Beijing Pension Care [Retirement Home Services]

Home-based care for the elderly is difficult, and community care is not expected (see the report yesterday). The elderly can only go to nursing homes.

Under the traditional concept of “bringing up children and preventing old age”, sending the elderly to nursing homes is a “post” choice for many families, and may even be considered “unfilial”.

However, many experts believe that with the rapid development of aging society, aging, empty nesting and sickness, more and more elderly people will be admitted to nursing homes. From the perspective of reducing loneliness, increasing safety, and improving the quality of life, the elderly, especially the elderly who are disabled, may be suitable places to live in nursing homes. “But the problem is that the quality of service in most nursing homes is not high.”

The reporter made unannounced visits to a number of public and private nursing homes in Beijing to experience the true life and needs of the elderly. The article concealed the name of the nursing home and tried to reflect the problems of the entire industry rather than targeting a pension institution.

“In the nursing home, there are some dementia and confusion, some are grumpy, yelling and screaming, and others are guilty and export wounding. Several people live in a room, and it is difficult to fall asleep in a night like this. It's not uncommon for you to meet a meal. You eat yours, he pulls him in. In such an environment, you must have a very strong endurance and patience.”

When he first entered the nursing home, Ren Fei (a pseudonym) used a distorted hand and shook his head in a trembling gesture to write the above text on the diary book.

"Death" common in nursing homes

In a public nursing home within the Third Ring Road, 68-year-old Ren Fei belongs to the younger generation.

Once he was a bank employee, an accident at the age of 45 led to paralysis, "into the nursing home in advance."

In the first few months, he felt strongly unaccustomed.

In a locked iron gate, more than 100 elderly people and more than 20 staff members formed a closed society.

Due to the tense bed, each room was increased as much as possible. It was normal for old people to be able to take care of themselves and not be able to take care of themselves. In the suite where Ren Fei lived, the four elderly people in the back room and the three old people in the outer house were responsible for taking care of them. The nursing staff could only sleep on the sofa.

Two years later, he got used to the old man in the same room, regardless of time and occasion. He used to the cries of the old people who were sick because of illness in the middle of the night. He used to cough for a long time and coughed his voice back to his belly for a long time.

In Daxing’s private nursing home, the 80-year-old Chen Guiying had an indescribable fear in her old lady’s bed full of conduits, especially when the night’s corridor was filled with all sorts of painful groans.

The reporter surveyed more than 100 nursing homes in Beijing. There is widespread self-care and inability to take care of the elderly.

According to the heads of several nursing homes, the district living and nursing care has become a problem for the financial and human resources of the general nursing homes. “We cannot reach the level of a blessing (the First Social Welfare Institute in Beijing).” This nursing home, where the self-care elderly and the elderly who are unable to take care of themselves, lives in a 7,000-seat residential home. Ordinary senior citizens have to wait for 10 years to stay.

Under conditions of mixed living, elderly people in nursing homes need to get used to the other thing: facing death.

Ren Fei was not sensitive to the word. When he was talking, he was expressionless and licked the bed he was sleeping on. The bed had already died of two old people. His eyes moved to the back room. A few months ago, when there was an old gentleman in the back room who suddenly fell ill, when the ambulance and his family arrived, “people have already broken their breath.”

During the two years of living in nursing homes, more than two dozen old people died. Ren Fei has turned a blind eye to the scene of stretchers entering and exiting, "having used to it for a long time."

On March 22, in an old private nursing home in Daxing, after an old man died, the hospital deliberately arranged to pull the hearsaw of the body out of the back door. “Try not to let other old people see it.”

The person in charge of the hospital said that nursing homes are old and sick, and they die a dozen or so people each year. They are "very common."

In nursing homes, the memorial for the dead is a simple way.

There will be at least one such dialogue among old people:

Which room's who is gone.

Oh, no wonder he never saw him.

There is no doctor in the nursing home for the elderly

Compared to Ren Fei's calmness, the 81-year-old Chen Guiying was very scared.

She suffered from severe diabetes and heart disease, lived in a nursing home for three years, fainted three times, and was sent to first aid twice.

The medical room in the nursing home she lives in has no doctors. There are only two "post-90" nurses. Apart from injections and simple nursing knowledge, there is not much understanding of the common diseases of the elderly.

Chen Guiying was worried every day. She feared that she could not wake up anymore because she was fainting. She was afraid that the next person who carried the nursing home was himself. She said that if the old man is suddenly onset or seriously ill, "the ambulance has not turned into the hutong, people may not be able to."

