Lessons from America’s Home-based Community Care for Seniors

The global society has gradually come to agreement on community retirement. Building retirement communities has become a trend. Community home-based care for senior citizens in America is exemplary quality elderly nursing, with its offer of good service and premium life, making people feel like wanting to get old quickly.

Recently, [China’s] Standing Committee of the National People’s Congress for the first time has examined the revised draft of Old People’s Rights Protection Act, which reevaluates elderly care and changes the currently law-regulated “family-dependent nursing for the aged” into “home-based care for the aged.”

In terms of building home-based care for the elderly, America has accumulated much experience. Communities feature great elderly nursing functions, which make elderly Americans peaceful at heart and physically comfortable. Because of the life purpose of a healthy regimen, a happy life and good completion for the aged is realized, most elderly American citizens choose community home-based care.

Good lessons can be learned from America’s experience with Home-based Care for Seniors in Communities.

Approaches/Methods to Home-based Care for Seniors

1. The boarding nursery method (“Retirement Family”): Great amenities and services. Facilities include infirmary, library, computer lab, gym, laundry, emergency call system, etc. Services cover dining, room-cleaning, activities and outings.

2. The daycare method (“Senior Nursing Center”): Residence in the center by day and rest at home at night. Daily centers are also equipped with great facilities with start grade services: one-bed, one-room with reading room, health center and activity center. Seniors are not only ensured three healthy meals in the day, but also entitled to readings, socials and making handicrafts, thus living their remaining years in comfort. Other subsidiary services, such as medicine management and special treatments for Alzheimer’s disease, are also available upon payment.

3. “Senior Care by Mutual Help” creates partners and pairs among seniors to help each other.

4. On-site service: The U.S. government provides a welfare home-based care program for seniors. Funded by the government, seniors in need are sent home-visiting nurses with healthcare services. Different from nannies, healthcare nurses have received training in nursing knowledge, and are also capable of cooking, cleaning and laundry. Only American citizens with green cards are entitled to enjoy the privileges. Chinese senior immigrants in America generally apply for green cards through their children. Having stayed for enough years to gain American citizenship, the elderly can then enjoy all the privileges for American seniors, including a pension of more than $700 per month and housing insurance, which are all covered by the government.

Recently, aid communities have been developing the fastest. Currently, America has 1,900 Continuing Care Retirement Communities altogether, 82 percent of which are run by nonprofit organizations. Most of them are turned from traditional nursing homes. In for-profit nursing communities, more than 50 percent employ an aid method while less than 10 percent are Continuing Care Retirement Communities.

America’s homecare nursing system gives support to the Home-based Care for Seniors mode. Good-quality, secured senior care should be an “all-four-in-one,” consisting of material guarantees, nursing protection, medical insurance and mental security. A home-care assistant’s job is somewhere between that of a domestic waiter and a professional nurse – they mainly take care of solitary elderly, the disabled and the sick, either at home or residential nursing centers.

In New York City, for instance, each borough has a nursing center that arranges and dispatches homecare assistants. The nursing centers determine the number of days that each assistant serves at his or her patient’s home depending on the elderly’s health conditions and self-help skills. In most scenarios, seniors under good health conditions and capable of helping themselves (usually between the ages of 70 and 80 years old) are attended by a daily homecare assistant who works eight to 12 hours from 8 AM to 6 PM. In the event of any senior getting sick or an emergency occurring, the center will change the number of workdays for assistants. For those under poor health conditions and incapable of helping themselves (usually over 80 years of age), they will be accompanied by assistants all day. Every day, homecare assistants make phone calls from their patient’s home to report their attendance upon arrival. In the meantime, the center’s administrators visit patients, gain feedback from them regarding the assistants’ work performance, heed their suggestions and take advice. Praises and rewards apply to the assistants who have done a good job, while proper critiques, education and fines await those who have done poorly. Homecare assistants’ wages range from $7 to $12 per hour, paid by the nursing center and free for patients.

Also, America has the world’s largest non-profit organization for senior care. Participants pay fees depending on their individual incomes, and the remaining cost is paid for by fiscal subsidies from federal government and social donations. This fully showcases the government’s fulfillment of duties in caring seniors and society’s human care. In general, communities have a tight cooperation with hospitals and specialized health institutions.

The Trend for Community Senior Nursing in China

Aging, solitude and dysfunction are common trends in the elderly population. China’s elderly population above 80-years-old amounts to over 20 million, with the dysfunctional and semi-dysfunctional population being more than 33 million. Demand for community care is increasing every day. In an acquainted community, the elderly can find a sense of security, belonging and love. The significance of community is great for the development of home-based nursing. A home-based nursing community for seniors is the right solution to combat aging for those with few children, solitude and dysfunctionality.

In my opinion, China’s community nursing can be divided into three styles: home-based community nursing, apartment-based community nursing and medical community nursing. Most seniors live in traditional communities, receiving care and mental support from families and friends — this falls into the category of home-based community nursing. Apartment-based communities are specially-designed senior apartments, with complete amenities and professional/individualized services catering to healthy self-maintainable seniors. Medical nursing communities are an outcome of the development of a highly-aged society, mostly catering to the senior population that can’t help themselves. These communities provide long-term medical care to meet the last demand of a good life-ending.

Beijing Sun City is currently China’s exemplary senior nursing community, an excellent example of the senior nursing industry, the pioneer of apartment-style and membership-style senior nursing communities, as well as a model base among 300 care and nursing projects promoted by Ministry of Civil Affairs. In 2011, Beijing Sun City was honored as a “Pioneer of a Green Nursing Community for Seniors” for its design concepts in senior friendliness, intelligence and meticulousness. Beijing Sun City’s medical and all-time Continuing Care Retirement Communities takes different strategies towards seniors under different health conditions. Home-based care mostly applies to low-aged and healthy seniors. Rent-based and medical nursing mostly apply to seniors who can partially help themselves and those who cannot at all. The City hospital regularly invites specialized doctors to offer treatment and cares, so the silver-aged apartment residents can enjoy the best 3-star hospital medical services at their home doors. The precondition of getting high-quality services is expensive, so this kind of nursing system only applies to those who are financially well off.

From ancient times to today, here and everywhere, “healthy regimen, happy life and good completion” are a trilogy in the nursing of seniors and also three key pursuits of a senior life. Currently, China has set up goals to build senior-friendly cities and livable elderly communities. More efforts are needed to establish a senior-friendly society with elderly-comfort communities and happy senior life families, with a work-focus on enhancing service functions in senior communities with home-based care and improving resources for these communities. More importantly, China needs to improve senior aide and nursing services, better senior citizens’ living and life qualities and pay great attention to healthcare and mental care capacities in its traditional communities.