When he received the order to deliver to Zhang Aihua, the delivery man Chen Hang was particularly careful.
It was the spring when the new crown pneumonia was at its peak, a deserted neighborhood where no one wanted to live unless they were unwell and self-isolated.
Through the open space infested with wild dogs and cats, climbing the stair railings broken by rust, he came to the door of the old house on the fifth floor, knocking on the old wooden door that shakes off the dust at the first touch.
After knocking for a while, there was a sound inside, but after waiting for more than 10 minutes, no one opened the door.
Chen Hang felt angry because during the Epidemic, not many people were willing to come out to deliver, and he had a huge number of take-out orders on hand and couldn’t spend too much Time on this one, otherwise he would receive a series of complaints.
He takeaway placed at the door, clicked the order has been completed, was about to turn around to go when the door came out an old lady’s complaint, “are hungry for a week, came to the key also did not bring, deliberately torture me ah? “
With the sound of talking a little louder, Chen Hang looked back, the old lady has opened the door lock, and then immediately turned around, dragging his body back.
At this time, he saw that it was a crippled old man, leaning on a plastic stool to help support her walk.
The old man thought he was the youngest son, when Chen Hang took the take-out into the house, while splitting his head and shouting, while grabbing to open the take-out box. It wasn’t until he looked up that he realized it was just a delivery man.
That was Zhang Aihua’s first takeaway.
Eat takeout and die
Zhang Aihua told Chen Hang, her youngest son originally came twice a week to give her a bath and make two days of meals, not eaten in the refrigerator, to eat when the microwave oven to heat up.
But those days, her son did not come over.
Originally, her youngest son called her and told her that they couldn’t go out because of the new pneumonia everywhere, so she should save some money and share the Food in the fridge for a few more days. But she was so old and deaf that she knew how to answer the phone, but she couldn’t hear what they were saying.
After she ran out of food, she couldn’t go downstairs by herself, holding a plastic stool, knowing she would fall half to her death. When she was really hungry, she took the old tea leaves from the cupboard, steeped them in water and then chewed them by the handful.
After she ate several meals of tea leaves, eaten to the point of vomiting, Chen Hang delivered takeout, this takeout, so fragrant that she herself did not believe that her son had ordered it.
“It must have been you who ordered the meal for me in order to help me. “
After a few weeks, however, she was finally convinced that it was her sons who had ordered it. The takeaways, which soon became as revolting to her as those tea leaves. At first, she ate with exceptional satisfaction because she was hungry for days, but after nearly a year of such take-out, she was on the verge of a breakdown.
The take-out was ordered and divided between her two sons, one of whom was responsible for a week. Originally, the take-out man delivered two deliveries to her each day; after two months, the take-out man delivered potentially three or four days’ worth. Her son found that this saved on delivery fees.
The number of takeaways grew, but her refrigerator broke down and lost its cooling function. On the days when the temperature picked up, the frozen ice from the quick-freeze layer dissolved and a strip of brown water ran out on the floor. The take-out began to stink and rot inside.
The system of the takeaway platform, the second time the order to Zhang Aihua was assigned to Chen Hang, he did not hesitate to take it. For this reason he did not take too many other orders, and when he arrived at the door, he found that she had stopped locking the door.
He knew that his line of work was a daily race against time, efficient and ruthless, but when he encountered such an old person, he always thought he could help her. However, the hygiene in the house was so bad that he put off the idea of helping to clean it up.
This time it has been half a year since the last time, there is movement outside the door, Zhang Aihua knew it was the delivery guy came. Many times, the delivery man has become a sounding board between her and her son.
She asked her youngest son to come over when she had a fever, and he used the delivery to buy her a box of ibuprofen and cefradine capsules; when the refrigerator broke down, her youngest son came to look at it and said there was nothing to fix to give her a replacement, but there was no follow-up; once a month, her youngest son would come over and give her a bath and throw away the lunch boxes together, even if it was sanitary.
Recently, she developed bed sores and said she wanted to go to the hospital. She knew that many elderly people with bed sores could easily die. But as usual, her youngest son bought an anti-inflammatory ointment with a takeaway delivery.
