老年公寓的外文翻译

外文翻译

老年人的住宅问题与选择

一、简介

住宅在老年人生活的极为重要。住房负担能力的影响老人对生活的其他必需品，如食品和医疗的负担能力。住宅附近的医疗设施，购物，交通和娱乐设施服务，可以提高生活质量。住宅是回忆过去，同时也是联系朋友和邻居的地方。存在支持功能和服务设施的住宅也可以使人们老有所养。在这一部分，我们会研究住房问题和老年人的选择。于此同时，我们将用一系列问题和练习测试住宅的智能。

二、老年人的住房情况

老年人的住房情况典型在哪里？我们将从五个方面开始研究：（1）住房所有权的普及，（2）常留现有地，（3）生活安排。（4）老年人对现有住房的依恋，（5）移动行为。

老年人与谁生活可以影响其购房能力，空间需要，以及对这些地方养老的能力。约54％的长者与配偶生活，31％独居，几乎13%和他的亲人居住而不是和他的配偶，同时有大约2%的老年人和没有关系的人居住。随着年龄的增长，老年人（主要是妇女）更可能独居或和亲人居住儿不是和配偶住在一起。年老体弱独居的妇女最有可能居住在有额外房间的家园，需要身心都支持性住房和服务来实现“老得其所”。人口的这一部分组成的群体，他们更愿意居住在有保障设施的建筑里。

很多老年人在生理上很大程度依赖他们生活很久的住宅。在这些地方他们将自己的孩子养大，留下了一生的记忆。它也是联系像邻居，店主这样一系列家庭成员的桥梁，除此之外位于教堂，图书馆，和一些社区服务设施附近。对于大多数老年人来说，在探索与追求中，住宅是他们个性的延伸。另外，住宅可以表现他们将来的经济保障，特别是对这些已经买下住宅的人来讲。对于住宅所有者来讲，住宅通常是他们做可靠的财产。住宅代表着一种独立，表明居民可以靠自己居住。基于这些原因，在AARP的一项关于老年人的住宅类型偏好的调查中，有将近80%的老年人想要居住在自己家里永远不想搬出的这种结果是可以理解的。这种现象被解释为居家养老偏好。

虽然大多数老年人目前社区附近的移动，寻求与一些如西南地区天气温暖的

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退休社区，遥远的西部和南部地区。

三、联邦政府的老年人住房方案

联邦政府有两个基本的住房战略来解决老人的住房问题。策略之一，被称为“供方”的方式，寻求建立如公共住房或第Section住宅为老年人提供居住的新住宅区。公共房屋由准政府地方公共住房当局管理。同时为老人和残疾人建设的第Section202住宅是由非盈利组织出资建造，包括宗教和非宗派组织。约有150万老年人或3％的老年人口生活在联邦政府资助房屋，约38.7万老年人居住在Section202住宅。随着时间的推移，由于经济适用型住宅建设的成本，政府已经转向远离这些新方案，问题是非老年住宅正在大量实施，有一种观点，政府应不再直接与参与建设住房。虽然与20世纪70年代末的高近2万建设单位相比，Section202住宅在过去十年的预算拨款先后为6000左右，但作为有联邦政府资助的为数不多的项目之一，它是一个非常受欢迎和成功的方案。在过去的十年里联邦政府不在投资新的项目，倡议强调需求方的补贴，提供低收入租房者使用证明或凭证，他们可以使用各种设置的多单元，包括在私营部门，公寓符合条件的租金和指导方针。这些凭证旨在减少住房费用过高。一些证明被称为“基于项目的补贴”，并连接到联邦资助，如Section202住房。然而，由于住房项目并没有授权，供应方和需求方一起计划只能满足符合租赁要求的约1/3老年人的需求。

虽然在面对的庞大的预算削减中，房屋的倡导者们一直试图留住现有的方案，注意力却一直朝着满足体弱长者的住房和服务需求转移。这个强调体现了在八十岁和九十岁的老年人中，需要一个有利的环境和与身体相关的服务的老年人越来越多。在这一群体中，老年人的公共住房和Section202住宅的比例很高。最初的是为六十岁或七十岁的独立性老年人建立，这类型的住房现在包括八十岁和九十岁的老年人，许多人已到百岁。因此，政府在制定策略时增加建筑服务使他们更好的适应体弱老年人的需要。90年代初在HUD的预算问题中的一项重大举措，已为联邦政府支付服务协调员，让他们评估居民对于政府资助房屋和与之相关的服务的需要程度。截至1998年，大约有1000位政府的协调员资助全国的房屋建设。

