Elderly care does not leave the "home" to open up the "last kilometer" of home-based elderly care services

"Old age care does not leave home" "service distance a bowl of soup"...... According to the survey, 90% of the elderly in China tend to care for the elderly at home, especially the active elderly and the disabled and semi-disabled elderly. In the face of huge inclusive and basic needs, home care services are also facing the embarrassment of lack of people, lack of funds and lack of standards. How to encourage and guide social forces and professional resources to extend and flow to the home? How to build a community home integrated service model and open up the "last mile" of home care services?

Difficulties: There is a big shortage of nursing talents for the elderly

"All the work at home is well done, and the attitude is enthusiastic. But outside of household chores, if you have some physical discomfort, the service staff can't handle it." For three years, Zhang Cuilan (a pseudonym), an 85-year-old living alone in Xiaodian District, Taiyuan, has always had regrets.

Zhang Cuilan's regret is also the reality of home care dilemma. The reporter learned that at present, most of the grass-roots home care services are not highly professional, and still prefer basic domestic service. Nursing staff's low education and professional level are insufficient, and the contradiction is prominent compared with the increasingly urgent demand for the combination of medical care and health care for the elderly.

Gao Huajun, executive director of the China Public Welfare Research Institute at Beijing Normal University, pointed out that disabled and mentally disabled elderly people need more sophisticated and professional long-term care, but neither family nor nannies can get it, which is a major challenge for the elderly.

"The pay is not good and I have to wait on people. I would rather find another job." I heard that the elderly care industry is developing rapidly and there is a shortage of high-quality nursing personnel, and Xiao Zheng, who wanted to engage in elderly care workers, finally gave up because of the gap between actual treatment and psychological expectations. It is understood that the current monthly income of most nurses is about three to four thousand yuan, and some are even lower. This kind of treatment on the market, not very attractive.

Low income, hard working conditions, heavy work content and lack of upward mobility are the main reasons why young people leave and highly educated professionals are reluctant to enter the old-age service circle. According to a report released by the China Institute of Public Welfare at Beijing Normal University, even according to the general standard of 1:3 completely disabled population care ratio, China's shortage of elderly care talents has reached 5 million. This has formed a huge constraint on the improvement of the overall level of home care services.

A senior citizen measures his blood pressure at the Jinyang Home Care Service Center in Caokan village, Luancheng Subdistrict, Luancheng City, Luancheng City, North China's Hebei province, June 2, 2021. Photo by Mu Yu, Xinhua News Agency

In this regard, Chen Yuzhuo, president of the pension Industry Committee of the China Asian Economic Development Association and vice president of the medical and nursing combination Professional Committee of the World Federation of Chinese Medicine Societies, suggested in an interview with the People's Daily Network reporter that the national level should increase subsidies for the training of relevant talents. Guide, promote and motivate from the aspects of vocational education, academic qualification recognition and social recognition.

"For the one-to-one service model of home care, there must be a large number of professionals and service personnel from institutions to families." As the person in charge of the elderly care institution, Ding Shaolei, CEO of Gold Nurse, told the People's Daily Network reporter that from the perspective of supply-side reform, professional service personnel such as nurses should be able to flow freely and invigorate talent resources.

Action is already under way in some places. For example, in the implementation plan for further promoting the development of the combination of medical and nursing care released by Beijing in May this year, a "quantitative" arrangement has been made for the training of elderly service talents: "From 2020 to 2022, at least 10,000 elderly care workers, 500 leaders of elderly service institutions and 500 elderly social workers will be trained every year."

At the same time, we will encourage and support medical personnel to practice in institutions that combine medical and nursing care. Classifying and evaluating the professional title promotion of health professionals engaged in home care for the elderly, emphasizing the evaluation orientation of professional ability and work performance, and weakening the mandatory requirements of papers and scientific research. Medical staff in institutions with integrated medical and nursing care enjoy the same treatment as other medical and health institutions such as professional title evaluation and continuing education for professional and technical personnel.