In the outdoor environment transformation, it is necessary to not only achieve barrier-free design in all aspects, but also to plan safe, comfortable and high-quality walking trails and special activity venues and places for the elderly. (Visual China/Photo)
Imagine a gentle and gentle young man with a tape measure coming to your home: while chatting with your old father, measuring the length of the old man's arms and legs. He also focused on the toilet, bedroom and kitchen. There is a rumor in my mouth: The toilet floor is not anti-slip, a handrail should be installed beside the toilet, and a small night light is missing at the head of the bed in the bedroom...
You thought to yourself: It seems that you have never called the decoration company. In fact, young people are an aging-friendly transformation appraiser.
Many children may think that the elderly are safest to stay at home, but they do not know that there are hidden risks in the home. Liu Nan, chief physician of the Rehabilitation Department of Peking University Third Hospital, once provided a set of data: 20% of people over 65 years old died within one year after a hip fracture, while fractures in hip , wrists, etc. are often caused by falls. Elderly falls often occur in the bathroom, kitchen and bedroom.
By appropriately transforming the home environment, eliminating hidden dangers of the elderly’s home life, and improving the quality of life of the elderly, this is the “home aging-friendly transformation”.
aging-friendly transformation is receiving attention from all parties. In 2022, the promotion of barrier-free environment construction and the aging-friendly transformation of public facilities appeared in the government work report for the first time. The Ministry of Civil Affairs and four other departments proposed to support 2 million elderly, disabled and disabled families in special difficulties to implement aging-friendly transformation during the 14th Five-Year Plan period.
Many places across the country have also begun to implement family aging-friendly transformation projects - the government provides financial subsidies for residents who receive aging-friendly transformation services, with subsidies ranging from thousands to tens of thousands of yuan per household, and a number of aging-friendly transformation companies have also emerged. Many industry insiders admitted that if the aging-friendly transformation wants to be truly professional, it is necessary to meet personal needs and be recognized by the market through evaluation and customized services.
Evaluator Household Survey
Zhang Qiang originally started to do the elderly products business in Qingdao , from selling elderly aids, food, and shoes for elderly people, covering the elderly’s food. After opening several chain stores, in April 2022, Yangzibao Health Technology Co., Ltd., which he founded, began to operate the "aging-friendly transformation" business.
Zhang Qiang told Southern Weekend reporters that the current government transformation business is evaluated by third-party companies, while the personal transformation business requires the evaluation of the elderly-friendly transformation company. "Home-entry evaluation is very important because each elderly person has different physical conditions and habits, and the installed facilities must meet their needs."
An aging-friendly transformation appraiser must first conduct a home survey, talk to the elderly, and measure the length of the elderly's torso and limbs. In this process, the appraiser understands the needs of the elderly and the hidden dangers at home on the one hand, and on the other hand, it also plays a psychological counseling role for the elderly.
Dong Hong, general manager of an aging-friendly renovation company in Fujian, told Southern Weekend reporters that most of these elderly people live alone or live with their spouses. "In life, they rarely come into contact with young people except their children, and they really want to talk to them." What projects and facilities are available for transformation in
? According to the "Recommended List of Home-Age-friendly Renovation Projects for the Elderly and Elderly Supplies Configurations" attached in the "Guiding Opinions on Accelerating the Implementation of the Elderly's Home-Age-friendly Renovation Projects for the Elderly and Supplies" jointly issued by the Ministry of Civil Affairs and nine other departments in 2020, it is divided into seven categories and thirty sub-items. The anti-slip floor, toilet handrails, etc. are basic configurations, and squat toilets and toilets are optional configurations.
When implementing the "Opinions", various places will also form their own implementation plans. For example, Nanshan District, Shenzhen listed the "gas leakage alarm" as the basic configuration, which is an optional configuration in the "Opinions".
Some requirements for the aging-friendly renovation of residential buildings in Shanghai are more specific. In June 2021, the Shanghai Municipal Housing and Urban-Rural Development Commission and the Civil Affairs Bureau jointly issued the "Shanghai's Technical Guidelines for the Aging Renovation of Existing Residential Houses", which proposed requirements such as "the clear width of the entrance hall should not be less than 800mm" and "the height of the TV cabinet should be 450mm~600mm, which is flat or slightly higher than the height of the elderly's sitting posture".
