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同学们好
今天我们一起来学习
《机构养老照顾模式》
当前
家庭规模日趋小型化
结构趋于核心化的4-2-1模式
和家庭流动的加速
等都对传统的家庭养老模式发起了挑战
使得机构养老成为一种不可缺少的养老模式
国家对养老服务体系的定位是
机构养老是支撑地位而不仅仅是补充
多层次 多元化的机构养老市场
也逐步扩大
机构养老照顾模式是指
老年人居住在专业的养老机构中
由养老机构中的服务人员提供全方位
专业化服务的养老照顾
适合于高龄多病和无人照料的老年人
机构养老照顾模式是
社会普遍认可的一种社会养老照顾模式
养老机构按形式分为社会福利院
养老院 敬老院
日间托老所 老年公寓
老年村老年护理院
临终关怀医院等
养老机构按功能分为技术护理照顾型养老机构
中级护理照顾型养老机构
一般照顾型养老机构
养老机构按投资和经营主体可分为公办公营
公办民营 民办公助及民办民营
养老机构的设施
除医疗设施外
还设置了活动室和阅览室
举办文化活动
丰富老年人的娱乐生活和精神生活
例如
美国的太阳城中心
就是养老机构的代表
它是世界闻名的老年人专业社区
是标准的老年人乐园
太阳城中心有独立的服务设施
如医疗机构 银行 超市 邮局 教堂
还有各种室内健身娱乐中心
如游泳池 网球场
高尔夫球场 保龄球场等
成为老年产业的发展基地
虽然美国养老机构环境很不错
但真正入住养老机构的也只有20%的老人
北欧养老机构的入住率为5%~12%
英国大约为10%。
总体而言
在西方发达国家
仅有5%~15%的老年人采用机构养老
西方发达国家
对入住养老机构的老年人执行分级管理
根据老年人的身体健康状态
生活自理程度及社会交往能力
分为自理型
半自理型和完全不能自理型三个等级
不同级别的老年人入住不同类型的养老机构
在中国
不同类型的老年人分到不同楼层
或不同楼幢入住
并提供不同的养老服务
目前
我国养老机构面临养老机构数量不足
供不应求
资源利用率不高
老年护理人才短缺等主要问题
首先是机构养老供不应求
根据民政部统计数据显示
截至2017年9月
我国养老机构总数超过14.46万家
相比于2012年底的4.43万家
增长了226%
虽然
养老机构在数量上有所增加
但相对于与日俱增的老年人
依然是存在缺口
虽然存在缺口
但我国养老机构还存在资源利用率不高的问题
在公办养老院或城市养老院人满为患
但有些民营养老院和乡镇养老院则无人为津
此外
老年护理人才短缺是机构养老的另一个问题
依世界惯例
每3位老人需要1名护理人员
以我国4060万失智失能老人为基数测算
护理人员需求量至少1000万人
2017年底数据显示
全国取得养老护理员资格证仅30万人
养老服务人才还存在短缺
机构养老也有诸多优点
首先
养老机构配套设施齐全
环境优美
而且它采用集中管理
能够使老年人得到全面的
专业化的照顾和医疗护理服务
其次
养老机构中
各种社会活动
和丰富的文化生活有助于解除
或减轻老人的孤独感
从而提高其生活品质
再次
养老机构人员的配备能创造就业机会
从而缓解就业压力
此外
机构养老可以减轻家庭的照顾负担
让老年人的子女从繁杂的日常照料中解脱出来
当然
机构养老也有它的缺点
例如加重家庭和社会经济负担
养老机构管理体制
和运行机制不能完全满足老年人的需求
机构养老容易造成亲情
友情的淡化和缺失
首先
家庭和社会经济负担加重
就家庭而言
机构养老需要有一定的经济支持
就社会而言
有关数据表明
预计到2030年
每4个中国人中就会有1位老人
如果要满足社会所有老人的需求
兴建大批养老院
耗资巨大
这将会增加社会的经济负担
其次
养老机构管理体制
和运营的机制不能完全满足老年人的需求
表现在国家投入的
环境和居住条件较好的养老机构数量不足
而民办养老机构由于实力不足
大多数养老机构生活环境条件较差
设备设施不齐全
服务队伍人力不足等
没有达到
《老年人福利机构基本规范》
和《养老护理员国家职业标准》
等法规的要求
再者
机构养老容易造成老人与子女
亲朋好友间情感的缺失
将老人送到养老机构后
子女们认为有养老机构的照顾相对比较放心
会因为工作忙等原因而减少了对老人的探望
容易造成亲情 友情的淡化和缺失
我国人口老龄化超前于社会经济的发展
养老照顾要承受巨大的财政负担
和人力资源需求的双重压力
这就要求我国既不能单纯执行居家养老
也不能大范围推广机构养老
而必须创新养老照顾模式
走多元化养老照顾之路
建立以居家养老模式为主体
以机构养老模式为辅的养老照顾服务体系
通过今天的学习
我们了解了机构养老照护模式的定义
现状以及优缺点等
今天我们的课就讲到这里
谢谢
-1.1 Human Life Expectancy and Age Classification of the Elderly
--Human Life Expectancy and Age Classification of the Elderly
--【Vedio Recommendation】 How do we measure life expectancy ?