四、房屋连续：一个老人的选择范围

一个在住房领域长期存在的假设是，随着老年人越来越虚弱，他们将不得不从一个设立的住房连续搬到另一个。住房选择的数字表明，沿着这条连续性我们

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发现了这些选择，其中包括单户住宅，公寓，集中住宅，资助房屋和护理院（肯迪格＆Pynoos，1996）。房屋连续的终点养老院。这些选择在他们的可获得性，可承担性，和对满足虚弱的老年人的能力方面有很大的不同。

一个支持性持续照顾的概念是基于这样的假设：住房选择可以由提供服务的数量和类型区别;在交通便利，功能和设计方面的生理状况支持;和住房所指向的人们的能力水平。住房选择的数字显示，这样的选择怎样满足独立，半依赖和依赖的老年人的需求。半依赖型老人可以在一些日常生活中，如做饭，打扫卫生，和购物等活动方面需要其他人的帮助。除了需要一些日常生活的帮助，依赖型老年人可能在如厕所，饮食和洗澡更基本的活动需要帮助助。虽然半依赖和依赖老年人可以在出现整个住房的连续中，独立的老年人不太喜欢住在有辅助生活设计及装备，以满足体弱长者的需要房屋类型，除非他们的配偶要求这些。

虽然连续性确定了住房类型的范围，但是越来越多人认识到，即使年老体弱的老年人需要帮助，他们也不一定要从一个地方搬到另一个地方。半依赖或依靠老年人能够在各种环境下生活，包括他们自己的住宅和公寓，前提是环境更加适宜，照顾者可以提供协助和方便实惠的服务。

五、在不同类型住房选择上的老年人的分布

约81％的老年人居住在单个家庭的单元房里，7.2％老年人居住在流动性住宅里。移动房屋，经常被称为现在的预制房屋，已经因为其相对较低的成本，房屋供应量正在迅速增长。约8％的老年人居住在公寓以及专门为他们居住而设计的街区。它们的范围很广，从主要支持退休后的休闲化的生活方式（主动退休社区）的适用性住房，到主要是为了迎合体弱的老年人的个人帮助和护理服务（Pynoos＆Golant，1995; Golant，1992年）。估计数字显示，约有老年人口总数的一百万（或刚刚超过3％），目前选择综合性支持住宅，这类住宅也提供服务。对住房选择可用性（本身就对许多不同类型的简短定义附录）在国家和地区之间差异很大。例如，在一些地区，分区禁止或使人们很难创造像附件公寓或ECHO单位住房类型。因此，对于老年人来讲，在为老年人提供的住宅类型选择上存在严重差距。

六、结论

住宅在老年人的生活中发挥了关键作用。大部分独立生活的老年人户主对他们所住的单位表示十分满意。然而，住房费用高，特别是对于租房者，仍然是许

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多老年人面临的财政问题，对于低收入的租房者和生活在农村地区的人来讲也是如此。联邦住宅计划，如公共房屋，第202条的住房和第8联邦住房方案由于资金有限，只能够解决只有约三分之一的符合条件的老年人。此外，对于体弱的老年人在可行的选项住宅方面存在短缺。直到最后十年，老年人住宅才被设想为主要的栖身之所。人们逐渐认识到，需要服务和支持功能的体弱多病的老年人，他们不得不离开自己家园或公寓，搬到护理或疗养院机构以获得援助。然而，随着时间的推移，可链接的多种类型的住房的概念，已经取代了原来的住房连续性的想法。对于体弱多病的老年人来讲可以生活在现有的住宅环境，包括拥有服务和住宅修改的他们自己的家园或公寓等。因此，在这过去的十年，我们努力修改了家园，为多单元住房增加服务协调员，和为辅助设施和ECHO单元创造选择机会。尽管家庭护理服务的大规模可变性提升了这些战略，但在养老院医疗补助政策仍然为体弱多病的老年人提供了动机。在对体弱多病的老年人住房领域方面，最显著的一个发展是私营福利性住宅的增长，现在许多州政府将其视为住宅替代疗养院。美联运动本身提出了一些监管融资的问题，以及长期护理，如居住环境应该包括什么，确保居民可以在此终老，符合居民喜好，保护个人权利和确保护理质量。然而，美联储的出现以及大范围的住宅选择表明，老年人在生活安排选择的空间将更大。

