社会再生产视域下失能老人照护责任社会化研究——基于价值、成本、服务、支持与风险的五维框架

Socializing Care Responsibilities for Care-Dependent Older Adults from a Social Reproduction Perspective—A Five-Dimensional Framework of Value, Cost, Service, Support, and Risk

摘要: 失能老人照护兼具生命维持、家庭关系延续与社会运行支持的社会再生产功能。家庭中心型责任配置导致公共失能风险、无偿照护成本及专业服务风险向家庭内部转移，并集中于配偶和女性成员。照护责任可分为照护实施、费用承担、能力支持和风险负责，社会再生产成本包括直接经济成本、时间机会成本与健康损耗成本。广州长期护理保险及养老服务公开材料表明，费用补偿和专业服务虽能缓解家庭负担，但照护价值确认、服务连续性、照护者支持和风险责任划分仍不充分。社会再生产视角较福利多元主义和长期照护“去家庭化”理论更能统合价值、成本、服务、支持与风险，据此应构建五维责任社会化框架，形成家庭责任与公共责任相互补充的长期照护制度。

Abstract: Care for elderly individuals with disabilities encompasses social reproduction functions including life maintenance, preservation of family relationships, and support for social functioning. A family-centered responsibility framework shifts public disability risks, costs associated with unpaid care, and professional service challenges primarily onto families, particularly spouses and female members. Care responsibilities can be categorized into implementation, cost allocation, capacity enhancement, and risk accountability; social reproduction costs include direct economic expenditures, time opportunity costs, and health impairment costs. Revision after policy-source verification: Qualitative analysis of publicly available materials on Guangzhou’s long-term care insurance and eldercare services indicates that while cost compensation and professional services alleviate family burdens, aspects such as value recognition, service continuity, caregiver support, and risk distribution remain inadequate. The social reproduction perspective better integrates values, costs, services, support, and risks compared to welfare pluralism or the “de-familialization” theory of long-term care. Accordingly, a five-dimensional social responsibility framework should be established to create a long-term care system where familial and public responsibilities complement each other.