-1.2 Population Aging
--【Literature Recommendation】World Report on Ageing and Health: 2015
-1.3 Influence and Countermeasures of Population Aging
--Influence and Countermeasures of Population Aging
--【Literature Recommendation】World Population Ageing Highlights:2019
-1.4 Goals and Principles of Elderly Care
--Goals and Principles of Elderly Care
--【Book Recommendation】Evidence-Based Geriatric Nursing Protocols for Best Practice
-1.5 Theories Related to Elderly Care
--1.5.1 Personality Development Theory and Life Review
--1.5.2 Disengagement Theory and Activity Theory
--1.5.3 Self-efficacy and Chronic Disease Management
--【Vedio Recommendation】8 Stages of Development by Erik Erikson
--【Literature Recommendation】Activity Theory, Disengagement Theory, and Successful Aging
--【Book Recommendation】Self-Efficacy in Changing Societies
-1.6 Elderly Support and Elderly Care
--1.6.1 Concepts of Elderly Healthcare, Elderly Support and Elderly Care
--1.6.2 Home-based Elderly Care Model
--1.6.3 Institutional Elderly Care Model
--1.6.4 Integrated Medical and Nursing Care Model
--【Vedio Recommendation】Day in the Life of Home Care
--【Website Recommendation】Official Website of the National Institutes of Health
-Concept Map
--【Concept Map】General Introduction to Geronological Nursing
-【Test】CHAPTER 1
-2.1 Aging Changes in the Elderly
--2.1.1 Aging of the Respiratory System
--2.1.2 Aging of the Cardiovascular System
--2.1.3 Aging of the Digestive System
--2.1.4 Aging of the Urinary System
--2.1.5 Aging of the Endocrine System
--2.1.6 Aging of the Motor System
--2.1.7 Aging of the Nervous System
--2.1.8 Aging of the Sensory System
--【Literature Recommendation】Exercise Attenuates the Major Hallmarks of Aging
--【Book Recommendation】Hazzard's Geriatric Medicine and Gerontology
-2.2 Comprehensive Health Assessment of the Elderly
--Comprehensive Health Assessment of the Elderly
--【Literature Recommendation】Instruments to evaluate mental well-being in old age: a systematic review
-2.3 Principles of Elderly Health Assessment
--Principles of Elderly Health Assessment
-2.4 Assessment of the Functional Status of the Elderly
--Assessment of the Functional Status of the Elderly
--【Literature Recommendation】The Lawton Instrumental Activities of Daily Living (IADL) Scale
-2.5 Assessment of Cognitive Function in the Elderly
--Assessment of Cognitive Function in the Elderly
-2.6 Assessment and Adjustment of the Living Environment for the Elderly
--Assessment and Adjustment of the Living Environment for the Elderly
-Concept Map
--【Concept Map】Elderly Health Assessment(1)
--【Concept Map】Elderly Health Assessment(2)
-【Test】CHAPTER 2
-3.1 Overview of the Psychological Characteristics of the Elderly
--Overview of the Psychological Characteristics of the Elderly
-3.2 Influencing Factors of Psychological Changes in the Elderly
--Influencing Factors of Psychological Changes in the Elderly
-3.3 Common Psychological Issues and Their Management in the Elderly
--3.3.1 Common Psychological Issues and Their Management in the Elderly (1)
--3.3.2 Common Psychological Issues and Their Management in the Elderly (2)
--【Book Recommendation】Development Through the Lifespan
-3.4 Depression in the Elderly
--3.4.1 Overview of Depression in the Elderly
--3.4.2 Clinical Symptoms of Depression in the Elderly
--3.4.3 Caring for Elderly Patients with Depression
--【Documentary Recommendation】Depression:Out of the Shadows
-3.5 Elderly Patients with Dementia
--3.5.1 Identification of Dementia Symptoms in the Elderly
--3.5.2 Intelligence Rehabilitation of Elderly Patients with Dementia
--3.5.3 Safety Care of Elderly Patients with Dementia
--【Website Recommendation】The Global Voice on Demaentia
-Concept Map
--【Concept Map】Elderly Mental Health and Mental Health Care
-【Test】CHAPTER 3
-4.1 Precautions for Daily Care of the Elderly
--Precautions for Daily Care of the Elderly
-4.2 General Care of Elderly Skin
--4.2.1 Characteristics and General Care of Elderly Skin
--4.2.2 Skin Itching and Its Management in the Elderly
--【Website Recommendation】American Academy of Dermatology