“They just want me to die, die early, this house demolition they can get the money. “
Did not stay long, Chen Hang felt there to become a large accusation scene, hurry to leave. Before leaving, Zhang Aihua asked him to help call his youngest son, “tell him that tomorrow will sign the demolition documents, see if he over. “Chen Hang felt that this is a lie, only dialed the phone to let her speak for herself.
“There is no time to come over, tomorrow Tanabata Festival, is the most crowded time. You help me ask how much the demolition back, if not at a loss, let her sign it herself. “The youngest son suddenly thought of something, slightly excited to say, you tell my mother, I found a good quality second-hand refrigerator, in a few days I have time to send over.
But this time, Zhang Aihua listened carefully, directly cursed, “second-hand refrigerator, how much to buy a new one? And you want my refrigerator a few days to break down? “
Soon, the youngest son hung up the phone.
More than a thousand kilometers away, in an old Home on Jianji Road in Guangzhou’s Haizhu District, another old man like Zhang Aihua, who was far from his children, came to the end of his Life.
Delivery rider Ma Yusong found the place according to the ordering address, but no one answered the door no matter how he tapped.
The takeaway was ordered by the homeowner’s children. They couldn’t reach the old man by phone, and they live too far away, so they wanted to see if the old man was okay at home through the delivery boy.
Through the crack of the security window, Ma Yusong vaguely saw someone fallen in the bathroom, an ominous feeling instantly rose up.
He borrowed a wrench and an axe from his neighbors and tried to smash the door or burglar window, but failed to do so.
After calling the police, firefighters soon arrived, and by the time paramedics arrived, the old man had sadly passed away.
Ma Yusong cried on the spot, for this unknown old man, but also for his own distant Parents.
Delivery is a daily struggle against time.
He has received bad reviews, deducted money, and been reprimanded by customers because of overtime. But there has never been a time when it was as heartbreaking as now.
He could not help but assume: “If I had come one step earlier, would everything have been different? “
Many people advised Ma Yusong not to blame himself, as what he had done was far beyond his job. The children, who should have been most responsible for the elderly, were absent from the scene in countless similar stories.
Most of their absence is due to one reason or another.
Zhang Aihua’s youngest son works at a gym in Kunming, and his job is to distribute flyers and solicit customers to open cards. As the performance and customer conversion effect is linked, the average monthly salary up to about 2400. The daughter-in-law, on the other hand, works as a cleaner in a school, 1700 a month.
“I have to rent 1200 a month, my daughter’s kindergarten school has to 1000, dinner expenses 1200 bar, the rest of the cell phone bills, buy a dress to buy a quilt, basically every month to count. How much money do I have left? This second-hand refrigerator, I still save a few months to squeeze out. In the youngest son’s opinion, he is really no way. When he brought his mother to live here, he had to rent a three-bedroom apartment, which directly increased his rent expenses by 500. Such additional expenses would make his life unsustainable.
Plus WeChat‘s Chen Hang asked him rhetorically, saying you extra time to do more work, send down takeout can be subsidized back to the 500.
The company’s main business is to provide a wide range of products and services to the public. To and from work, lunch and shopping peak, have to be wound up all the time, and Internet promotions to grab customers, where I have time to run takeout? In fact, he can’t switch to takeout to make more money because he has hepatitis.
Zhang Aihua’s oldest son, then because of the failure of borrowing online loans to do business, with his wife and daughter went to Shenzhen to open up online cars.
Internet loans he borrowed 120,000, five-year period, together with more than 200,000 have to pay back, more than 5,000 per month. At the same time, he needs to support the Family, to create a better environment for the two children, so he needs a job with an income of more than 10,000. He couldn’t find such an income job in Kunming, so he had to choose to go to economically developed areas.
But the cost, he also can not take his mother. Renting a room in Shenzhen, an extra room is more than 1000, but also have to arrange a manpower dedicated to wait for food and living. And, running online taxi, to earn enough 10,000, he has to run more than 20 orders a day. Not even a breath of air, let alone to deal with the elderly living problems.
According to the economic cost of layers of screening down, takeout becomes a remote support of the second choice.