Assessors will also respect the aesthetic preferences of some elderly people.While working as a designer at a well-known architectural design agency in Shanghai, Yang Guangbang performed aging-friendly renovation for the residence of a Shanghai model worker. When installing the anti-slip floor, the construction team was preparing to lay the floor, but the old man felt that it was "uncreative" and asked to lay the floor diagonally. Later, Yang Guangbang discovered that the old man’s idea was correct: the room was irregular and the slanted paving just fitted into the layout.
In order to make it more comfortable for the elderly to go up and down the stairs, Yang Guangbang’s team not only replaced the anti-slip handrails for the corridor, but also specially studied the color preferences of the elderly and installed warm lights to the handrails to "let the elderly feel the temperature of home."
Aging-friendly transformation is not just accessible
After listening to the speech of professor of the School of Architecture of Tsinghua University Zhou Yanmin , Shanghai native Qi Xi began to pay attention to his father's every move: he got up at 4 a.m. at night, and struggled to get out of bed in the morning...
When he was carrying out aging-friendly transformation for his father's home, the position of the handrail was installed was Qi Xi observed his father's movements and behaviors and told the decoration master; the shoe cabinet was designed to be 850mm so that his father could borrow strength when changing shoes, which is exactly the height of the general horizontal handrail.
"Children should care more about the elderly and pay attention to the details of their lives." Zhou Yanmin told Southern Weekend reporters that their parents have a dark toilet at home, and their parents pay more attention to power saving. Sometimes they are reluctant to turn on the lights when going to the toilet during the day. During the renovation, she knocked off the toilet's non-load-bearing wall a little and installed a piece of glass to let the toilet borrow some light outside so that the elderly will not fall because of the darkness of the toilet.
Many respondents told Southern Weekend reporters that China's aging-friendly transformation is still in its infancy and is currently similar to accessibility transformation. However, the elderly gradually lose their self-esteem because they are difficult to take care of themselves in life. This problem is often overlooked.
Most of the popular aging-friendly transformations on the market are provided with auxiliary tools or inconspicuous decorations. Zhou Yanmin emphasized that the aging-friendly transformation is not only for the safety of the elderly, but also to satisfy their desire to live independently. "For example, if an elderly person wants to go to the toilet, he can slowly walk over with the furniture and door frames by himself. It will be much better than asking someone to help or solve it in bed every time."
In reality, after some elderly people have difficulty in legs and feet, their children will quickly buy a wheelchair for them. Once the elderly form dependence, they will never be able to walk. A more scientific approach should be to let the elderly use walker , so as to gradually restore their walking ability. A wheelchair is the last option.
According to the survey, Zhou Jingmin, deputy chairman of the Academic Committee of the Age-friendly Architecture of the Chinese Architecture Society and professor of the School of Architecture and Planning of Tongji University, found that most of the current residential buildings are brick-concrete or shear wall structures, and the immutability of their load-bearing walls makes the adaptability and flexibility of the functional space very poorly. Therefore, integrating within the limited space and adjusting the layout through furniture has become a more feasible transformation method that suits the daily needs of the elderly.
For example, adjust the layout to ensure that there is enough wheelchair swivel space in each room; cancel the sofa and merge it with the dining table to form a hospitality and communication space; cancel the bathtub and change it to a shower, increasing the practicality and spaciousness of the bathroom, etc.
Zhou Jingmin discovered that in the pilot program of aging-friendly transformation in Shanghai, Dongpeng Group established a special bathroom team to develop suitable products for bath cabinets, bath equipment, handrails and anti-slip floors needed by the elderly; Panasonic Group provided elderly-friendly doors and fresh air system that are conducive to wheelchair access; Weishizhuo developed installation technology, etc.
"Only products with high quality and low price and rich variety can green and aging-friendly transformation be achieved." Zhou Jingmin said.
Many places are actively promoting home-friendly transformation, and the picture shows living facilities that facilitate the daily living of the elderly. (Visual China/Photo)
Why are the elderly not willing?
Home-based elderly care occupies a fundamental position in my country's elderly care system. However, according to the National Aging Commission's " Fourth Sampling Survey on Living Conditions of Urban and Rural Elderly in China", more than two-thirds of the elderly live in old houses that have been built for more than 20 years, and more than 60% of the elderly believe that the housing they live in has a "discomfortable" problem.
