scholarly journals 老齡化背景下長期照護的現實選擇: 基於儒家倫理觀的思考

Author(s):  
Lanshu JIANG ◽  
Ling ZHOU ◽  
Ran REN

LANGUAGE NOTE | Document text in Chinese; abstract also in English.中國邁入老齡化國家之後,失能老人的長期照護將會成為未來養老問題中的難點。失能老人作為病患的權利需要靠社會的福利制度來得以維繫,這在目前中國福利制度仍未十分健全的情況下是很難實現的。本文將通過對中國儒家倫理觀的思考,吸取其精華,探索老齡化背景下符合中國國情的長期照護發展之路。According to the standard set by the United Nations, if more than 10% of the population of a society is over 60 years old, then that society qualifies as an aging society. This means that China has been an aging society since 2000. Currently, China has one hundred and forty-nine million people over 60 years old, of which more than thirty million require long-term care to various degrees. 8% of elderly rural Chinese are unable to afford institutional long-term care, even if such institutional care is available. Obviously, China faces grave challenges in providing long-term care for its ever-increasing elderly population.Unfortunately, Chinese bioethics has failed to conduct careful research on these challenges to develop appropriate Chinese public policy on long-term care. This essay offers a Confucian ethical approach to the issue and proposes a series of policy recommendations framed in terms of Confucian ethical concerns. As is well known, Confucian ethics places great emphasis on the virtue of filial piety (xiao) on the part of children, who are expected to respect and take care of their elderly parents. It is the Confucian view that elderly people should, insofar as is possible, live at home, with the assistance of their children, and lead their elderly lives among their children and grandchildren. Living in an institution with other elderly people is not considered a normal, much less ideal, human living environment. This essay argues that this Confucian value should be preserved in contemporary Chinese society. This requires proper policy formulation and governmental contributions. First, in moral education, the Confucian virtue of filial piety and familial interdependence, rather than individual independence, should be promoted. Second, the government should provide financial incentives and awards to children who choose to stay home to take care of their elderly parents or grandparents. Finally, based on the Confucian virtue of beneficence (ren), the government should offer special assistance to families with seriously disabled elderly members. People should also be encouraged to organize volunteer groups to offer help to needy families. In short, the Confucian moral principle of reciprocity (“do not impose on others what you would not want others to do to you”) suggests that if we do not want to be abandoned by our children and by society when we become old, it is high time for us to act and set appropriate long-term policies.DOWNLOAD HISTORY | This article has been downloaded 935 times in Digital Commons before migrating into this platform.

2019 ◽  
Author(s):  
Chia-Shan Wu ◽  
Jiin-Ru Rong

Abstract Background Relocation to a long-term care (LTC) facility is a major life change for most elderly people. Following relocation, many elderly experience difficulties in adapting to changes in the living environment. Taiwan is increasingly becoming an "aging society” and the numbers of those who relocate from family residences to long-term residential care facilities have increased over years. However, in-depth evidence on the experiences of the elderly of their stay in LTC facilities in Taiwan is relatively sparse. This study aimed to explore the relocation experiences of the elderly to a LTC facility to inform policy and practice to address their needs effectively. Methods A qualitative study, using semi-structured in-depth interviews, was conducted to explore the experiences of 16 elderly people who have relocated to and lived in a LTC facility in Taiwan for up to a period of 12 months. All interviews were recorded, transcribed, and analyzed using grounded theory approach. Results Participants’ accounts reflected four interrelated key themes: wish to minimize the burden, but stay connected with the family; perceived barriers to adaptation; valuing tailored care; and acceptance and engagement. Each theme included interrelated subthemes that influenced one another and represented the different stages in the relocation journey. Most participants viewed relocation as a way of minimizing the burden of their care from family members, but desired to keep a close connection with family and friends. Participants recounted experiences of psychological resistance while making the decision to relocate. Fear of losing autonomy and the ability to perform self-care was a major reason for resistance to adapt. Provision of tailored care was accorded much value by the participants. The decision to accept the relocation and to adapt themselves to the new environment due to their needs for constant care was explicit in some accounts. Conclusions Relocation to LTC facility is a dynamic process in the first year of moving into the facility, and involves a range of emotions, feelings and experiences. Adaptation of the elderly into the LTC facility can be maximized if the relocation is well planned with provisions for individually tailored care and family involvement.