As a form of elderly care that has emerged in recent years, it is limited in what it can do except act as a sounding board to confirm that the elderly are alive.
This is by no means a predicament for individual families.
According to the National Bureau of Statistics, China ranks first in the world in terms of the growth rate of population aging. As of the end of 2019, the domestic population of people over 60 years old has exceeded 250 million, accounting for 18.1% of the total population. Among them, more than 40 million elderly people are disabled and mentally handicapped, showing accelerated growth compared to previous years.
Under the national condition of “getting old before getting rich”, young people are dragged into the high-efficiency and high-paced socialized production machine, and increasingly The “volume”, the lack of time, coupled with intergenerational conflict and a series of other problems, society as a whole is facing the plight of the shrinking function of family retirement.
The “elderly takeaway”, but is this dilemma, the most extreme ** end of the side. ***
For many elderly people, especially the disabled and mentally handicapped elderly, tired children difficult to understand their real needs, but also can not provide long-term meticulous care, hire nannies and fear that the other party closed the door to dominate, at this time, the professional nursing institutions have become the immediate need.
Sociologist Lan Peijia called it “the market subcontracting of filial piety”.
On the surface, the elderly industry is a promising sunrise industry. But in reality, there are a large number of private nursing homes struggling on the edge of death.
The various problems of nursing homes are also a concentrated manifestation of the dilemma of Chinese elderly care.
Sent to the nursing home
The attitude of the elderly and their children towards nursing homes is at two extremes.
In Zhang Ling’s eyes, the nursing home is the only option for their family, “If we don’t find a nursing home, our siblings may have to turn against each other. “
The sudden cerebral infarction caused Zhang Ling’s 75-year-old father, Zhang Jianjun, to completely lose control of his body. He tried to speak, but his stiff tongue did not cooperate; even his five senses were pulled by the disordered nerves into an extremely uncoordinated form.
If he was not careful, saliva would drip down the corners of his mouth.
During his hospitalization, he was cared for by three children in turn. Four times a day, he was given nasal feedings, where food was made into a paste and injected gently and slowly into the gastric tube at a moderate temperature, so that no air could be mixed in. …… After the cap of the gastric tube was closed and fastened, it was wrapped in gauze and then wrapped tightly with a leather band. Take warm water to rinse after you’re done to avoid food hoarding and deterioration.
Long-term bed rest is prone to bed sores and urinary tract infections, so you also have to turn your father often, open the urinary catheter, as well as change the urine pad – your father’s weight of more than 150 pounds, and the body is wrapped with a variety of tubes and lines, these tasks each time to toss and turn half a day to complete.
There is no special treatment for the sequelae left by cerebral infarction, and with Zhang’s large infarct area, doctors deduced that the probability of returning to normal was slim.
Before his father was discharged from the hospital, Zhang Ling and his two sisters proposed to his mother Wang Fengxia: “Why don’t the two old men live together in a nursing home? “
Wang Fengxia did not want to, the older people are, the more they do not want to leave the familiar circle of life. In order to stay at home, she once offered a condition: whoever is willing to take care of us, the pension will be given to whoever.
The three daughters, however, fussed and shirked their responsibility to take care of their parents, and after several days of heated exchanges, Wang Fengxia compromised.
When they set out to find a nursing home, they realized that nursing homes are not so easy to get into.
Public nursing homes are cheap, and competition for beds is fierce. Except for the “three elderly” (incapable of work, no source of livelihood, no supporters and dependents) recommended by the streets and those who had made significant contributions to society, all others had to wait a long time. Everyone else has to go through a long wait.
Everbright Securities previously published a report on the elderly, which mentioned that the national benchmark public nursing home – Beijing First Social Welfare Institute, the entire hospital only 1,100 beds, the queue of registered elderly people once more than 10,000, the annual waiting list can only be a few dozen, many elderly people wait until the death of the waiting list.
Three daughters took the initiative and sent the old couple to a private nursing home in Baiyun District, Guangzhou, which had been established for more than ten years. Although it covers a large area, with many room options and a medical office approved by the health Bureau, the home has not been renovated for a long time, and it has an air of decay everywhere.
The nursing home is divided into two different worlds according to whether they can take care of themselves or not.
