Grundy E
Br Med J (Clin Res Ed). 1987 Mar 7;294(6572):626-9. doi: 10.1136/bmj.294.6572.626.
The aging of the elderly population is of crucial importance as people who are over 80 make far greater use of health and social services than any other age group. Government guidelines on the provision of services, which are generally related to the whole population aged 65 and over, fail to take account of this change in the age structure of the elderly population and are no longer appropriate. Recent trends in the provision of domiciliary services, day care, specialist housing for the elderly, and residential care have been related to changes in the number of potential consumers. Ironically, despite the government's stated commitment to "community care," the chief growth area has been private institutional care. The number of day care places and sheltered housing units has also increased in real terms, but the provision of domiciliary services, such as home help and health visitor visits to the elderly, has either fallen behind or barely matched the increase in the number of very old people. If community care is to be made a reality and if the present inadequate levels of service are to be maintained, let alone improved, then additional resources, greater cooperation among agencies, and a more imaginative approach to the development and delivery of services are urgently needed.
老年人口老龄化至关重要,因为80岁以上的人比其他任何年龄组更多地使用健康和社会服务。政府关于服务提供的指导方针通常适用于65岁及以上的全体人口,没有考虑到老年人口年龄结构的这一变化,已不再适用。最近在提供居家服务、日托、老年人专用住房和寄宿护理方面的趋势与潜在消费者数量的变化有关。具有讽刺意味的是,尽管政府宣称致力于“社区护理”,但主要增长领域却是私立机构护理。日托场所和庇护住房单元的数量实际上也有所增加,但居家服务的提供,如上门帮助和健康访视员对老年人的探访,要么落后,要么仅与高龄老人数量的增加相匹配。如果要使社区护理成为现实,如果要维持目前不足的服务水平,更不用说加以改善,那么迫切需要额外的资源、各机构之间加强合作,以及在服务的开发和提供方面采取更具想象力的方法。