老龄认知障碍友好社区社会照顾的治理机制研究

Research on the Governance Mechanisms of Social Care in Age-Related Cognitive Disorder-Friendly Communities

摘要: 随着我国人口老龄化与高龄化进程的急速逆转，老龄认知障碍群体的长周期照护需求已成为新时代基层老龄社会治理面临的核心难题与战略瓶颈。传统“医疗院舍化”模式因供需失衡与社会隔离，难以支撑超大规模老龄社会下的能力维护诉求。本文立足于老龄化治理的范式转型，系统探讨老龄认知障碍者从“疾病身份”向“社会身份”的认知转向，阐明老龄群体社会身份重构与照顾权利回归的理论逻辑。文章从物质环境、社会环境与生活友好三个维度，论证老龄认知障碍友好社区这一老龄包容性空间的支持体系建构路径；从正式照顾资源整合、多学科团队协同及非正式支持网络激活层面，剖析多元主体协同的老龄社会照顾运行机制。进一步结合我国当前养老服务、长期护理保险及老龄法治的发展现状，提出社会照顾权利的制度确认、长护险制度完善以及三级规范体系建设的法治化保障路径，为构建具有包容性、尊严感与协同性的老龄认知友好社会提供制度支撑。

Abstract: With the rapid reversal of China’s population aging and advanced-age trends, the long-term care needs of individuals with cognitive impairments among the elderly have become a central challenge and strategic bottleneck for grassroots elderly governance in the new era. The traditional “medical institutionalization” model struggles to meet capacity maintenance demands under large-scale aging societies due to supply-demand imbalances and social isolation. Grounded in paradigm shifts in aging governance, this paper systematically examines the cognitive transition of elderly individuals with cognitive impairments from a “disease identity” to a “social identity”, elucidating the theoretical rationale behind reconstructing their social identities and restoring their care-giving rights. From three dimensions—material environment, social environment, and livability—the study outlines pathways for establishing supportive systems for inclusive communities tailored to elderly individuals with cognitive impairments. It further analyzes operational mechanisms for multi-stakeholder collaborative elderly care through integrated formal care resources, multidisciplinary team collaboration, and activation of informal support networks. Finally, considering current developments in China’s elderly care services, long-term care insurance, and legal frameworks, the paper proposes institutional safeguards—including legal recognition of social care-giving rights, improvements to long-term care insurance systems, and establishment of standardized tri-level governance structures—to foster an inclusive, dignity-oriented, and collaboratively supported society for elderly individuals with cognitive impairments.