In the self-care area below the fifth floor, the elderly live a relatively rich life, and can gather in groups to play cards and mahjong, and gossip about family life. The more energetic ones are allowed to go for a walk in the sun in the garden downstairs.
Above the fifth floor, the elderly who are disabled and mentally handicapped are housed, with each bed equipped with an emergency pager, wheelchairs, small tables for eating, and toilets all around.
The management is based on the model of hospital inpatient units, with medical staff checking in twice a day in the morning and evening, and three meals delivered by caregivers. The activity area here has been abandoned for a long time, and a few big words written in red paper are stuck on the wall in a twisted way – “Blessing is like the East Sea, longevity is like the South Mountain “.
Wang Fengxia accompanied Zhang Jianjun into the couple’s room on the sixth floor. The spacious room was filled with old, off-painted solid wood furniture, and the children were in a frenzy to arrange it.
Sitting on the freshly made bed, she looked at Zhang Jianjun, and then at her children who were ready to leave, and her eyes slowly drooped.
“I remember when I used to send you to the university to report, also such a big bag. But you are prepared to enter society, your father and I, may be the last stop before entering the grave. “
The three daughters do not understand the sudden sadness at present; in their view, living in a nursing home has been called a blessing.
Day of death
“Eat, wear warm clothes and don’t have to work” is what the children see as a peaceful old age. But when the old man was there, it was like riding the train to death, and the air around him was a slow flow of “old air”.
This, until half a month later Zhang Ling came to visit his parents alone, only to really read.
In order to make it easier to take care of them, the old people who were disabled and demented were shaved into inches, and Zhang Ling would always mistake the grandmother for the grandfather.
Here, gender seems to be only a vague symbol.
Principal Jiang, who is in her 90s in the innermost room, has Alzheimer’s disease and her intelligence has deteriorated to the level of a preschooler. She sits in a wheelchair, the back of which is wrapped with straps around the railing to prevent a jostling fall.
Just step into the corridor, Zhang Ling heard her hysterically shouting, “Good people come over, untie me. “
Half an hour repeating this sentence, tirelessly like.
The nurse occasionally came to her and soothed a sentence: “Good girl, good girl. She begged more eagerly, “It’s dark, I want to go home, please let me go. “
As if a crumpled newspaper, in vain to spread themselves.
A few steps away from President Jiang, another old woman in her 80s was also confined to a wheelchair by cloth, covered with a blanket and sunbathing with her eyes closed.
A caregiver passed by, pointing to the old lady’s long earlobes and joking: “A look is rich and long-lived. “
Hearing this, the old man’s deeply wrinkled face did not fluctuate.
For them, is longevity really something to rejoice about?
In Zhang Ling’s opinion, the old people are like the audible ornaments in the house. Silently pestle there, periodically be wiped some, as long as not bumped, the day is considered a success.
The traces of the flow of time are all over their bodies. But on a deeper spiritual level, time is stagnant, almost no longer extending forward.
The father, Zhang Jianjun, had not yet regained his speech function, and when he saw his young daughter arrive, he opened his mouth wide and kept “ahhhhh”, trying hard to raise his hand. The trembling hand.
I’m very relaxed here, every day to reach out for food, but it feels particularly meaningless. “
Wang Fengxia said she now hopes that Zhang Jianjun can quickly get well, as before, as painful as a fight with her.
She sometimes feels that living in a nursing home is not much different from being in prison.
The care here is a full agency, custody plus protection model, it is to ensure the physical safety of the elderly as the first priority.
In order to prevent accidents, many caregivers restrict the elderly who can take care of themselves from going outside of their own care, so their daily activities are very limited. Basically, they are just circling around a small area of the bed and occasionally go to the hallway outside the door to sit for a while.
Even within the designated area, some autonomous behaviors of the elderly are considered as “restless”.
Tao Jiumei is a person who can’t be bothered. When she sees the table dusty or the floor dirty, she can’t help but clean it up herself. Every time the caregiver sees it, she is like an enemy, immediately stop her: “Let me do it, you can take care of yourself! “
In their eyes, action is always accompanied by danger. Therefore, avoiding action is the same as killing the danger in the cradle. Some caregivers even feel that those who are bedridden are more worry-free.