2020 ◽  
Author(s):  
Chia-Shan Wu ◽  
Jiin-Ru Rong

Abstract Background Relocation to a long-term care (LTC) facility is a major life change for most elderly people. Following relocation, many elderly experience difficulties in adapting to changes in the living environment. Taiwan is increasingly becoming an "aging society” and the numbers of those who relocate from family residences to long-term residential care facilities have increased over years. However, in-depth evidence on the experiences of the elderly of their stay in LTC facilities in Taiwan is relatively sparse. This study aimed to explore the relocation experiences of the elderly to a LTC facility to inform policy and practice to address their needs effectively. Methods A qualitative study, using semi-structured in-depth interviews, was conducted to explore the experiences of 16 elderly people who have relocated to and lived in a LTC facility in Taiwan for up to a period of 12 months. All interviews were recorded, transcribed, and analyzed using grounded theory approach.Results Participants’ accounts reflected four interrelated key themes: wish to minimize the burden, but stay connected with the family; perceived barriers to adaptation; valuing tailored care; and acceptance and engagement. Each theme included interrelated subthemes that influenced one another and represented the different stages in the relocation journey. Most participants viewed relocation as a way of minimizing the burden of their care from family members, but desired to keep a close connection with family and friends. Participants recounted experiences of psychological resistance while making the decision to relocate. Fear of losing autonomy and the ability to perform self-care was a major reason for resistance to adapt. Provision of tailored care was accorded much value by the participants. The decision to accept the relocation and to adapt themselves to the new environment due to their needs for constant care was explicit in some accounts. Conclusions Relocation to LTC facility is a dynamic process in the first year of moving into the facility, and involves a range of emotions, feelings and experiences. Adaptation of the elderly into the LTC facility can be maximized if the relocation is well planned with provisions for individually tailored care and family involvement.


Stanovnistvo ◽  
2012 ◽  
Vol 50 (1) ◽  
pp. 1-18 ◽  
Author(s):  
Gordana Matkovic

In Serbia, the long-term care as a system does not actually exist. One part of the system is regulated through cash benefits, one part through institutional social care and community-based social services, and one part is just being established under the health care system. The linkages among these segments are not strong and there is insufficient awareness of the need to regard the different parts of the system as being interdependent and interconnected. According to the different surveys, home care is needed for the daily functioning of more than 80,000 elderly people, especially for around 27,000 of those who are completely immobile. More than 300 thousand elderly persons have indicated that they are in need of some type of self-care support. By tradition, elderly people in Serbia rely primarily on family support. Some are getting the state support as well. Research shows that 62 thousand elderly persons (5 percent) receive attendance allowance; 9,000 elderly are accommodated in institutions (0.7 percent), while 11.7 thousand (1 percent) persons received some type of support through home care community based services. In addition, in Belgrade there are also 2,000 elderly who are beneficiaries of medical and palliative care at home. The government expenditures for these purposes can be very roughly estimated at 0.55 percent of GDP, largely for cash benefits (0.37 percent). Considered over a medium and longer term, the government expenditures on longterm care in Serbia will inevitably increase significantly, primarily due to an increase in the number and share of elderly people and the increase in additional life years spent in ill health or in need of assistance. An increase in the expenditures will also be influenced by a change in the family models and the increasing number of elderly that will be living alone, as well as the diminishing possibilities for reliance on the closest family members, especially due to emigration flows both at local and national levels. Finally, it is important not to neglect the effect of emulating more developed countries, as well as the EU?s pressure to adequately respond to the needs of the elderly. Therefore, the state and society must promptly prepare a systematic, comprehensive, timely and fiscally responsible response. This response must recognize the capacities of all stakeholders, from family to state and non-state and match the capacities with the appropriate roles in the system of long-term care provision.


Author(s):  
Seonsam Na

Until recently in South Korea, the central dilemma facing children with ageing parents was how and by whom their parents should be cared for. In accordance with the norm of filial piety, the eldest son used to take responsibility. However, with the recent proliferation of long-term care hospitals, this arrangement is changing. These institutions, which play the combined role of rehabilitative hospital, long-term care centre, and nursing home, admit elderly people who do not require active medical intervention. The government’s promotion of these hospitals, centred on deregulation, ambiguity around their function, and the lack of alternative care facilities, has led to an expansion of the sector and consequently to the ‘nursing hom(e)fication’ of many of these institutions. While these hospitals ease the pressures associated with an ageing population, their mainstreaming has had an impact on healthcare, medicine, and the lives of elderly people. The hospital field has become commercialised, medical practice is being transformed, and the dignity of elderly people is being lost through hospitalisation. In this new care regime, filial piety itself is undergoing transformation—from an ideology underpinning the domestication of care, to the market idiom of service compliance. In this article, I introduce these hospitals and investigate how their growth has brought about a Korean style of elderly care commodification, revealing the undercurrents of healthcare privatisation and the neoliberalisation of welfare.


