中国城市老人社区照顾综合服务模式的探索

《中国城市老人社区照顾综合服务模式的探索》从宏观的老龄化社会趋势到社工专业视角下需求导向为本的基础认知着眼，落实于城市老人照顾的探索与建构。强调一个由老人需求导向带动、结合社会工作专业手法的综合服务模式如何发挥评估与实务工作的效果，并具体说明社区内老人综合服务中心的必要性和可行性，为社工、民政工作人员、民间组织工作者提供了重要参考。

目　　录 第一章　世界人口老龄化趋势…………………………………………………………………1 第一节　老年人与人口老龄化……………………………………………………………1 第二节　世界人口老龄化的历程、现状和趋势…………………………………………6 第三节　世界对人口老龄化的认识和回应………………………………………………11 结　语………………………………………………………………………………………17 思考题………………………………………………………………………………………17 第二章　中国人口老龄化趋势…………………………………………………………………19 第一节　中国人口老龄化的历程…………………………………………………………20 第二节　中国老年人口的现状……………………………………………………………24 第三节　中国人口老龄化的发展趋势……………………………………………………35 结　语………………………………………………………………………………………42 思考题………………………………………………………………………………………42 第三章　老年人需求的基本概念与含义………………………………………………………43 第一节　需求与老年人的照顾支援………………………………………………………43 第二节　需求的认识和评估………………………………………………………………45 第三节　老年人需求的类型………………………………………………………………51 结　语………………………………………………………………………………………54 思考题………………………………………………………………………………………55 第四章　对中国老年人需求的认识……………………………………………………………56 第一节　经济需求…………………………………………………………………………56 第二节　健康需求…………………………………………………………………………61 第三节　精神需求…………………………………………………………………………72 第四节　老年人的照料需求………………………………………………………………76 结　语………………………………………………………………………………………82 思考题………………………………………………………………………………………83 第五章　中国城市老年社会保障………………………………………………………………84 第一节　城市老年社会保障的现行政策…………………………………………………84 第二节　城市老年社会保障现行政策体系的总体特征…………………………………97 第三节　对城市老年社会保障现行政策体系的反思……………………………………102 结　语………………………………………………………………………………………104 思考题………………………………………………………………………………………105 第六章　中国城市老年社会服务………………………………………………………………106 第一节　老年社会照顾体系………………………………………………………………106 第二节　中国老年养老方式的转变………………………………………………………114 第三节　中国城市社区老年社会服务……………………………………………………122 结　语………………………………………………………………………………………132 思考题………………………………………………………………………………………132 第七章　以社区为本的社会支持网络理念概述………………………………………………134 第一节　社会支持网络的含义……………………………………………………………135 第二节　以社会网络分析为指导的社工介入……………………………………………142 结　语………………………………………………………………………………………143 思考题………………………………………………………………………………………144 第八章　中国社区照顾支持网络的需求分析——以广州市A区试点为例 …………………145 第一节　广州市A区老人社区支援服务需求调查背景 …………………………………145 第二节　调查显示老人社区照顾资源……………………………………………………147 第三节　老人的健康状况与失能情况……………………………………………………156 第四节　老人的经济状况…………………………………………………………………160 结　语………………………………………………………………………………………164 思考题………………………………………………………………………………………165 第九章　以社区网络模式推行社区照顾的策略：广州的经验………………………………166 第一节　解构中国城市“老人支持网络”………………………………………………166 第二节　H街“老人支持网络”的成功经验 ……………………………………………174 第三节　社区老人照顾的问题和困难……………………………………………………176 第四节　重构“老人照顾网络”策略……………………………………………………178 结　语………………………………………………………………………………………182 思考题………………………………………………………………………………………182 第十章　城市老人照顾：整合网络介入策略的综合服务中心模式…………………………183 第一节　整合服务网络……………………………………………………………………183 第二节　整合服务网络介入新模式………………………………………………………186 第三节　老人综合服务中心应用“新模式”的特点与运作……………………………191 结　语………………………………………………………………………………………193 思考题………………………………………………………………………………………194 第十一章　城市老人照顾探索性研究…………………………………………………………195 第一节　《广州市老年人优待办法》对城镇老人经济生活的影响 ——以广州市荔湾区逢源街社区为例…………………………………………195 第二节　“村改居”社区老人经济保障的实证探究 ——以广州市Y区B街X村为例 …………………………………………………206 第三节　老年居民也参保 ——对《广州市城镇居民基本医疗保险试行办法》的分析…………………215 第四节　广州市老人贫困与社工介入角色——以荔湾区逢源街道个案为例…………229 第五节　“星光老年之家”期待星光灿烂 ——以B街为例探讨“农转居”地区“星光计划”的困局 …………………252 结　语………………………………………………………………………………………265 思考题………………………………………………………………………………………265 参考文献…………………………………………………………………………………………266 CONTENTS Chapter 1　The Trends of Global Ageing ...................................／1 1.1　Elderly and the aging of population .............................／1 1.2　The history, current situations and trends of the aging issues around the world ..................................／6 1.3　The understanding and responding of the world aging problem .....／11 Remarks ..............................................................／17 Follow up thinking ...................................................／17 Chapter 2　The Trends of Population Aging in China .......................／19 2.1　The process of population aging in China ........................／20 2.2　The current situations of aging population in China .............／24 2.3　The future trends of population aging in China ..................／35 Remarks ..............................................................／42 Follow up thinking ...................................................／42 Chapter 3　The Concepts and Meanings of the Elderly Need .................／43 3.1　Needs and elderly care-support ..................................／43 3.2　The recognization and assessment of elderly need ................／45 3.3　The classification of elderly need ..............................／51 Remarks ..............................................................／54 Follow up thinking ...................................................／55 Chapter 4　The Recognization of Chinese Elderly Needs ...................／56 4.1　Domestic need ...................................................／56 4.2　The need of wellbeing and health ................................