【摘要】 采用质性研究方法比较和分析了城市居家失能老人的照料处境、主观需求及社会网络资源的互动逻辑,发现老人面临社会隔离、疏于照料和监护不足等风险,"接力"而非"反哺"的照料伦理主导了家庭资源流向,老年配偶勉为其难地承担第一照料责任;子女"谋生"冲击"尽孝",通过家庭内部"雇佣"或领取老人的养老金"包干"的方式分工照料责任;雇佣保姆减轻了家庭照料者的负担,然而"经济理性"多于"社会情感"。精准化居家养老服务以老年食堂、陪同与喘息服务最为紧迫,其他还包括无障碍环境改造、医疗上门等,建议出台家庭照料者补贴政策,规范和加强护理人员培训,并通过长期护理保险解决相关费用问题。更多还原

【Abstract】 We adopted qualitative research methods to compare and analyze the care situation, subjective needs and interaction logic of social network resources of disabled elderly in urban homes, and found that the disabled elderly at home face the risks of social isolation, neglect of care and inadequate monitoring; the ‘relay’ care ethic dominates the flow of family resources rather than the ‘back feeding’. The spouses as caregivers cry out for respite services while taking the primary responsibilities; ‘filial piety’ gives way to ‘make a living’, the children provide care through mutual subsidies or exchanging the pension for care, the helpers are helped; employing nannies reduces the burden of family caregivers, but fees are high and services are unsatisfactory, more ‘economic-rational’ than ‘social-emotional’. Canteens, escort and respite services are the most urgent accurate home care services for the elderly, other services include barrier-free environment renovation and medical visits. We also recommend that introduce subsidy policies for family caregivers, standardize and strengthen nursing staff training, and solve related problems through long-term care insurance.更多还原