The vice president of the nursing home frankly admitted that for private nursing homes, it is not easy to set up a medical room. “There is no way to recruit a doctor.” In this case, the nursing home can only do a careful observation of the old man. “There is a problem. Quickly contact family members."

Living in a public nursing home, 75-year-old Niu Zhengli always carries a urine bag. He also had serious kidney problems. He also looked forward to having a doctor in the nursing home. "I can be less guilty." Every night, the nurses tied the urine to him and he was "uncomfortable." Sometimes he caught a cold and the nurse in the nursing home only told him not to leave the house. "More than one quilt cover is enough."

In a survey of more than 400 nursing homes in Beijing, a survey by the reporter found that due to the inability of medical conditions, many nursing homes refused to accept elderly people who could not take care of themselves. Some nursing homes that accept elderly people who cannot take care of themselves also often sign an agreement with their relatives. If the old man is at risk, relatives must take it away.

According to the data from the Beijing Municipal Coordination Research Institute in 2011, there is no medical service for the 70% pension facility in Beijing, and more than 96% of the city’s elderly people suffer from various diseases.

The elderly people in a private nursing home in Chaoyang are fortunate because Guo Jun is a "good man."

Guo Jun was a chief physician and cardiologist of a hospital before his retirement. After retirement, she drove Audi to send her mother to this nursing home. The immediate medical conditions surprised her. There were only one little girl learning Chinese medicine in the elderly nursing home for 200 elderly people and knew nothing about first aid knowledge.

Afterwards, the director of the hospital became Guo Dafu of the nursing home. There is no medical clinic, a medical clinic is built, there is no health insurance (the old people use the medical insurance to take medicine to see the sick in the nursing home), and contact the medical insurance.

In two years, at least 10 old people were pulled back from the death line. Before the family members and 120 arrived, Guo Dayi continued the old people's attachment to life.

Guo Jun hopes that more doctors will be able to walk into nursing homes, but students in recent medical colleges are reluctant to come, "not to mention experienced doctors." Guo Jun also thought about launching a retired doctor. A former colleague of hiss looked at the condition of the nursing home and called her after leaving. "How can you stay alive? I would rather go to kindergarten to see the children, at least to see hope."

Nursing workers feed seniors for "two seconds a spoonful"

85-year-old Zhang Shuzhen lives in a private nursing home in Changping. She does not like her own carer.

The care worker surnamed Xue, a 45-year-old woman with a strong Gansu accent, was responsible for caring for seven elderly people.

Every morning at six o'clock in the morning, Xue care workers wash their faces and perform activities for the old people who can't take care of themselves. Then, pick up a big box full of lunch boxes and go to the cafeteria to play breakfast for 7 old people.

On March 16th, the breakfast was Hanamaki and rice porridge. Zhang Shuzheng was able to eat on her own, and the old lady's clinical dysphagia was difficult to swallow.

Xue care workers put the Hanamaki and rice porridge into the juicer and break it, then slowly push it into the old woman's mouth with a large needle without a needle. When the situation is not good, it is necessary to insert a pipe in the nose of the old lady and inject it directly.

There are also five elderly people who can't take care of themselves. Although they don't need to eat liquid food, they need to have a spoonful of spoonfuls of food for feeding.

From cooking rice, rice to feeding liquid food, feeding rice, and then to cleaning the dishes, Xue care workers only used 30 minutes, because the old people opened their meals and the nurses were cooking, a difference of half an hour.

This is true for all three meals a day.

Those elderly people who were fed were unable to speak of their mouths, their hands could not move, and the speed of their meals was controlled by the nursing staff.

Living under the same roof, Zhang Shuzheng and other self-caregiver old people hold injustice for them. "The nurses are fed for two seconds and one spoonful, and they feed them without interruption. Can the old people bear it?"

According to a survey conducted by the reporter at the nursing home, the ratio of carers to the elderly is 1:7. The carer has almost no special training, and even some people do not even know the word.

In order to prepare for the star rating of the city’s aged care service, the nursing home has also sent training materials to the nursing staff. Several nursing staff can not let others finish their homework. When the reporter unannounced visits in the elderly room, a carer asked the reporter with a medicine bottle. “I don’t know the word and help to see if it is a medicine for lowering blood pressure. How much do I eat each time?” There was also a carer who told the old man to stand and squeeze. dew.

Difficulties in the recruitment standards and training

Although he did not like it, Zhang Shuzhao did not dare to offend the nursing workers. “All of them are working in the same village and offending one team to offend a group of people.”