Too much regulation and restraint, in turn, can make the elderly believe that they are really very frail, so that they dare not, and do not want to leave the acre of land in front of them.
For most of the year, Tao Jiumei did not even leave the floor she was on.
She always looked around with her walker by the door, like a child waiting for her parents to pick her up after school. Once someone appears, her eyes will follow silently until the other person disappears out of sight, only to retract silently. If someone passes by and her eyes meet, she can’t help but go up and talk.
She speaks softly and solemnly, as if she is exchanging secrets with someone, but in reality, the conversation is just about daily chores. Sometimes she also warmly invites people to visit her room, there is a bed in the house has been empty for a long time, she would like someone to live in.
Zhang Ling also went to her room, which has a slightly bitter, cold, sickly atmosphere. It was as if the dregs of the Medicine had been cooked over the fire, overnight.
Entertainment is scarce, the elderly sleep less, there is nowhere to spend most of the time can only fill with small talk. But because of the lack of new insights, in the end, everyone is talking about their own little old stories, and the caregivers are not even interested in listening to them for a long time.
To pass the time, Wang Fengxia asked Zhang Ling to bring a piece of water writing cloth. She copied the Chinese zodiac and festivals on it, and watched them disappear into thin air after a while.
Wu Xinyue, a doctor of sociology from Donghai University, once did fieldwork in a nursing home in a county-level city in southern Jiangsu Province. The elderly people there all used the term “death day” to describe their living condition.
In the Wu dialect, the word “dou dai dai” means to muddle through life, waiting for lunch after breakfast, waiting for dinner after lunch, and unable to help but lament after dinner “A day has finally passed”.
There is no enthusiasm, no expectation. After being deprived of freedom and vitality in the name of protection, living, it seems, has become a heavy task.
Even the joy when the children come to visit is swallowed up by a greater despondency after they leave.
Second Abandonment
In a sense, family members also play a role in building an authoritarian care model that compresses the world of the elderly.
Wu Xin Yue once saw a grandmother’s family rushing aggressively to the director’s office because the grandmother had accidentally fallen and broken her bones while exercising in the nursing home’s courtyard in the morning.
The director felt aggrieved: every elderly person has the freedom to exercise in the morning, and the staff cannot keep an eye on them all the time, so how to prevent such risks?
Later, the nursing home still made financial compensation, but also to strengthen the management, such as reminding the elderly walk as far as possible to use a walker, mobility problems as far as possible to take a wheelchair, it is best not to exercise in the morning.
From the perspective of the elderly, the care philosophy of many private nursing homes does lack humanistic care and does not respect their subjectivity. But when you take into account many realistic factors and look at the overall environment, there really seems to be no better choice.
According to the care ratio set by the Guangzhou government, a nursing home usually has one aunt taking care of 5 to 10 elderly people at the same time. When she is helping one of them to dress and feed, her salary will be deducted if any of the other elderly people out of sight accidentally fall down.
Falling down is the number one taboo in the world of the elderly.
After getting older, the elderly generally osteoporosis, muscle atrophy, once the impact of external forces, it is easy to fracture. The fracture itself is not fatal, but the various complications caused by fractures such as lung infections, bed sores, urinary tract infections, and thromboembolism can be fatal.
Lease site, construction and infrastructure construction and purchase of equipment and other initial investment, plus the operating costs of staff salaries and daily living expenses during the operating period, itself has made private nursing homes generally unable to make ends meet.
Zhang Ling, the director of a private nursing home in Henan, who entered the business in 2006, has spent ten years still not profitable. In her eyes, the elderly is a high-risk industry, “the elderly admitted to the hospital is inherently frail, and many are themselves suffering from disease, for some dementia, mental retardation of the elderly, or in the dementia boundary, often particularly high risk “.
Many of the elderly people who are admitted to private nursing homes only deliver bed and meal fees, and their families do not purchase care services for these elderly people, but the family will initiate a lawsuit whenever anything goes wrong in the nursing home.
When the court issues a judgment, it basically agrees to the family’s request for compensation on the grounds that the nursing home provides paid services.