2020 ◽  
Author(s):  
Chia-Shan Wu ◽  
Jiin-Ru Rong

Abstract BackgroundRelocation to a long-term care (LTC) facility is a major life change for most elderly people. Following relocation, many elderly experience difficulties in adapting to changes in the living environment. Taiwan is increasingly becoming an "aging society” and the numbers of those who relocate from family residences to long-term residential care facilities have increased over years. However, in-depth evidence on the experiences of the elderly of their stay in LTC facilities in Taiwan is relatively sparse. This study aimed to explore the relocation experiences of the elderly to a LTC facility to inform policy and practice to address their needs effectively.MethodsA qualitative study, using semi-structured in-depth interviews, was conducted to explore the experiences of 16 elderly people who have relocated to and lived in a LTC facility in Taiwan for up to a period of 12 months. All interviews were recorded, transcribed, and analyzed using grounded theory approach.ResultsParticipants’ accounts reflected four interrelated key themes: wish to minimize the burden, but stay connected with the family; perceived barriers to adaptation; valuing tailored care; and acceptance and engagement. Each theme included interrelated subthemes that influenced one another and represented the different stages in the relocation journey. Most participants viewed relocation as a way of minimizing the burden of their care from family members, but desired to keep a close connection with family and friends. Participants recounted experiences of psychological resistance while making the decision to relocate. Fear of losing autonomy and the ability to perform self-care was a major reason for resistance to adapt. Provision of tailored care was accorded much value by the participants. The decision to accept the relocation and to adapt themselves to the new environment due to their needs for constant care was explicit in some accounts.ConclusionsRelocation to LTC facility is a dynamic process in the first year of moving into the facility, and involves a range of emotions, feelings and experiences. Adaptation of the elderly into the LTC facility can be maximized if the relocation is well planned with provisions for individually tailored care and family involvement.


2019 ◽  
Author(s):  
Chia-Shan Wu ◽  
Jiin-Ru Rong

Abstract Background Relocation to a long-term care (LTC) facility is a major life change for most elderly people. Following relocation, many elderly experience difficulties in adapting to changes in the living environment. Taiwan is increasingly becoming an "aging society” and Taiwanese elderly is shown to differ in their expectations of long-term residential care. However, in-depth evidence on the experiences of the elderly of their stay in LTC facilities in Taiwan is relatively sparse. The aim of this study was to explore the relocation experiences of the elderly to a LTC facility to inform policy and practice to address their needs effectively. Methods A qualitative study, using semi-structured in-depth interviews, was conducted to explore the experiences of 16 elderly people who have relocated to and lived in a LTC facility in Taiwan for up to a period of 12 months. All interviews were recorded, transcribed, and analyzed using grounded theory approach. Results Participants’ accounts reflected four interrelated key themes: wish to minimize the burden, but stay connected with the family; perceived barriers to adaptation; valuing tailored care; and acceptance and engagement. Each theme included interrelated subthemes that influenced one another and represented the different stages in the relocation journey. Most participants viewed relocation as a way of minimizing the burden of their care from family members, but desired to keep a close connection with family and friends. Participants recounted experiences of psychological resistance while making the decision to relocate. Fear of losing autonomy and the ability to perform self-care was a major reason for resistance to adapt. Provision of tailored care was accorded much value by the participants. The eventual decision to face the challenge and to adapt themselves to the new environment due to their needs for constant care was explicit in some accounts. Conclusions Relocation to LTC facility is a dynamic process in the first year of moving into the facility, and involves a range of emotions, feelings and experiences. Adaptation of the elderly into the LTC facility can be maximized if the relocation is well planned with provisions for individually tailored care and family involvement.


2003 ◽  
Vol 54 (4) ◽  
pp. 277-284 ◽  
Author(s):  
Masanori Komatsu ◽  
Kayoko Hirata ◽  
Idumi Mochimatsu ◽  
Kazuo Matsui ◽  
Hajime Hirose ◽  
...  

2018 ◽  
Vol 30 (10) ◽  
pp. 1620-1641 ◽  
Author(s):  
Erin Hye-Won Kim ◽  
Changjun Lee ◽  
Young Kyung Do

Objectives: We examine how statutory workweeks affect workers’ provision of long-term care for their non-coresident elderly parents. Method: The Korean government reduced its statutory workweek from 44 to 40 hr, gradually from larger to smaller establishments, between 2004 and 2011. Using multiple regressions, we assess how the reduction affected visits, financial transfers, and in-kind transfers to parents. Annual longitudinal data come from the 2005 to 2013 waves of the Korea Labor and Income Panel Study. Results: The reduction caused an increase in the frequency of visits and in-kind transfers among male workers, with no significant impact on their financial transfers. Among female workers, we found no impact on any outcomes. Discussion: We interpret the findings within the context of developed Asian countries with long work hours and Confucian traditions, and suggest regulating workweeks as a policy tool to encourage familial long-term care in the rapidly aging societies.


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