-4.3 Clothing Hygiene for the Elderly
--Clothing Hygiene for the Elderly
--【Literature Recommendation】The Design Methods of Functional Clothing for the Elderly
-4.4 Dietary Care for the Elderly
--4.4.1 Nutritional Needs of the Elderly and Influencing Factors of these Needs
--4.4.2 Dietary Care for the Elderly
--【Book Recommendation】Nutrition Care of the Older Adult: a Handbook for Dietetics
--【Website Recommendation】Nutrition for older persons
-4.5 Sleep Guidance for the Elderly
--4.5.1 Sleep Characteristics of the Elderly
--4.5.2 Sleep Guidance for the Elderly
--【Book Recommendation】An Occupational Therapist's Guide to Sleep and Sleep Problems
--【Website Recommendation】American Academy of Sleep Medicine
-4.6 Exercises Guidance for the Elderly
--4.6.1 Evaluation of Exercise Intensity in the Elderly
--4.6.2 Precautions Elderly Undertaking Exercises
--【Website Recommendation】American College of Sport Medicine
--【Book Recommendation】Handbook of Activities for the Elderly
-Concept Map
--【Concept Map】Elderly Daily Care
-【Test】CHAPTER 4
-5.1 Characteristics of Drug Metabolism and Pharmacodynamics in the Elderly
--Characteristics of Drug Metabolism and Pharmacodynamics in the Elderly
--【Website Recommendation】How Drugs Work In the Elderly
-5.2 Common Adverse Drug Reactions and Their Causes in the Elderly
--Common Adverse Drug Reactions and Their Causes in the Elderly
-5.3 The Principles of the Use of Medications in the Elderly
--The Principles of the Use of Medications in the Elderly
-5.4 Prevention of Adverse Drug Reactions in the Elderly
--Prevention of Adverse Drug Reactions in the Elderly
-5.5 Medication Compliance in the Elderly
--Medication Compliance in the Elderly
-Concept Map
--【Concept Map】Medication Safety and Care for the Elderly
-【Test】CHAPTER 5
-6.1 Falls in the Elderly
--6.1.1 Epidemiological Characteristics of Elderly Falls
--6.1.2 Risk Factors for Falls in the Elderly
--6.1.3 Prevention of Falls in the Elderly
--【Website Recommendation】CDC STEADI(Stopping Elderly Accidents, Deaths & Injuries Tool Kit)
-6.2 Dysphagia in the Elderly
-6.3 Urinary Incontinence in the Elderly
--Urinary Incontinence in the Elderly
-6.4 Constipation in the Elderly
-6.5 Dry Mouth in the Elderly
--【Website Recommendation】Academy of Nutrition and Dietetics
-6.6 Elderly Nutritional Deficiencies
--Elderly Nutritional Deficiencies - emaciation
-6.7 Visual Impairment in the Elderly
--Visual Impairment in the Elderly
--【Website Recommendation】Senior Eye Exams
-6.8 Senile Deafness
-6.9 Elderly Delirium
-6.10 Elderly Frailty
--【Literature Recommendation】Frailty in elderly people/Frailty in older people
-6.11 Pneumonia in the Elderly
-6.12 Hypertension in the Elderly
--【Literature Recommendation】2018 Chinese Guidelines for Prevention and Treatment of Hypertension
-6.13 Stroke in the Elderly
-6.14 Stable Angina in the Elderly
--Stable Angina in the Elderly
-Concept Map
--【Concept Map】Nursing Care for the Elderly with Common Health Problems and Diseases
-【Test】CHAPTER 6
-7.1 Concept of Hospice Care
--【Website Recommendation】 Definition of Palliative Care,WHO
-7.2 Death Education
--【Book Recommendation】The Meaning of Death by Herman Feife
-7.3 Nursing for Pain in the Dying Elderly
--Nursing for Pain in the Dying Elderly
-7.4 Nursing for Major Bleeding in the Dying Elderly
--Nursing for Major Bleeding in the Dying Elderly
-7.5 Nursing for Delirium in the Dying Elderly
--Nursing for Delirium in the Dying Elderly
-7.6 Nursing for Dyspnea in the Dying Elderly
--Nursing for Dyspnea in the Dying Elderly
--【Website Recommendation】The Hospice and Palliative Nurses Association,HPNA
-7.7 Psychological Problems and Nursing in the Dying Elderly
--Psychological Problems and Nursing in the Dying Elderly
--【Book Recommendation】On Death and Dying ,by Elisabeth Kübler-Ross
-7.8 Grief Counseling for the Widowed Elderly
--Grief Counseling for the Widowed Elderly
--【Book Recommendation】I Wasn't Ready to Say Goodbye,by Noel·Brook,Blair·Pamela
-Concept Map
--【Concept Map】Hospice Care for the Elderly
-【Test】CHAPTER 7