The only way to solve this problem is to include a special agreement in the admission contract, such as an agreement in advance that the nursing home should not pay compensation in the event of an accident such as a fall or death of an elderly person, as long as the nursing home is not found to be directly responsible for the accident. However, in practice, such an agreement can easily lead to resistance from family members.
Trapped in the narrow gap, Zhang Ling, who has seen too many peers get into debt because of similar incidents, can only pray that nothing goes wrong in their own nursing homes, especially not to have the elderly fall, “once the accident, a nursing home is finished “.
So, to prevent safety risks and to ease the burden of care, restraint becomes the prevailing means of protection in nursing homes.
Everyone acquiesces that the elderly can be deprived of their freedom for the sake of safety, but where are the reasonable boundaries of restraint? There is no clear definition.
So often, caregiving can be just as violent and harmful.
On the night of April 7, 2019, Gao Chai, a 102-year-old woman, died in her bed in a nursing home in Nanchang. Until her death, she was unable to break free from the restraint belt tied to her right armpit.
After the body was cremated and buried, the family asked the hospital when they were packing up their belongings, they wanted to see the surveillance video of the old man before he died to determine the exact time of death and the state before he died.
The public security authorities retrieved the surveillance video from April 1 to April 7 before Gao’s death and found that she was forcibly restrained by her caregiver for seven consecutive days.
In the surveillance video on April 7, Gao, who was lying on her side, was tied to the bed by two caregivers with a restraint belt. Gao struggled to indicate that she should not be tied, but the caregivers ignored it and pulled the knotted restraint belt tightly again.
After the nurses left, Gao relied on one hand to struggle to untie the restraint belt, and after half an hour, she finally untied it and tucked it under the quilt. Not long after, the male nurse entered the room with the lights on, and in the midst of the two tearing, tied Gao up again with significantly more force than the last time. Gao kept slapping the blanket to show he didn’t want to be tied, but it still didn’t work.
This time, Taka tossed and turned for an hour and still could not get the restraint straps under his right armpit untied. She thought of another way – to drill out the restraint straps. But it was quickly shoved back in by the male caregiver. Male caregivers untie the short restraint belt picked up from the trash, the restraint belt under the right armpit of the high boy pulled down and tied to another object, this time to drill can not drill out.
Surveillance video shows that after 20:47, Gao has not moved. She lies to the left, curled up. This surveillance video makes the family distraught.
Daughter Hu Rulan clearly remembered that day she went to visit her mother, her mother is still in good shape, mung bean cake and porridge cake have eaten a lot, drinking porridge insisted that she did not have to feed. But in the blink of an eye, that became the last time she and her mother saw.
Granddaughter Peng Shufang recalled that as early as the end of last year, Gao Chai had complained about the use of restraint straps by his caregivers, “I did not steal anything, why tie my hands and feet. “
But the nursing home’s reply at the time was, “People of this age can’t be trusted in all their words, just like children. “
They believed the home and did not look into it further.
In an interview with the local television station in Jiangxi, the caregiver involved said that the restraint straps tied to the high boy was made of cloth torn from the sheet, tying the old man because the old man had fallen from bed not long ago.
At that time, the family raised the hope that the cost can be increased to find a caregiver who can always accompany Gao to prevent Gao from falling again, the hospital to “not enough manpower, can not hire a caregiver for the reason “The hospital refused on the grounds that there were not enough nurses.
The family also did not continue to fight, acquiescing to the hospital’s use of the restraint belt as the only line of defense.
In a sense, it was a collusion. The children passed the responsibility of caring for the elderly to the nursing home, and as a result, the elderly who lost their subjectivity were “abandoned twice” by the nursing home.
That’s why, in the face of the surveillance video, the home had the courage to throw down a sentence.
“More than 100 years old is normal to die, a rope how can tie people to death? “
Nursing home folding
For most private nursing homes, “not enough staff” behind the four words, they continue to hide the pain points for many years – -It is difficult to make a profit.
Typically, nursing home occupancy rates need to reach 75-85% to achieve break-even, while the reality is that the national nursing home occupancy rate is only 50%.