The Opinion pointed out that during the 14th Five-Year Plan period, the government should implement aging-friendly transformation for elderly, disabled, and disabled elderly families with special economic difficulties through subsidies and other means. Where conditions permit, the scope of transformation objects can be expanded to elderly, disabled, disabled, and disabled elderly families among urban and rural minimum living allowance recipients.
Starting from 2020, the district government of a city in the south has begun to provide family aging-friendly transformation services for disabled elderly people over 60 years old and those over 80 years old. It was officially implemented in 2021. The funding standard for each household is 10,000 yuan, and the part that costs more than 10,000 yuan for the renovation will be borne by the residents themselves.
A person from the Civil Affairs Bureau of the District told Southern Weekend reporters that the district has implemented more than 200 renovations so far, but it is far less than expected. Previously, the street office promoted policies to the elderly through exhibition boards and senior citizen college activities, hired third-party companies to call the elderly to preach each household, and even included mobilizing the elderly to participate in the family's aging-friendly transformation into the performance appraisal of the district's subordinate street offices, but the results were still not ideal.
"We thought the elderly would apply enthusiastically, but in fact they were not very willing." The above-mentioned person analyzed that some elderly people do not have high requirements for their living environment and think there is no need to renovate; some elderly people live with their children, worried that their children will not be willing to squeeze out living space and change their home decoration style; there are also some cases, such as the residence has multiple property owners, and the property owners will find it difficult to reach a consensus on whether to renovate.
Zhou Yanmin pointed out to the Southern Weekend reporter that some elderly people are often unable to make up for their elderly-friendly transformation due to insufficient understanding or physical conditions, and must obtain support and help from their children to complete it.
Liu Ying, co-founder of Chengdu Langli Elderly Care Industry Development Co., Ltd., also noticed this. She often adapts to aging and transformation through various channels, mainly for young people, "gradually, young people are moved." "Most of them have a good educational background and know the importance of this matter. Some children may be too busy at home and use the method of transformation to be filial. Some also consider that if they don't spend money on transformation now, if the elderly really fall down in the future, it may cost more."
"It is difficult to be professional when users are not individuals."
According to a reporter from Southern Weekend, when promoting aging-friendly transformation, most regions adopt bidding methods.
"The government has done a lot to open a market for aging-friendly transformation, but this industry cannot always rely on government orders." Liu Ying pointed out that from a national perspective, the funding standard of 10,000 yuan per household is already very high, and the funding standard of some local governments with limited financial resources is 1,000-3,000 yuan per household. Therefore, low prices have become an important consideration in bidding, which often limits the profit margin of the winning company and may also affect the service quality.
An industry insider revealed to the Southern Weekend reporter that a city in North China tried the waters for aging-friendly transformation in 2017. When bidding for service providers from the society, bidders included decoration companies, social work service agencies, and auxiliary equipment (auxiliary treatment equipment) rental companies. Later, an auxiliary equipment rental company won the bid. When the company was carrying out an aging-friendly transformation for an elderly person, it arranged two aging-friendly nursing beds in the elderly room, and hurriedly "completed" the renovation task.
"The room was filled with two beds, and the elderly had to call the community and asked to remove a nursing bed." The person said that in the early stages of the aging-friendly transformation, participants often formulated aging-friendly transformation plan based on their original experience. "But there are professional thresholds for the aging-friendly transformation, and professional appraisers are required to communicate with the elderly at home and provide customized services."
The person from the Civil Affairs Bureau of a certain district in the south mentioned that an elderly man only wanted to apply for a wheelchair on the demand list, but when he learned that the wheelchair on the list was not electric but hand-pushed, he withdrew his application. "The government has limited funds, and the facilities chosen mainly consider basic needs. The product level is more popular, and some personalized needs may be difficult to meet."
Liu Ying believes that in addition to the low profit and low and standardized profit , the government-promoted aging-friendly transformation often receives positive reviews in the acceptance process, because the elderly will feel that they enjoy a benefit and are embarrassed to give their opinions, but the company also loses the opportunity to summarize experience from criticism."In short, when users are not customers, it is difficult for companies to be professional." Isn't it easy for
to raise prices?
evaluation and customization means that aging-friendly transformation is not a cheap service. Government funding is suitable for solving the "necessary needs" - the basic needs of some special and difficult elderly people, and more humane and targeted aging-friendly transformation needs are far beyond what government projects can meet.
