Establish a social support system for family caregivers of disabled elderly people

Under the background of the increasing life expectancy of the population, the rapid increase of the elderly population with disability and dementia, and the gradual decline of family nursing function, the establishment and improvement of long-term care service system is the fundamental way to deal with the future care crisis of the elderly population in China. The long term care service system does not exclude informal family care, on the contrary, family members are the key care providers and care arrangement coordinators in the long term care resource system. The 14th Five-Year Plan for National Economic and Social Development of the People's Republic of China and the Outline of the 2035 Vision Goals emphasize that in improving the elderly care service system, "support families to assume the function of elderly care." Family caregivers are the main force in the family to provide daily care and spiritual comfort for the elderly. Supporting family caregivers, making full use of family care resources, and improving family care ability are the contents that cannot be ignored in improving China's pension service system and long-term care service system.

The practical need to support family caregivers of disabled older persons

The results of the fourth sample survey on the living conditions of the elderly in urban and rural China show that there are more than 40 million disabled and semi-disabled elderly people in China. Under the circumstances of insufficient supply of socialized long-term care services, obvious cultural preference for family care and limited family purchasing ability, it is a common reality in China that disabled elderly people are mainly cared for by family members at home.

Family caregivers of the elderly with disabilities at home are a very large group. The survey results of Beijing's "precise help" demand show that the family caregivers of disabled elderly people are mainly the children and spouses of the elderly, mainly middle-aged and elderly people aged 50-69 years old, and nearly 30% of the family caregivers are employed. The survey also showed that family caregivers of disabled elderly people took care of the elderly for an average of 11.5 hours per day, and half of them took care of the elderly for more than 8 hours per day, with an average care period of nearly 12 years. The care provided by family carers is very extensive, involving daily life care, housework, medical and other activities such as going out and hospitalization, etc. Many family carers also need to do some basic care work, such as monitoring the vital signs of the elderly, injecting drugs, wound care and emergency injury management. However, most family caregivers have not received education or training in caring for disabled older persons, and caregivers generally lack certain caregiving knowledge and skills.

Due to the long-term intensive care of disabled elderly people, family caregivers are very prone to physical exhaustion, increased negative emotions, social restrictions, and economic difficulties, and employed family caregivers have conflicts between family care and work. Data from a survey on the demand for "precise help" in Beijing show that nearly 70% of family caregivers feel pressure to take care of disabled elderly people. Among them, half of the family caregivers have physical pressure, 45% have economic pressure and social communication restrictions, more than 30% of the family caregivers have psychological pressure, and nearly 30% of the working family caregivers have caring and work conflicts.

Being under heavy caregiver pressure for a long time will damage the physical and mental health of caregivers, and easily lead to elder abuse behavior, and reduce the quality of family care for disabled elderly people. At present, China's elderly population cohort is basically not affected by the family planning policy, and family care resources are relatively rich. However, in the future, as the parents of the only child gradually enter the age and disability period, family caregivers will face the dilemma of lack of daily assistance from family members, and even no temporary emergency substitute caregivers, and the pressure of care can be imagined.

Family caregiver support policies and practices are still in the exploratory stage

Affected by the traditional family nursing culture, the family caregivers of the elderly have always been a group that has not received enough attention in the public sphere. In recent years, there have been scattered support for family caregivers in national and local policies related to elderly care services, and some pilot services to support family caregivers have been launched in some urban areas. On the whole, the policy and practice of family caregiver support for the elderly in China is still in the exploratory stage, and there are still many deficiencies.

First, there is no legal basis for supporting family carers, nor has there been a unified policy provision at the national level, resulting in insufficient authority and impetus for policies. At present, most of the policies related to family caregiver support are local policies, and authoritative and stable policies and regulations are urgently needed to promote the change of social concepts and the development of family caregiver support practice.