老年公寓的外文翻译(2)

外文翻译

extension of their own personalities which is found in the furnishings . In addition, the home can represent a sense of economic security for the future, especially for homeowners who have paid off their mortgages. For owners, the home is usually their most valuable financial asset. The home also symbolizes a sense of independence in that the resident is able to live on his or her own. For these types of reasons, it is understandable that in response to a question about housing preferences, AARP surveys of older persons continue to find that approximately 80% of older persons report that what they want is to \in their own homes and never move.\This phenomena has been termed the preference to \

Although most older persons move near their current communities, some seek retirement communities in places with warmer weather in the southwest, far west and the south.

The Federal Government's Housing Programs for the Elderly

The federal government has had two basic housing strategies to address housing problems of the elderly. One strategy, termed the \side\approach, seeks to build new housing complexes such as public housing and Section 202 housing for older persons. Public housing is administered by quasi-governmental local public housing authorities. Section 202 Housing for the elderly and disabled is sponsored by non-profit organizations including religious and non-sectarian organizations. Approximately 1.5 million older persons or 3% of the elderly population live in federally assisted housing, with about 387,000 living in Section 202 housing. Over time, the government has shifted away from such new construction programs because of the cost of such housing, the problems that a number of non-elderly housing programs have experienced, and a philosophy that the government should no longer be directly involved with the building of housing. Section 202 housing, a very popular and successful program, is one of the few supply-side programs funded by the federal government, although the budget allocation during the last ten years has allowed for the construction of only about 6,000 units per year compared to a high of almost 20,000 units in the late 1970s. Instead of funding new construction, federal housing initiatives over the last decade have emphasized ‘demand side’ subsidies that provide low-income renters with a certificate or a voucher that they can use in a variety of multiunit settings, including apartments in the private sector that meet rental and

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condition guidelines. These vouchers and certificates are aimed at reducing excessive housing costs. Some certificates are termed ‘project based’ subsidies and are tied to federally subsidized housing such as Section 202. Because housing programs are not an entitlement, however, supply-side and demand side programs together are only able to meet the needs of about 1/3 of elderly renters who qualify on the basis of income.

While advocates for housing have been trying to hold on to the existing programs in the face of huge budget cuts at HUD, much of the attention has been shifting towards meeting the shelter and service needs of the frail elderly. This emphasis reflects the increasing number of older persons in their eighties and nineties who need a physically supportive environment linked with services. This group of older persons includes a high percentage of older residents of public and Section 202 housing. Initially built for independent older persons who were initially in the late sixties and early seventies, this type of housing now includes older persons in their eighties and nineties, many of whom have aged in place. Consequently, the government is faced with creating strategies to bring services into these buildings and retrofit them to better suit the needs of frail older persons. A major initiative of the early 1990s, which may be stalled by current budget problems at HUD, has been for the federal government to pay for service coordinators to assess the needs of residents of government assisted housing complexes and link them with services. As of 1998, there were approximately 1,000 service coordinators attached to government assisted housing complexes across the country.

The Housing Continuum: A Range of Options for Elderly

A long-standing assumption in the field of housing has been that as persons become more frail, they will have to move along a housing continuum from one setting to another. As the figure on housing options suggests, along this continuum are found a range of housing options including single family homes, apartments, congregate living, assisted living, and board and care homes (Kendig & Pynoos, 1996). The end point of the housing continuum has been the nursing home. These options vary considerably in terms of their availability, affordability, and ability to meet the needs of very frail older persons.

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The concept of a continuum of supportive care is based on the assumption that housing options can be differentiated by the amount and types of services offered; the supportiveness of the physical setting in terms of accessibility, features, and design; and the competency level of the persons to whom the housing is targeted. The figure on housing options indicates how such options generally meet the needs of older persons who are categorized,as independent, semi-dependent and dependent. Semi-dependent older persons can be thought of as needing some assistance from other persons with instrumental activities of daily living (IADLs) such as cooking, cleaning, and shopping. In addition to needing assistance with some IADLs, dependent older persons may require assistance with more basic activities such as toileting, eating and bathing. Although semi-dependent and dependent older persons can be found throughout the housing continuum, independent older persons are very unlikely to reside in housing types such as assisted living specifically designed and equipped to meet the needs of frail older persons unless their spouses require these needs.

Although the continuum of housing identifies a range of housing types, there is increasing recognition that frail older persons do not necessarily have to move from one setting to another if they need assistance. Semi-dependent or dependent older persons can live in a variety of settings, including their own homes and apartments, if the physical environment is made more supportive, caregivers are available to provide assistance and affordable services are accessible.

Conclusions

Housing plays a critical role in the lives of older persons. Most older homeowners who function independently express a high level of satisfaction with their dwelling units. However, high housing costs, especially for renters, remain a financial burden for many older persons and problems associated with housing condition persist especially for low- income renters and persons living in rural areas. Federal housing programs such as public housing, Section 202 housing, and Section 8 housing certificates have only been able to address the basic housing problems of only about one-third of eligible older persons because of limited budgets. Moreover, a shortage of viable residential options exists for frail older persons. Up until the last decade, housing for the elderly was conceived of primarily as shelter. It has become

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increasingly recognized that frail older persons who needed services and physically supportive features often had to move from their homes or apartments to settings such as board and care or nursing homes to receive assistance. Over time, however, the concept of a variety of housing types that can be linked has replaced the original idea of the continuum of housing. It is possible for frail older persons to live in a variety of existing residential settings, including their own homes and apartments with the addition of services and home modifications. Consequently, the last decade has seen a number of efforts to modify homes, add service coordinators to multi-unit housing and create options such as accessory and ECHO units. Although these strategies have been enhanced by a somewhat greater availability of home care services, Medicaid policy still provides incentives to house frail older persons in nursing homes. The most visible development in the field of housing for frail older persons has been the growth of private sector assisted living which is now viewed by many state governments as a residential alternative to nursing homes. The AL movement itself has raised a number of regulatory and financing issues that cross-cut housing and long term care such as what constitutes a residential environment, insuring that residents can age in place, accommodating resident preferences, protecting the rights of individuals and insuring quality of care. Nevertheless, the emergence of AL along with a wider range of other housing options holds out the promise that older persons will have a larger range of choices among living arrangements.

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