韩国家庭成员成为“家庭照料护理员”的影响因素分析及其对中国的启示

摘要

One eight of the total population of Korea is the elderly over the age of 65 in 2015,and the ratio is expected to rise up to 40％ by 2060.Due to the increase in the life expectancy and decrease in the fertility rate, the elderly dependency ratio is also expected to grow even higher in the near future.Korea, where the cultural construct has its deep roots in Confucianism,elderly care has been regarded as the duty of adult children, especially the eldest son and the daughter-in-law.Family caregivers have reported psychological and financial burdens on elderly care.Meanwhile, as nuclear households surge and women, who has traditionally been taking the major role of elderly care, start to actively participate in economic activities, the demand for formal elderly care has also been increasing.
　　In order to alleviate family burden and share social responsibility of elderly care,Korean government introduced Long-Term Care Insurance (LTCI) system in 2008, which takes social insurance framework and entails provision of care services to the qualified elderly of age 65 or above.However, in the area of in-home care service, care payments claimed by care workers who have family relationship with the care recipients started to increase rapidly.This unexpected emergence of ‘family care workers', who are professional care workers and provide in-home care services for their own family members, is against the purpose of LTCI implementation.Despite the government's effort to discourage family care workers through curtailing the hourly payments they can claim, the number of family care workers is ever increasing.Few influential factors behind the increase of family care workers have been
　　suggested and the factor of financial gains has been the major focus.Financial benefit alone however, does not explain the constant increase of family care workers whose care payment claim limit has been severely cut back.
　　This study analyzed the interview data of 17 family care worker cases in order to figure out why family members become certified care workers to support their elderly.Using Kemp,Ball & Perkins's convoy of care model (2013) as the backbone of the qualitative content analysis, influential factors of the emergence of family care worker were examined at multiple levels and perspectives.The major factors were categorized into three: 1) filial piety and devotion, 2) financial gains, and 3) mismatch between care needs and care supply.
　　For the second part of analysis, China's current elderly care status was compared with Korea's LTCI program, so as to draw implications for China, the country that has similar cultural construct and is in the process of developing the long-term care system for the elderly.China currently is heavily insufficient in care personnel and is lacking in the professional education system that can train and foster care workers.Taking Korea's precedent into account,China will have to develop the elderly care model that satisfies both care recipients and caregivers.
　　For further improvement of Korea's LTCI system and family care worker situation,this study suggests three: 1) integrated approaches for the family burden of both caring and livelihood, 2) establishment of care worker supervision system for service quality control, and 3) regular investigation of the needs of care recipients and caregivers and reflection to the care service contents.

目录

声明

Acknowledgement

Abstract

Table of Contents

List of Tables

List of Figures

1 Introduction

1．1 Background

1．2 Research Question

1．3 Research Methodology

1．4 Significance of Study

2 The Key Concepts and System Background

2．1 The Key Concepts

2．1．1 Informal Care and Formal Care

2．1．2 Family Care Workers-The linkage between Informal and Formal Care

2．2 System Overview：Korea’s Long-Term Care Insurance

2．2．1 Purpose

2．2．2 Eligibility

2．2．3 Benefits

2．2．4 Service Delivery

2．2．5 Financing Source

3 Literature Review

3．1 Theoretical Approach on the Linkage between Formal and Informal Care

3．2 Cultural Background and Perception on Caregiving for the Elderly

3．3 Long Term Care System

3．4 The Emergence of Family Care Workers

3．4．1 Inflnential Factor Identification

3．4．2 Analysis on the Existing Factors

4 Case Analysis

4．1 Analysis Framework

4．2 Influential Factors

4．2．1 Traditional Cultures and Values-Filial Piety and Devotion

4．2．2 Financial Interests-Benefits

4．2．3 Policy Mechanism-Mismatch between Care Needs and Service Supply

5 Policy Analysis

5．1 System Comparison：China’s Long-Term Care System

5．1．1 Eligibility

5．1．2 Benefits

5．1．3 Service Delivery

5．1．4 Financing Source

5．2 Implications for China

5．3 Directions for Future Development

Conclusion

Reference