However, it is not easy for the aging-friendly transformation industry to shift customers from government to individuals. "We once saw several elderly families, and we were also moved, but we gave up after inspection." Dong Hong admitted that at present, personal orders are mainly to meet the basic needs of the elderly, and there are not many high-end customized services, so the unit price is not high. In addition, each family has different needs. Once the elderly have various problems after the transformation, the company may be held accountable, so it is not cost-effective to make personal orders. Although government projects are cheaper than individual orders, their winnings are large quantities, standardization, and not difficult.
In reality, young people like to spend money on "downward but not upward" - they spend more money on their children than the elderly, and the elderly are generally frugal. These factors make it difficult to raise prices when they are aging-friendly transformation. Therefore, it is difficult for enterprises to regard family aging-friendly transformation as their complete main business.
Zhang Qiang's company still mainly sells products for the elderly, and the revenue of aging-friendly transformation only accounts for 10%-15% of the total store revenue. Liu Ying's company not only undertakes the government and individual aging-friendly transformation business, but also undertakes the aging-friendly transformation orders for community nursing homes and private nursing homes, but her goal is to focus on personal aging-friendly transformation in the future.
Liu Ying is constantly looking for breakthroughs. The company has used the accumulated data of more than 50,000 elderly-friendly transformation cases to establish a transformation evaluation system from the aspects of the elderly’s living ability, auxiliary equipment needs, home environment, family relationships, personality and psychology, and provides digital evaluations for elderly people in different situations to reduce the cost of assessment.
"According to our evaluation system, there are specific requirements for where a handrail is and how high a nail is, and the construction team cannot make random changes. We hope to provide customized and standardized replicable and promotional services." Liu Ying said.
. How to connect government funding and individual differentiated needs in the aging-friendly transformation, Japan’s experience may be referenced.
Hoshida, head of the Public Welfare Department of the Eden Nursing Home in Japan, told Southern Weekend reporters that Japan began to implement the "Nursing Insurance Law" in 2000, stipulating that Japanese citizens over 20 years old must pay insurance premiums. Elderly people over 65 years old can use it for housing aging-friendly renovation, purchase and rent aging-friendly appliances, etc. The maximum amount of nursing insurance for renovation is 200,000 yen (about 10,000 yuan), of which 10% shall bear, and the rest shall be paid by the insurance. As for the specific renovation plan, it will be determined by the elderly and their families themselves.
takes into account the needs and carries out "acupuncture" transformation
In addition to the in full swing of family aging-friendly transformation, community aging-friendly transformation is also an important branch of aging-friendly transformation.
Yang Guangbang believes that the current aging-friendly renovation is often limited to indoors, and the local renovation of public spaces inside or outdoors is not complete. "The needs of the elderly should be considered in a comprehensive way and a 'acupuncture-style' transformation of the elderly's living environment and living environment should be carried out."
The aging-friendly renovation project of Shanghai Jiangchuan Road Community, which Yang Guangnang participated, is located in an old industrial area. Residents live in old public housing, with narrow house space and many private items piled up in the stairwell. There are many safety hazards for the elderly's activities. Outside the residence, the area lacks leisure space, and people and vehicles are not diverted at major intersections, while the elderly respond more slowly and are prone to traffic accidents.
They adopt a transformation solution that combines points, lines and surfaces. The point is the renovation of homes and residential buildings. The line is to analyze the daily travel trajectory of the elderly, and set up handrails and slow-moving systems at key nodes of some roads to protect the travel safety of the elderly. On the other side is a newly built park and a canteen for the elderly, and the second floor of the canteen is designed into a large terrace with river views.
In terms of the transformation of outdoor environment, Zhou Jingmin believes that not only should the all-round accessibility design be achieved, such as ramps, lighting, signs, handrails, etc., but also safe, comfortable and high-quality walking trails and special activity venues and places for the elderly to provide space for exercise, healing the body and communication.
(Yang Guangbang is a pseudonym)
Southern Weekend reporter Yang Kaiqi