However, in Ren Fei's diary, he was unsteady for the carer. “Some old people sometimes make nuisances, make them difficult to care for, and do not care about the dignity of others.”

The janitors are also complaining, earning less money and doing more work, "giving people urinary urination and speaking out ugly."

Xue care worker pays 2,200 yuan per month and manages to live. She said that the money sent home is the tuition for the children. It is the brick of the new house and the medicine for the parents to cure the disease. "The work is dirty, but I must insist."

Not everyone can persist. Within a week, Xue's two fellow villagers resigned and returned home. "We can't do it." Xue said. One month has been spent and the other has been three months.

After two walks, the nursing home staff became more nervous. The recruiting care worker did not have to examine the quality and skills and could stay as long as he wished. "In the beginning, they did not dare to let them do too heavy work and fear to scare them away." The head of the nursing home said.

The reporters surveyed more than 100 nursing homes in Beijing. The ratio of carers to the elderly (including self-care and self-care) is generally above 1:7, and there is even one to ten.

“The nursing home care workers are harder to recruit and the rest of the industries are reluctant to come.” The heads of a number of nursing homes believe that besides low wages and heavy work, the industry “is unpromising and has no way out” is also difficult to recruit. The reason for nursing workers, "usually it is mostly from the poor people who come to Beijing to do this work."

According to the “Administrative Regulations for Jinan Elderly Care Service Institutions,” the pension service agencies must implement care in a graded manner, and the proportions of nursing staff and residents (self-care, self-care, self care, and special care) are 1:7 and 1:5 respectively. 1:3, 1:1. Yesterday, relevant officials of the Beijing Municipal Civil Affairs Bureau stated that there is no clear provision in Beijing, and there is no unified regulation in the Ministry of Civil Affairs. "It is not mandatory, who (nursing home) will not ask for trouble," said a person in charge of a nursing home.

In fact, the National Occupational Standards for Nursing Care Workers issued by the State clearly stipulates the requirements, training, assessment, and rank of nursing workers. However, the heads of several nursing homes in Beijing frankly stated that “people are not able to recruit, but also talk about standards and training”.

Loneliness in Nursing Homes "increases contagion"

In Ren Fei's diary, there was a page written with a colored pen with a big "bear" word.

He said that it is loneliness in the nursing home that it is contagious and desperate. The diary wrote: Lonely reminds me of my deceased parents, my loved ones, and even a strange idea - to accompany them.

He did not want to go out of the house and did not know what to say to the old man in the courtyard. "It's been two years and everything I can say is finished."

Zhang Shuzheng does not want to go to the yard. Although she is in a nursing home, she is a well-to-do person. She said too lazy to run into the "old neighbor" (had once lived in a room), the old lady suffering from Alzheimer's disease, and swearing that she had stolen many things from her.

She is eager to talk to others about her past, her mother’s early death, her stepmother’s suffering, and the hard times she has brought up five children...

However, she did not like the volunteers who flock to nursing homes. When she came, she was very enthusiastic about the elderly. When she left, she said, “Next time I visit you again.” Few people would come for the second time.

"I don't mean that the volunteers are not good." The person in charge of the nursing home said that the old man, like the children, takes care of everything and cares for everything. "Now the nursing home is also very cautious about volunteers, and it also makes great efforts to appease the elderly. ."

It is all the elderly people who are happy to visit their children.

When the reporter visits a number of nursing homes, when the footsteps in the hallway are sounded, there are always a few elderly people who open their curtains and pry their heads.

Which elderly people have family members can always cause some envy. At this time, distributing the fruit brought by the children to the elderly in the same house is more like a show off.

The daughter has not been here for two months. The 81-year-old Chen Guiying could not sit still.

She rarely went out tremblingly through the courtyard to the nursing home office and went straight to the small door leading to the street, but no effort to unscrew the handle.

The staff rushed forward to help. Chen Guiying asked, “When will my daughter come?” Chen Guiying kept turning back on the way back to the house. Twenty minutes later, she came to the office trembling again and pleaded with the staff. "Whether or not you call my daughter, let her come and see me."

More often, the TV was in the room, and Chen Guiying looked at the window from her back to the TV. In the yard outside the window, rows of chairs were scattered near the root of the wall. Over 100 people's nursing homes almost always sat there.

The sun sits on the eastern wall on the east side and goes west to sit on the western wall. In this way, one day a day, few people speak.