In order to ensure the occupancy rate, the price of the nursing home can not be set too high. In order to make revenue cover operating costs, they can only try to cut labor expenses and save on the construction of facilities.
Mu Guangzong, a professor at Peking University, has said bluntly that private nursing homes are the most difficult to operate in China. According to data released by the Ministry of Civil Affairs, 51% of the country’s private senior care institutions have only a flat income, and 40% of them are in the red for many years.
When he decided to start Guangwai Senior Apartments, Zhang Fuxiang did not expect that the nursing home, which was one of the purposes of “relieving the difficulties of parents in the world”, would become his biggest problem three years later. The rent is $2 million per year, and more than 40 people are living in the home.
With an annual rent of 2 million yuan, more than 40 caregivers, nearly 20 logisticians, and 5 medical staff, the first phase of the project cost more than 7 million yuan, and the second phase has so far invested more than 5 million yuan. However, Guangwai Senior Living now only has a monthly turnover of more than 400,000 yuan, “not to mention the profitability now, it is unimaginable in a few years. “
“The difference between private and public is too far. “Zhang Fuxiang can’t help but sigh,” the government built nursing homes, land, houses, equipment, personnel, everything has financial support. We start a nursing home, everything depends on ourselves. “
Beijing Normal University China Institute of Public Welfare Research Center for the Elderly Senior Analyst Cheng Him also said, “The main difference between public and private is financial support. “
Take land as an example, public nursing homes are free to get state land, while private nursing homes have to get land at market price. Even if the government continues to help the development of private nursing homes in terms of land and operating subsidies, the cost of most institutions remains disproportionate to the rise in revenue in the face of pressure from various sources such as labor, rental costs, and expenses for consumables.
This also determines that their hardware support and service quality can only meet the bottom of the elderly’s survival needs.
For example, Wang Fengxia’s nursing home, with its old housing, rudimentary facilities, limited food choices, care model based on restraint, and recreational activities only in response to inspections, is close to the “get by and get over it The four words “get by and get over it” are posted as a banner.
On top of survival, the more abstract and subtle things, perhaps only the financial strength of the high-end nursing homes are able to touch.
Take a high-end nursing home in Yuexiu District, Guangzhou, for example, humanized design permeates every detail of the room décor. Each caregiver here can take care of up to three elderly people, and the nutritionist will match three meals a day according to the dietary pyramid; the nursing home is equipped with a rehabilitation hospital, with convenient and quick referral channels.
The activity space is divided into 12 areas according to different functions: chess and cards room, painting and calligraphy room, nostalgia room, meditation room, sensory therapy room for doing psychological guidance ……. A university for the elderly is opened, teachers are invited to come over to teach painting and calligraphy and vocal Music, and the social work team organizes recreational activities and teaches the use of digital products every day.
We also take an active intervention attitude towards the elderly with disabilities and dementia. There is a special rehabilitation room for physical training and brain preservation.
High quality means high charges.
A double room, the acquisition fee plus bed fee, nursing fee, and other miscellaneous, at least 8,000 per month, the higher level of care, especially the cognitive disorder area, will have to run 20,000 per month.
This threshold is enough to turn away the vast majority of the working class.
The elderly from ordinary income families like Wang Fengxia are not qualified to expect a high quality of life in their old age, and their biggest hope is that their caregivers can be friendly.
The “aunts” at the bottom of the stigmatization chain
In Chinese nursing homes, caregivers are usually local female workers who have been laid off or middle-aged women who are migrant workers.
Also known as “aunts”, the treatment of elderly caregivers is not comparable to that of sister-in-laws and childcare workers. In Guangzhou, for example, the monthly salary of a childcare worker can reach 8,000, but the monthly income of elderly caregivers is generally only 3,000 to 4,000.
Maintaining the cleanliness of the elderly and the surrounding environment is one of the main tasks of caregivers. In this process, they inevitably come into contact with the elderly’s bodies and even excrement.
The perceptual level of filth is a big hurdle for them to cross. In addition, the crossing of gender and physical boundaries can also bring a sense of moral “dirty”.
