生命视角下城市孤寡老人生命质量提升的个案研究

A Case Study on Improving the Quality of Life of Urban Lonely Elders from the Perspective of Life

摘要: 随着我国城市化进程加快和社会老龄化程度加深，城市孤寡老人数量不断增加。他们因家庭支持缺失、健康风险高、社会支持弱，生命质量问题突出。因此，本研究以北京市Q社区孤寡老人M为社会工作个案服务对象，依托生态系统理论为分析框架，通过访谈法和观察法收集数据，从而系统探讨影响其生命质量，探究其生命质量的多重机制、介入路径及成效。研究发现，微观层面，家庭支持缺位与慢病共病交织，引发生理心理双重衰退；中观层面，社区服务被动、住院床位紧张、护工专业参差，造成照护碎片化；宏观层面，养老与医保政策缺乏专项设计，孝道文化弱化进一步削弱非正式支持。在M老人社会工作个案介入阶段，通过构建“个体赋能–医社养联动–照护优化”路径，从而有效减少住院等待期、提升医疗体验、筑牢安全感，进而多维度改善M老人的生命质量。研究结论表明，城市孤寡老人生命质量提升需突破单一系统干预局限，构建“微观个体支持–中观主体协同–宏观制度保障”的整合体系，为构建城市孤寡老人精准、可持续的支持系统提供了有益的探索与启示。

Abstract: With the accelerating urbanization process and the deepening degree of social aging in China, the number of urban elderly people living alone has been on the rise. Due to the lack of family support, high health risks, and weak social support, the issue of their quality of life has become particularly prominent. Therefore, this study takes the elderly individual M, who lives alone in Community Q of Beijing, as the subject of social work case services. Relying on the ecosystem theory as the analytical framework, data is collected through interview and observation methods. This aims to systematically explore the factors influencing their quality of life, and to delve into the multiple mechanisms, intervention paths, and effectiveness regarding their quality of life. The research reveals that at the micro level, the absence of family support, intertwined with the coexistence of multiple chronic diseases, triggers a dual decline in both physical and mental health. At the meso level, passive community services, a shortage of hospital beds, and inconsistent professional standards among caregivers result in fragmented care. At the macro level, the lack of specialized designs in elderly care and medical insurance policies, along with the weakening of the traditional filial piety culture, further undermines informal support. During the social work case intervention phase for Elderly M, by establishing a path of “individual empowerment—medical-social-elderly care linkage—care optimization”, the waiting period for hospitalization has been effectively shortened, the medical experience has been enhanced, and a sense of security has been strengthened. As a result, Elderly M’s quality of life has been improved in multiple dimensions. The research findings suggest that enhancing the quality of life of urban elderly people living alone requires transcending the limitations of single-system interventions. It is necessary to construct an integrated system of “micro-level individual support—meso-level stakeholder collaboration—macro-level institutional assurance”, which provides valuable exploration and inspiration for the establishment of a precise and sustainable support system for urban elderly people living alone.