【作者】 王强；

【导师】 许琳；

【作者基本信息】 西北大学 ， 社会保障， 2022， 硕士

【摘要】 智障属于残障类型中的一种,智障者由于缺乏行为能力,自我照护能力低,绝大多数智障者长期生活在家中,依靠家人供养和照护。当监护人迈入老年后,不仅难以得到智障者的照护支持,反之还需要老年监护人继续照护智障者,传统的“代际支持”养老模式在智障者家庭难以实现。特别是,许多监护人都在担心“我百年以后,孩子怎么办?”可见智障者家庭的养老不仅面临监护人年老后谁来照顾的难题,也存在监护人失去照护能力或者年老去世后,智障者照料者缺失的困难,实际上智障者和监护人是两个共生的弱势群体。为破解智障者家庭所面临的养老难题,本文从智障者家庭的养老需求入手,旨在了解智障者家庭的特殊性养老需求现状,并从社会支持的角度分析智障者家庭养老需求的影响因素,从而为完善养老服务体系,实现老有所养、弱有所扶,提升包括残障人士在内的全体人民的生活质量提供政策依据。由于智障者本身缺乏行为能力,完全依靠监护人照护来生活,因此监护人是智障者家庭生产生活的主导力量。本文通过借鉴需求层次理论和家庭生命周期理论,根据监护人照护能力随生命周期演进而不断弱化直至完全丧失的过程,将处于“老年期”的智障者家庭划分为:稳定期——衰退期——解体期这三个不同的阶段,而在不同的周期内,智障者家庭有着特殊的养老需求。在稳定期内,刚迈入老年期的监护人还保有一定的照护能力,但是智障者家庭面临着照护力量少、照护难度大的状况,需要通过喘息服务来缓解智障者家庭照护压力;随着智障者家庭进入衰退期,监护人照护能力已经不足以支持照护智障者,这时通过共同入住养老机构,由专业的机构护理人员照护智障者和老年监护人成为这一时期智障者家庭最急迫的需求;而监护人去世后,智障者家庭实际上基本解体,有一定积蓄的智障者家庭可以预先通过特殊需要信托服务,为未来智障者的基本生活提供经济上的保障。本文据此从理论逻辑上推导出智障者家庭所亟需的三类养老服务需求——喘息服务、“双养”服务、特殊需要信托服务。社会支持一直以来被视为帮扶弱势群体的主要方式之一。事实上,实现智障者家庭“老有所养”离不开社会各界的支持。本文利用在陕西省调研中所收集到的151份问卷数据,首先对智障者家庭这三类养老服务需求的现状进行分析;其次,从正式社会支持和非正式社会支持的角度分析不同的社会支持对智障者家庭养老需求的影响状况。分析结果显示,79.5%的智障者家庭对喘息服务有需求,67.5%的智障者家庭对双养服务有需求,47.7%的智障者家庭对特殊需要信托服务有需求。从不同变量的交互分析来看,监护人身体健康状况越差、智障者残疾程度越重的智障者家庭对喘息服务需求更高;监护人文化程度越高、健康状况越差以及生活在城市、家庭收入越高的智障者家庭对“双养”服务的需求越高;监护人文化程度越高、智障者残疾程度越重和城市户籍、家庭收入越高的智障者家庭对特殊需要信托服务需求更高。非正式社会支持和正式社会支持对智障者家庭喘息服务需求有降低或减弱作用,得到亲戚和志愿者服务等帮助越多、拥有医疗保险的智障者家庭对喘息服务的需求越低;正式的社会支持对智障者家庭“双养”服务需求和特殊需要信托服务有增进作用,特别是有养老保险的智障者家庭对“双养”服务和特殊需要信托服务的需求更高。针对分析结果,本文从正式社会支持和非正式社会支持两个方面为实现智障者家庭养老需求提出建议。更多还原

【Abstract】 Intellectual Disabilities are one of the types of disabilities.Due to their lack of behavior ability and low self-care ability,the vast majority of intellectual disabilities live at home for a long time and rely on their families to support and care.When the guardians enter the old age,the intellectual disabilities are not only difficult to take care of the old guardians,but also need the elderly guardians to continue to take care of the intellectual disabilities.The traditional "intergenerational support" pension model is difficult to achieve in the families with the intellectual disabilities.In particular,many guardians are worried," Who take care of my child when i die?" It can be seen that the families of people with intellectual disabilities not only face the problem of who will take care of the guardians when they are old,but also the difficulties of the absence of the caregivers for people with intellectual disabilities after the guardians lose the ability to take care or die in the old age.In fact,the intellectual disabilities and the guardians are two symbiotic vulnerable groups.To solve the pension problems facing the family wirh intellectual disabilities,this paper from the pension needs of the family with intellectual disabilities,aims to understand the particularity of the family pension demand,and from the perspective of social support of the family pension demand,to improve the pension service system,realize the old,weak to help,improve the quality of life,including the disabled people provide policy basis.Because the intellectual disabilities themselves lack behavioral ability and rely entirely on the care of guardians to live,guardians are the leading force in the production and life of the families with intellectual disabilities.This paper by drawing on the hierarchy of need theory and family life cycle theory,according to the guardian care ability with the life cycle evolution and weakening until completely lost process,the families with intellectual disabilities in the "old period" are divided into three different stages: stable —— decline period —— disintegration period,and in different stages,the family with intellectual disabilities has special pension needs.During the stabilization period,The guardians who have just entered the old age still maintain a certain care ability,However,families with intellectual disabilities are faced with the situation of less care power and difficult care,respite services are needed to relieve family care pressure for people with intellectual disabilities;As families with the intellectual disabilities go into decline,Guardian care is not enough to support care for people intellectual disabilities,At this time,through a joint residence in the pension institutions,the care of the intellectual disabilities and the elderly guardians by professional institutional caregivers became the most urgent needs of the families with the intellectual disabilities in this period;After the death of the guardian,families of the intellectual disabilities are actually basically disintegrated,families of intellectual disabilities with certain savings in advance through special needs trust services,to guarantee the basic life of the intellectual disabilities in the future.Accordingly,this paper deduced the three types of demand for elderly care service —— respite care services,common pension services and special needs trust services that are urgently needed by families with intellectual disabilities.Social support has long been seen as one of the main ways of helping vulnerable groups.In fact,the realization of the "old support" of the families with intellectual disabilities cannot be separated from the support of all sectors of society.Using 151 questionnaires collected in Shaanxi Province,this paper analyzes the current situation of pension needs of the families,and the influence of different social support from the perspective of formal social support and informal social support.The analysis results show that 79.5% of families with intellectual disabilities need respite services,67.5% of families common pension services,and 47.7% of families need special needs trust services.From the interactive analysis of different variables,families with guardians of poorer health and intellectual disabilities of greater disabilities,have a higher demand for respite services;the guardians of higher the education level,the worse the health condition,and the familes living in cities and have higher family income,have higher the demand for "common pension" services,and higher educated guardians,intellectual disabilities of greater disabilities,living in cities families with intellectual disabilities and more richer family have a higher demand for special needs trust services.Informal social support and formal social support has a reduced or weakened effect on the demand for respite services of families with intellectual disabilities,and families with intellectual disabilities with more help from relatives and volunteers and have medical insurance have a lower demand for respite services,formal social support has an enhanced effect on the "common pension" service needs and special needs trust services of families with intellectual disabilities,especially those with endowment insurance who have a higher demand for "common pension" services and special needs trust services.According to the analysis results,this paper proposes suggestions for realizing the pension needs of families with intellectual disabilities from both formal social support and informal social support.更多还原