／61 4.3　Psychological need ..............................................／72 4.4　The need of daily care ..........................................／76 Remarks ..............................................................／82 Follow up thinking ...................................................／83 Chapter 5　The Social Protection for the Elderly in Urban China ..........／84 5.1　The current policy of social welfare for the urban elderly ......／84 5.2　The characteristics of the current policy of social welfare for the urban elderly ...........................／97 5.3　The reflection on the current social welfare system for the urban elderly ..............................................／102 Remarks ..............................................................／104 Follow up thinking ...................................................／105 Chapter 6　The Social Service for the Elderly in Urban China .............／106 6.1　The system of social care for the elderly .......................／106 6.2　The transformation of elderly care modes in China ...............／114 6.3　The elderly community social service in Chinese city ............／122 Remarks ..............................................................／132 Follow up thinking ...................................................／132 Chapter 7　An Overview of the Community-based Social Support Network .....／134 7.1　The concept of social support network ...........................／135 7.2　From social network analysis to social work intervention ........／142 Remarks ..............................................................／143 Follow up thinking ...................................................／144 Chapter 8　Need Analysis of Community Care and Support Network:A Case in Guangzhou ..................................／145 8.1　The background of the community elderly service’s need assessment in a district ..................................／145 8.2　Survey result about the resources of community care .............／147 8.3　Elderly health and disability condition .........................／156 8.4　Elderly economics condition .....................................／160 Remarks ..............................................................／164 Follow up thinking ...................................................／165 Chapter 9　The Strategy of the Community Networking Model: Guangzhou’s Experience ......................................／166 9.1　Destruction of the elderly social support networks in Chinese city ................................................／166 9.2　Elderly social support networks model’s successful experience at H Street .........................................／174 9.3　Community elderly care’s difficult and problem .................／176 9.4　The strategy of reconstructing the elderly care networks ........／178 Remarks ..............................................................／182 Follow up thinking ...................................................／182 Chapter 10　Urban Elderly Care:Integrated Service Model with Networking Approach ..........................................／183 10.1　Integrating service networks ...................................／183 10.2　Integrated service model with networking approach ..............／186 10.3　Implication of integrated service model with networking approach in a elderly center ........................／191 Remarks ..............................................................／193 Follow up thinking ...................................................／194 Chapter 11　Exploratory Research in Urban Elderly Care ...................／195 11.1　The impact of“elderly special privileges ordinance”to urban elders’ economic conditions in Guangzhou—based on Liwan District, Fengyuan Street, Guangzhou .....................／195 11.2　Evidence-based research on elders’ economic security in urbanized countryside nearby Guangzhou—based on Tuhua Village, Huazhou District, Guangzhou .....................／206 11.3　Analyses of elders who join in the “basic old-age pension and medical insurance systems” ........................／215 11.4　Social work intervention in poor urban elderly—a case in Liwan district, Fengyuan Street .............................／229 11.5　Rural-to-urban elderly service’s dilemma in community elderly activity center ..............................／252 Remarks ..............................................................／265 Follow up thinking ...................................................／265 References ...............................................................／266

李昺伟，中山大学社会学与人类学学院副教授，中山大学社会工作教育与研究中心高级研究员。

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