An Empirical Research On The Living Arrangement Preference Of Middle-aged And Older People In Urban China And A Demand Analysis Of Community Home Care Services For Urban Elderly

Part I What determines the preference for future living arrangements of middle-aged and older people in urban China?ObjectiveLiving arrangements are important to the elderly.An understanding of their living preferences assists us in responding to the needs of the elderly as well as in anticipating future long-term care demands.The aim of this study is to provide a clear understanding of preferences for future living arrangements and their associated factors among middle-aged and older people in urban ChinaMethods 2264 subjects were enrolled into the study from the China Health and Retirement Longitudinal Study(CHARLS)2011-2012 baseline survey to obtain an understanding of various factors related to the preference for future living arrangements among middle-aged and older people in urban China.Results The most popular preference for future living arrangements was living close to their children in the same community/neighborhoods,followed by living with adult children.The degree of community handicapped access,number of surviving children,age,marital status,access to community-based elderly care centers and number of years lived in the same community were significantly associated with the preferences for future living arrangements among the respondents.Conclusion and RecommendationThere is a trend towards preference for living near adult children in urban China.Additionally,age has a positive effect on preference for living close to their children.Considerations should be made in housing design and urban community development plans to fulfill older adults'expectations.In addition,increasing the accessibility of public facilities in the residential area was important to the elderly,especially for those who preferred living in proximity to their children rather than co-residing with their children.We found that more surviving children were associated with a lower likelihood of choosing "institutionalization",and it positively contributed to preference for intergenerational living arrangements in our study.As expected,compared with their married counterparts,people who were separated/divorced/widowed preferred living with adult children rather than living independently.A relatively shorter length of residence in the same community was an important indicator of preference for independent living;this finding might require further research.Part? Study on the index system of community home care service demands of urban elderlyObjectiveConstructs an index system of community home care service for urban elderly who can take care of themselves or those with slight disability,so provides the basis for subsequent analysis of these services demands with the help of the Kano model.MethodsPurpose sampling was adopted,and then 16 experts were selected to carry out Delphi expert consultation.Results After consulting experts,combined with the views of group discussion,we finally identified a community home care service index system with 7 first level indicators,and 26 second level indicators.Part? Analysis of the demands of community home care service for urban elderly ObjectiveTo inverstigate the community home care service demands of urban elderly who can take care of themselves or those with slight disability in Nanjing City,then the Kano model was used to analyze the attributes of these demands.MethodsA sample survey was conducted among 320 elderly urban residents in Nanjing city by means of convenient sampling,and their demands for community home care services were analyzed.Results and ConclusionAmong the 26 community home care service requirements,we screened out 2 must-be requirements items,4 one-dimensional requirements items,5 attractive requirements items,1 reverse requirement items,and the other 14 items are indifference requirements.The elderly canteen and short-term care service were considered as the most basic essential community home care services.If these services were not available,it would reduce their satisfaction with community home care services.Regular visits by medical personnel,lectures on knowledge of prevention and care of common diseases,set additional senior center and college for senior citizens are particularly expected.Community home care services that amaze elders include reconstruction design for residential and community barrier-free environment,the organization of elderly collective activity and care skills training.There were no need for payment services for gas,power and water.Policy Recommendationone is attracting enough attention to the important role of the elderly canteen and short-term daycare service in the services system for the elderly,and should pay special attention to the dining demand of the oldest old,the widowed and elderly with low income to middle income,at the same time we should pay special attention to the short-term care needs of the widowed elderly.Strengthening community home visits and health promotion of chronic diseases,so that improve the health literacy of the elderly.In order to meet the spirit and culture demand of the elderly,we should increase senior center construction and expand the educational resources for the elderly.Where possible,promoting the reconstruction design for residential and community barrier-free environment and carrying out home safety education regularly are needed.It is advisable to actively organize collective activities for the elderly and support industry convergence of pension service,tourism and health preservation.Care skills training might be carried out in the community to promote self-help or mutual aid for the aged.There is no need to set up community home care service item of payment services for gas,power and water.