文献来源:

American Association of Homes and Services for the Aging http://www.aahsa.org/

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Housing Problems and Options for the Elderly

Introduction Housing is a critical element in the lives of older persons. The affordability of housing affects the ability of the elderly to afford other necessities of life such as food and medical care. Housing that is located near hospitals and doctors, shopping, transportation, and recreational facilities can facilitate access to services that can enhance the quality of life. Housing can also be a place of memories of the past and a connection to friends and neighbors. Housing with supportive features and access to services can also make it possible for persons to age in place. In this session, we will be examining housing problems and options for the elderly. Along the way, we will be testing your housing IQ with a series of questions and exercises.

Housing Situation of Older Persons

How typical is the housing situation of the olders?We will begin by examining five areas :（1）Prevalence of home ownership （2）Length of stay in current residence （3）Living arrangements （4）Attachments of older persons to where they live （5）Moving behavior.

With whom older persons live can influence housing affordability, space needs, and the ability to age in place. About 54% of older persons live with their spouses, 31% live alone, almost 13% live with related persons other than their spouse and about 2% live with unrelated persons. With increasing age, older persons (primarily women) are more likely to live alone or with a relative other than a spouse. Frail older women living alone are the persons most likely to reside in homes with ‘extra’ rooms and to need both physically supportive housing features and services to \This segment of the population is also the group most likely to move to more supportive housing settings such as assisted living.

Many older persons have strong psychological attachments to their homes related to length of residence. The home often represents the place where they raised their children and a lifetime of memories. It is also a connection to an array of familiar persons such as neighbors and shopkeepers as well as near by places including houses of worship, libraries and community services. For many older persons, the home is an

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extension of their own personalities which is found in the furnishings . In addition, the home can represent a sense of economic security for the future, especially for homeowners who have paid off their mortgages. For owners, the home is usually their most valuable financial asset. The home also symbolizes a sense of independence in that the resident is able to live on his or her own. For these types of reasons, it is understandable that in response to a question about housing preferences, AARP surveys of older persons continue to find that approximately 80% of older persons report that what they want is to \in their own homes and never move.\This phenomena has been termed the preference to \

Although most older persons move near their current communities, some seek retirement communities in places with warmer weather in the southwest, far west and the south.

The Federal Government's Housing Programs for the Elderly

The federal government has had two basic housing strategies to address housing problems of the elderly. One strategy, termed the \side\approach, seeks to build new housing complexes such as public housing and Section 202 housing for older persons. Public housing is administered by quasi-governmental local public housing authorities. Section 202 Housing for the elderly and disabled is sponsored by non-profit organizations including religious and non-sectarian organizations. Approximately 1.5 million older persons or 3% of the elderly population live in federally assisted housing, with about 387,000 living in Section 202 housing. Over time, the government has shifted away from such new construction programs because of the cost of such housing, the problems that a number of non-elderly housing programs have experienced, and a philosophy that the government should no longer be directly involved with the building of housing. Section 202 housing, a very popular and successful program, is one of the few supply-side programs funded by the federal government, although the budget allocation during the last ten years has allowed for the construction of only about 6,000 units per year compared to a high of almost 20,000 units in the late 1970s. Instead of funding new construction, federal housing initiatives over the last decade have emphasized ‘demand side’ subsidies that provide low-income renters with a certificate or a voucher that they can use in a variety of multiunit settings, including apartments in the private sector that meet rental and

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condition guidelines. These vouchers and certificates are aimed at reducing excessive housing costs. Some certificates are termed ‘project based’ subsidies and are tied to federally subsidized housing such as Section 202. Because housing programs are not an entitlement, however, supply-side and demand side programs together are only able to meet the needs of about 1/3 of elderly renters who qualify on the basis of income.