Auntie Gu, who takes care of Zhang Jianjun, recalls the first time she helped a male old man change his diaper and take a bath, and was so embarrassed that she grinned, “I couldn’t open my eyes to see …… “
It took almost half a year to get unemotional and see this as a standardized daily labor.
Until now, she still feels that this job is not decent. For 7 years, she has been lying to her friends and family back home that she works in a supermarket.
There is a serious mismatch between the intensity of the work and the income, and she can neither gain a sense of self-worth from the work, nor gain respect and recognition from others and society.
In a work environment where negative feedback is interlocked, it is difficult for aunties to truly empathize and care for the elderly from the heart. The negative emotions that accumulate over the years are inadvertently transferred to the elderly.
During the fieldwork, Wu Xinyue once witnessed a scene in which a caregiver was panting, carrying and dragging a grandmother who had lost her ability to care for herself from her bed to a wheelchair, when the grandmother suddenly turned her head and pointed at Wu Xinyue and said, “If this sister came to carry me, she would not be able to do so. “
The caregiver heard this instantly exploded: “You think well! People are college students, doctoral students, people out to be cadres! They are young, which will come here to do this kind of work, only people of my age to get you! “
Serious staff turnover has been the main problem plaguing the development of the elderly service industry. Few of the aunts who stay in the industry do so out of love for the industry, more often, they are resigned to their fate.
Unlike what the aunts are complaining about, elderly care is not unskilled hard work, it is actually a comprehensive profession that integrates communication, nursing, management, psychology, nutrition and other fields.
In order to deliver young blood to the industry and improve the professionalism of the nursing team. In recent years, universities and colleges have been adding majors such as geriatric services. However, very few young people actually stay on the front line.
Starting from the first month of the internship, they have to bear the physical and psychological impact. Many people will vomit and cannot eat when they see severely festering bed sores; because of the frequent lifting of the disabled elderly, the workload is not enough to get a lumbar strain; when it comes to constipation, it is too late to think, put on the gloves and start “manual removal of stool “.
Even if you can overcome the psychological barriers, many things still do not transfer to their will. For example, the elderly people with dementia, one second they are fine, and the next second they are inexplicably slapped by him. “You can’t count on it, after all, he doesn’t even know what he’s done. “
There are also old people who do not sleep in the middle of the night, get up “bang” knocking on the door, and make a fuss about going out and going home. The little girl on night duty was scared to death.
Each day’s chaos will accumulate in the hearts of young people countless reasons to resign.
Research shows that Beijing’s geriatric management and service graduates have only a 30% industry retention rate. At the current training rate, the market demand will not be met in 10 years. In order to retain young people, a scarce resource, many institutions will take management posts as bait.
“Talking about money is more vulgar, I talk to you about the future, there are no college students in the industry now, as long as you enter the industry, adhere to a few years is the manager, get an annual salary. “
An interview, Shenyang City, home edge of the Xing nursing home in charge of Zhou Liguo said so to the applicant.
“And what is the salary now? “
“After deducting the insurance, it comes to 2600 yuan. “
“As a restaurant waiter is more than this, but not as tired. “
Zhou Liguo was choked on the spot no words.
At present, the domestic elderly and family service personnel subsidy policy is not perfect, the corresponding wage standard also needs to be improved, and parents do not want their children to do after graduation “waiter” work. This has led to a large number of talents trained by the elderly-related majors to go to other “fast-money and decent” industries.
With the structural dilemma difficult to break through, most of the young people who have not yet left are in the process of walking with “aging” and finding some meaning beyond worldly success.
Jing Yuan, 28, is the youngest caregiver in Wang Fengxia’s nursing home. Almost all of her peers who interned with her back then have already changed careers, opening stores, engaging in sales …… friends circle daily dynamics seem to be steaming, while her nursing home life mixed in the rapid change of information flow, how to look out of place.
She often feels like a bottomless pit here, constantly sucking up her youthful energy, but still not changing the bottom of the twilight.
But there is always some fine warmth that will keep her again and again.
The daytime vomited all over her principal Jiang, that night a rare noisy. The first thing you need to do is to get a good idea of what you’re getting into. “
At that moment her heart completely loosened up. When people get old, they really turn back into children.
And being young, she is still willing to be the brace of arms for the time being.
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