufficient attention paid to the needs of the elderly for spiritual comfort, medical care, cultural entertainment, and other aspects. Thirdly, there is a lack of professional training. Volunteers are unable to provide high-quality and specialized services to the elderly due to a lack of professional care knowledge and skills during the service process. The fourth issue is the lack of effective organization and coordination in volunteer service activities, resulting in weak planning and sustainability of services, making it difficult to form a long-term mechanism. Enhancing the endogenous driving force of rural elderly care services, addressing the shortcomings of rural elderly care services and filling them in is an inevitable requirement for promoting balanced development of rural elderly care services, which can better meet the happiness and sense of achievement of rural elderly people. Firstly, to solve the problem of mismatched rural elderly care welfare, it is necessary to coordinate the matching of welfare provision and welfare use in the field of elderly care services, and improve the quality and happiness of elderly care services in rural areas. One is to strengthen the research and dynamic evaluation of the needs of elderly people in rural areas, and promote and guide social organizations to provide more accurate services needed by rural elderly people in policies. The second is to accelerate the cultivation of specialized organizations and institutions for public welfare rural elderly care services as the main providers of elderly care services by promoting state-owned elderly care enterprises to go to the countryside, government purchases, and public and private construction. The third is to support local governments to appropriately tilt their financial investment towards rural areas, and to appropriately invest in rural areas in coordinating the use of welfare lottery public welfare funds, ensuring sufficient financial support for rural elderly care services. At the same time, we will promote the construction of public welfare rural regional elderly care service centers, promote differentiated and differentiated provision of elderly care benefits, and form a diversified pattern of elderly care public service supply. Secondly, to solve the problem of excessive marketization of rural elderly care services, the government needs to strengthen supervision and regulation, and increase investment in rural public elderly care service products. One is to continuously improve the centralized care system for elderly, disabled, dementia, single living, and extremely poor people in rural areas, especially underdeveloped areas, relying on existing social welfare centers and nursing homes and other service institutions. Priority should be given to supporting the construction of elderly care homes with outstanding nursing functions in blank counties (cities, districts), ensuring that each county has at least county-level support service facilities focusing on professional care for disabled and partially disabled and extremely poor people. On the premise of adhering to the public welfare nature of public elderly care institutions, we should meet the centralized support needs of the elderly, disabled, dementia, and extremely poor people living alone, especially focusing on economically disadvantaged disabled and dementia elderly people and elderly people from special family planning families, and provide them with free or low-cost care services. The second is to focus on cultivating a public welfare elderly care culture in rural communities, in order to achieve sustainable development and fair supply of rural elderly care services. Carry out national education on population aging and promote filial piety culture of respecting and loving the elderly in rural areas. Give full play to the leadership role of village level party organizations in village affairs, lead and guide village committees and grassroots charitable organizations to play a typical demonstration role, regularly carry out selection activities for typical cases of filial piety and love for the elderly, and promote the formation of a good social atmosphere of elderly care, filial piety, and respect for the elderly in rural areas. Once again, to solve the problem of hollowing out elderly care in rural areas, the key is to enable the elderly to become self-help individuals and participants. One is to establish the concept that the elderly are both service demanders and service providers. Any family or individual should not just be passive recipients of elderly care services, but should become active participants and service providers. On the occasion of the Double Ninth Festival in 2024, General Secretary Xi Jinping wrote back to the representatives of the "Silver Age Action" elderly volunteers, clearly stating: "We hope that elderly friends can maintain a healthy mentality and enterprising spirit of being old and strong. They should not only have a sense of security and happiness in their old age, but also contribute their 'silver hair strength' to promoting Chinese style modernization. We should encourage healthy and capable elderly people to engage in light physical labor such as animal husbandry to improve their self-care ability and reduce the cost of elderly care. The second is to expand the connotation of family elderly care function. Support and encourage the practice of "helping the elderly with the elderly" within families, which breaks through the traditional intergenerational care habits of families and encourages healthy and capable younger relatives or spouses of family members to take care of older adults. For children or relatives who return home to take care of the elderly, regular free training on care knowledge and medical skills will be provided, and appropriate subsidized financial support will be given to family members and relatives who specialize in caring for economically disadvantaged and disabled elderly. The third is to popularize the renovation project of aging friendly facilities in rural areas, providing aging friendly living conditions for elderly people living at home, and improving their living convenience and self-service ability. We should encourage the digital construction of rural areas to serve the smart elderly care life in rural areas. Through technological means such as the Internet of Things, big data, and artificial intelligence, we can provide more convenient, efficient, and personalized elderly care services for rural elderly people, enhance their safety and convenience in life, improve the quality and efficiency of elderly care, and ultimately enhance their sense of happiness and achievement in integrating into modern life. Finally, vigorously develop volunteer mutual aid services. By leveraging the advantages of mutual familiarity and harmonious relationships among elderly people in rural areas, we will strengthen the leading and exemplary role of grassroots party organizations in rural mutual aid elderly care services, and deepen the development of volunteer elderly care services. Advocate the establishment of a mutual aid elderly care system involving grassroots organizations and social organizations such as village self governance organizations, young healthy elderly people, rural left behind women, and professional social work institutions, and cultivate rural mutual aid social forces as the main body of elderly care services through government procurement of services and other means. Fully rely on village level party organizations to build, manage, and run village level mutual aid nursing homes, support the village party branch secretary to serve as the chairman, and select capable and enthusiastic elderly people or village elites to serve as executive directors and secretaries general. Promote the "Party building+rural elderly care services" model and incorporate it into the evaluation and assessment system for grassroots Party building by Party committee secretaries at the city, county, and township levels, as well as the work content of "two-way reporting and two-way evaluation" for village Party organization secretaries, to ensure the implementation and refinement of various work tasks. (New Press) (This article is a phased achievement of the National Social Science Fund's general project "Research on the Innovative Development of Marx's Labor Liberation Theory in the Era of Artificial Intelligence" (21BKS098)) Authors: Wu Hongluo (Professor at the School of Marxism, Fujian Normal University), Ma Cong (PhD student at the School of Marxism, Fujian Normal University)
Edit:Luo yu Responsible editor:Wang xiao jing
Source:cssn.cn
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