While advocates for housing have been trying to hold on to the existing programs in the face of huge budget cuts at HUD, much of the attention has been shifting towards meeting the shelter and service needs of the frail elderly. This emphasis reflects the increasing number of older persons in their eighties and nineties who need a physically supportive environment linked with services. This group of older persons includes a high percentage of older residents of public and Section 202 housing. Initially built for independent older persons who were initially in the late sixties and early seventies, this type of housing now includes older persons in their eighties and nineties, many of whom have aged in place. Consequently, the government is faced with creating strategies to bring services into these buildings and retrofit them to better suit the needs of frail older persons. A major initiative of the early 1990s, which may be stalled by current budget problems at HUD, has been for the federal government to pay for service coordinators to assess the needs of residents of government assisted housing complexes and link them with services. As of 1998, there were approximately 1,000 service coordinators attached to government assisted housing complexes across the country.

The Housing Continuum: A Range of Options for Elderly

A long-standing assumption in the field of housing has been that as persons become more frail, they will have to move along a housing continuum from one setting to another. As the figure on housing options suggests, along this continuum are found a range of housing options including single family homes, apartments, congregate living, assisted living, and board and care homes (Kendig & Pynoos, 1996). The end point of the housing continuum has been the nursing home. These options vary considerably in terms of their availability, affordability, and ability to meet the needs of very frail older persons.

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The concept of a continuum of supportive care is based on the assumption that housing options can be differentiated by the amount and types of services offered; the supportiveness of the physical setting in terms of accessibility, features, and design; and the competency level of the persons to whom the housing is targeted. The figure on housing options indicates how such options generally meet the needs of older persons who are categorized,as independent, semi-dependent and dependent. Semi-dependent older persons can be thought of as needing some assistance from other persons with instrumental activities of daily living (IADLs) such as cooking, cleaning, and shopping. In addition to needing assistance with some IADLs, dependent older persons may require assistance with more basic activities such as toileting, eating and bathing. Although semi-dependent and dependent older persons can be found throughout the housing continuum, independent older persons are very unlikely to reside in housing types such as assisted living specifically designed and equipped to meet the needs of frail older persons unless their spouses require these needs.

Although the continuum of housing identifies a range of housing types, there is increasing recognition that frail older persons do not necessarily have to move from one setting to another if they need assistance. Semi-dependent or dependent older persons can live in a variety of settings, including their own homes and apartments, if the physical environment is made more supportive, caregivers are available to provide assistance and affordable services are accessible.

Conclusions

Housing plays a critical role in the lives of older persons. Most older homeowners who function independently express a high level of satisfaction with their dwelling units. However, high housing costs, especially for renters, remain a financial burden for many older persons and problems associated with housing condition persist especially for low- income renters and persons living in rural areas. Federal housing programs such as public housing, Section 202 housing, and Section 8 housing certificates have only been able to address the basic housing problems of only about one-third of eligible older persons because of limited budgets. Moreover, a shortage of viable residential options exists for frail older persons. Up until the last decade, housing for the elderly was conceived of primarily as shelter. It has become

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increasingly recognized that frail older persons who needed services and physically supportive features often had to move from their homes or apartments to settings such as board and care or nursing homes to receive assistance. Over time, however, the concept of a variety of housing types that can be linked has replaced the original idea of the continuum of housing. It is possible for frail older persons to live in a variety of existing residential settings, including their own homes and apartments with the addition of services and home modifications. Consequently, the last decade has seen a number of efforts to modify homes, add service coordinators to multi-unit housing and create options such as accessory and ECHO units. Although these strategies have been enhanced by a somewhat greater availability of home care services, Medicaid policy still provides incentives to house frail older persons in nursing homes. The most visible development in the field of housing for frail older persons has been the growth of private sector assisted living which is now viewed by many state governments as a residential alternative to nursing homes. The AL movement itself has raised a number of regulatory and financing issues that cross-cut housing and long term care such as what constitutes a residential environment, insuring that residents can age in place, accommodating resident preferences, protecting the rights of individuals and insuring quality of care. Nevertheless, the emergence of AL along with a wider range of other housing options holds out the promise that older persons will have a larger range of choices among living arrangements.

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