Birds of passage
The old people who are most in need of daycare are those with restricted mobility or in poor health. But the shortage of medical and nursing staff in Taiwan, the high cost of providing such care and the fact that it is not covered by the National Health Insurance scheme mean that hospitals around the country have little inclination to set up daycare centers or residential nursing homes. At present only five hospitals are providing daytime nursing care on an experimental basis: the Cardinal Tien Center in Hsintien, the Monroe Hospital in Hualien, the Puli Christian Hospital, the Chiayi Christian Hospital and the Provincial Fengyuan Hospital.
For instance, the Cardinal Tien Center first applied in July last year for a Department of Health subsidy to set up an old people's daycare center, which is now attended by 20 old people. Every day it sends vehicles to bring the old people to the hospital, and apart from the regular visits by a doctor once a fortnight, there are also three nurses and three assistants in full-time attendance. "Most families want their old people to live in the nursing home full time, but from the hospital's standpoint we would rather they opt for daycare, so that the old people can go home in the evenings and enjoy family life," says nursing director Lu Hui-chen.
Daycare section leader Lin Hui-ling notes that daycare patients only attend for about two months on average. The reason they leave is not because they can't adapt, but because families take turns to look after their old folk, and when the time with one family member is up, the old person is sent to another place. "For the convenience of family members, the old people constantly have to move and readapt to new surroundings," says Lin Hui-ling, who is deeply sympathetic of the plight of the elderly today.
An old age of dignity and independence
"The concept of daycare for the aged is very good and very much in step with the needs of modern society, but I'm opposed to the idea of the family 'placing' the old person in care," says Lin Tsung-yi, who believes this takes away the old person's right of self-determination. He stresses the importance of letting old people make their own choices.
What is the best way to let old people live independent, dignified lives? Perhaps Norway, where welfare provision for old people has a history of over a century, can provide us with some lessons.
Ching Pao-lin, nursing director at the Cardinal Tien Center's nursing home, visited Norway this May to study their methods. She says that Norwegians retire at 55, and because of this people start very early planning their post-retirement lives.
In old people's centers in Norway, it is not the staff who supervise the old people, but rather the old people who supervise the staff. Whether in terms of facilities, care methods, or the content of activities, these are all requested of the staff by the old people themselves according to their own needs. In Norwegian old people's centers, it is the old people who are the real masters.
At the same time as we are beginning to study how to care for old people and treat them well, perhaps we should also start learning how to be old people ourselves in the future.
[Picture Caption]
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Old people's daycare can help reduce the burden on families while still fulfilling old people's need for a home life. Perhaps it is a workable approach to solving today's problem of how to care for the elderly.
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Lunch is the high point of the day in a rural daycare center. After their meal, the old folk go home to tend the fields or look after their grandchildren.
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Don't laugh! We might be old, but as the teacher says, "practice makes perfect."
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Live a day, learn a day. Look at the almost childlike pride with which this old lady shows off her work.
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According to traditional Chinese values, honoring and caring for the elderly is the family's unequivocal responsibility. But today's changing conditions make it difficult to live up to this ideal.
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Unlike the healthy senior citizens who attend daycare centers, most long-term residents in old people's homes are chronically ill and unable to look after themselves.
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Health is the key to everything. The daycare center attached to the Cardinal Tien Center hospital is equipped with all kinds of exercise and rehabilitation facilities for old people's use.
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Having finally laid down the burden of a lifetime of toil, how can old people pass their remaining years with dignity and independence?