The common topic appeared around 3 o'clock in the afternoon. The delivery person who delivered the newspaper threw the newspaper of the day across the iron gate. The old man in the yard rushed to ask the guards of the newspaper:

Will it be fine tomorrow?

Solution

As for the status of mixed living, nursing care shortages, medical vacancies, and psychological loneliness that are mostly present in nursing homes, the reporter interviewed Beijing civil affairs experts and experts on researching pensions.

[mixed issue]

"The government should subsidize according to health status"

Yao Yuan, deputy dean of the School of Social and Population Studies at Renmin University of China, believes that the common practice in foreign countries is that old people live in nursing homes in accordance with the ability to take care of themselves and cannot take care of themselves very detailedly, and there are very few cases of mixed living. The reason for the mixed old-age care institutions is that old-age care institutions, especially private pension institutions, must first consider the existence of old people's expenses under pressure from land, funds, personnel, and construction. The second problem is the implementation of policies. China has already adopted the assessment standards for elderly people who are staying in pension institutions, but this standard has not been strictly enforced.

He believes that the government must first adjust the funding methods for pension institutions, such as changing the bed-based subsidy to subsidize the elderly according to their health status, and increase the subsidy for disabled elderly beds.

Earlier, relevant officials of the Beijing Municipal Civil Affairs Department stated that this year will increase the formulation and revision of local standards for nursing homes.

[care worker problem]

Beijing trains 1,000 people this year

For the shortage of care workers in nursing homes, Mu Guangzong, a professor at the Population Research Institute of Peking University who has long paid attention to the care of the aged, believes that at present there are quite a few professional talents for institutional pensions in China and there is no professional development model. The status of first-line nursing staff in elderly care institutions who directly care for the elderly is insufficient, the structure is irrational (more women than men), professional education background and training shortages, which directly affect the care for the elderly and restrict the development of the pension institutions. Government departments need to have relevant industry career plans, and some professional schools should strengthen personnel training in this area.

A related person from Beijing's civil affairs department stated that last year, the dean of the pension facility was trained and 1,100 person-times of nursing care workers were trained, more than double the amount of nursing care in previous years. This year, 1,000 people's nursing staff training tasks were completed. According to the plan for the development of old-age businesses during the “12th Five-Year Plan” period in Beijing, by 2015, there are 10,000 nursing staff (people) in the elderly, which has increased from 15 in 2010 to 50.

[medical issues]

Nursing homes should cooperate with medical institutions

For the lack of medical rooms and doctors for nursing homes, Mu Guangzong, a professor at the Population Research Institute of Peking University, believes that most of the old-age care institutions are civil affairs systems and social capital. Most of them are “pensions” and lack disease prevention and control functions. This has affected some old-age care institutions. The operation. In the future, the elderly who are staying in the old-age care institutions will be particularly in need of medical care as a result of their aging and disability. The superficial pension needs are “material pensions” and the deep-rooted pension needs are “medical care and pensions”. For this reason, nursing homes must combine with qualified hospitals and doctors to provide them with the function of medical care.

The Beijing Municipal Bureau of Health had suggested that for large-scale pension institutions, clinics should be set up according to the set standards. For nursing care aged care institutions, resources and functions can be shared with “nursing homes” in medical institutions.

In addition, the Municipal Health Bureau also recommends the integration of training and qualification certification for hospitals, elderly care workers, and the overall management of nursing staff in nursing homes and nursing homes.

[Lonely problem]

Family care is important for the elderly

In the face of lonely old people in the nursing home, relevant officials of the Beijing Municipal Civil Affairs Department stated that during the “12th Five-Year Plan” period, the number of psychological counselors in the 10,000 elderly people in Beijing will increase by 20 people from 15 people.

Mu Guangzong believes that the old-age care institutions must pursue "quality old-age care", be small enough to provide delicious foods, and provide personalized medical care services, to provide diversified spiritual care. After the spiritual ownership, it is necessary to realize "the organization culture for the elderly." “Cultural pension” pays attention to the material, spiritual, emotional, and spiritual needs of the elderly. Foreign countries call it body-mind-spiritual needs and can better achieve old pleasure and old age. At the same time, the family's spiritual support function for the elderly cannot be replaced by the pension institution. Spouses, children, grandchildren, relatives and friends, and visits and greetings have a crucial role in the physical and mental health of elderly people staying in retirement institutions.

"After many children come and see, even if they make more calls, the elderly are better than the panacea." The heads of several nursing homes in Beijing admitted frankly.

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