Research On The Well-being Failures And Policy Support For Family Caregivers Of Disabled Elderly

With the acceleration of population aging,the group of elderly and disabled people in China is constantly expanding,and the majority of disabled elderly choose home care mode.The fourth sampling survey data on the living conditions of the elderly in urban and rural China shows that 95.6%of the elderly are mainly cared by their families,with spouses,children,and other relatives becoming the most important caregivers.Affected by social transformation and fertility policies,the shortage of human resources for family care for disabled elderly will become increasingly prominent,and the task of family care will become increasingly heavy,seriously affecting the well-being of family caregivers for disabled elderly and the sustainability of family care.This article takes the well-being failures of family caregivers for disabled elderly as the logical starting point,and adopts a mixed research method of quantitative and qualitative analysis.The quantitative data is based on the 2018 China Health and Retirement Longitudinal Study(CHARLS)data.Qualitative data includes interview materials and policy texts.It presents the well-being failures of family caregivers from four dimensions:physical,mental,social participation,and economic conditions,exploring family support,government support,enterprise/unit support,community support,etc.on the well-being of family caregivers for disabled elderly.Sort out the existing policy support for disabled elderly family caregivers in China,and based on summarizing the experience of policy support for disabled elderly family caregivers in Western countries,propose the construction of a policy support system for family caregivers.The following conclusions are drawn in this article:Firstly,the well-being failures of family caregivers for disabled elderly is highlighted.The well-being of the disabled elderly family caregivers in China can be examined from four dimensions:physical,mental,social participation,and economic conditions,which are specifically manifested in the physical condition of physical overdraft,sleep disorder,disease aggravation,and many other symptoms;High mental pressure,complex and diverse emotions,accumulation of negative emotions,and even triggering mental illness;Social participation is limited,time is not autonomous,activities are not free,and leisure is not accessible,resulting in a certain degree of "social isolation";The economic pressure on family caregivers is diverse,and the medical expenses required for disabled elderly patients are high,which increases the financial burden on families;Affected by care activities,family caregivers may adjust their job positions or reduce their working hours,indirectly affecting their personal economic income.Secondly,there are differences in the impact of support from families,governments,enterprise/units,and communities on different dimensions of well-being for family caregivers.The emotional and service support of families have a significant impact on the physical and mental well-being,as well as social participation well-being of family caregivers for disabled elderly.However,in terms of the economic well-being dimension of family caregivers for disabled elderly,the impact of government pension insurance and paid leave by enterprises/units is significant,and the variable of families support is no longer significant.Community services only have a significant impact on the social participation well-being of family caregivers for disabled elderly.Overall,there are differences in the impact and level of support from families,governments,enterprises/units,and communities on the different dimensions of well-being of family caregivers for disabled elderly.Currently,the support of family caregivers for disabled elderly in China presents a "differential circle" feature centered around family caregivers,and effective support from national policies is relatively lacking.Thirdly,the policy support for family caregivers of disabled elderly in China is mainly based on local exploration,at a lower level,and lacks systematic support.At present,support policies for family caregivers in China mainly include service support based on respite care,economic support based on tax preference,employment support based on nursing leave,and skill support based on training of family caregivers.The support for family caregivers of disabled elderly lacks legislation at the national level,the rights of family caregivers are ignored,the top-level policies are insufficient,the policy system is fragmented,and the policy support for disabled elderly family caregivers by local governments is scattered and inconsistent.Fourthly,the policy support for family caregivers of disabled elderly in Western countries is relatively mature and complete.Western countries have protected the legitimate rights and interests of family caregivers for disabled elderly at the legislative level,and have constructed a relatively comprehensive policy framework covering economic support,employment support,and service support through collaborative management and service integration of multiple subjects,forming a diversified combination of policy instruments.The effective implementation of policy support for disabled elderly family caregivers in Western countries not only reduces government financial pressure but also meets the psychological needs of disabled elderly home care,providing reference for the construction of policy support system for disabled elderly family caregivers in China.Fifthly,it is proposed to construct a policy support system for disabled elderly family caregivers from four aspects:clarifying policy objectives,coordinating governance with multiple subjects,diversifying policy content,and integrating policy instruments.Based on the idea of civil society rights,a policy support system for disabled elderly family caregivers should be established with the disabled elderly family caregivers as the center.The policy subject involves institutions related to the economic and service security of family caregivers,aiming to play a leading role by the government,improve relevant policies and regulations,and encourage and guide the coordinated governance of diverse social forces.The policy content includes comprehensive support instruments such as economic support,service support,employment support,psychological and skill support.Starting from the strategic perspective of addressing population aging,we comprehensively utilize legal,economic,promotional,technological and other policy instruments to meet the diverse well-being needs of family caregivers for disabled elderly.Research innovation:The first is to build a theoretical analysis framework of "family care-multi subject support-family caregiver well-being" by using the pressure process theory and welfare pluralism theory,which expands the research space on the well-being failures of family caregivers;The second is to conduct a multidimensional analysis of the well-being failures of family caregivers,comprehensively presenting the well-being failures of disabled elderly family caregivers from multiple dimensions such as physical,mental,social participation,and economic condition,enriching the dimensions of research on the well-being of disabled elderly family caregivers and the content of policy support;The third is to use mixed research methods to analyze the well-being failures and impact mechanism of family caregivers.Firstly,quantitative data is used for analysis,and then qualitative data is used to futher explain,supplement and expand the quantitative research results,deeply analyzing the role of different welfare providers in improving the well-being of disabled elderly family caregivers at present.