Keywords

1 Introduction

China’s aging level reached 14.9% at the end of 2013. With the sharp increase of the number of empty nesters and elders, the traditional family pension and institutional pension have been unable to meet the increasing needs of the elderly [1]. In the Construction of social old-age service system “12th Five-Year”, China explicitly proposed the establishment of “community home care service system”. The model of community home care provides a new way to solve the diversified needs of the elderly service. Taking the community home care service center as the carrier, it can not only enable the elderly to live in familiar environment, but also make full use of community resources, providing relatively professional pension services for the elderly [2].

Nanjing has carried out a lot of beneficial exploration in the construction of social home pension system. Such as “love table” “benevolence supermarket”, “elderly activity room” etc. The elderly do not need to get out of the community to accept the elderly service, this greatly relieves the pressure of family pension [3].

There are also many problems during the development of the community home care system. In 2006, the China Aging Research Center surveyed the needs of elderly for daily life care, health care, spiritual comfort and other services provided by the community home care service centers, and concluded that the elderly have great demand for these services [4]. For example, many community home care centers often serve young elderly, healthy elderly, self-care elderly, but lack of the services for elderly people who cannot take care of themselves. The pension facilities in some community home care centers do not conform to the size of the elderly, which leads to the low utilization of the pension facilities. Although some centers provide facilities and services for the elderly with different disabilities, but there is a big gap between the fees and the actual economic conditions of the elderly. There are also some centers lack of the services to the spiritual needs of the elderly, and can not provide relevant services such as cultural entertainment, education, and re employment [5], The quality of the service staff is also uneven [6]. In order to provide better service for the elderly, improve the utilization rate of resources, improve the quality of life of the elderly, Through the investigation of 8 community home care centers in Nanjing Gulou District, this paper study the layout and functional configuration of the community home care center, and at last give some suggestions.

2 The Current Situation of the Layout and Function Allocation of Community Home Care Service Center in Nanjing

2.1 Research Data Sources

This research data is from the questionnaire survey and in-depth interview last from September 2016 to November 2016, which is for 1014 elderly people who receive service from the community home care service center of 8 communities in Gulou District of Nanjing. The research includes the desire of the elderly and the layout of the community home care center, the content of service supply and the utilization ratio and etc. The 8 districts include the old district, the high-grade district, the district of staff and their family, the commercial district and so on. A total of 816 valid questionnaires were collected, and analysis the data by SPSS and EXCEL. The following Table 1 gives the pension willing of elderly of different lifestyle. The pension willing means that the elderly prefer the style of community home care.

Table 1. The pension willing of elderly of different lifestyle (N = 816)(%)
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It can be found that there is a strong demand for the elderly in different life forms. Among them, the oldest old, the healthy and the low-income groups choose to receive services more than the others. Although the elderly in 8 communities showed strong demand for the elderly services, there was a significant difference in the needs of the elderly in different backgrounds, educational level and economic level. For example, the elderly with low income and low education level hope for more beds in centers, faster home delivery, more door-to-door care and so on. But the elderly with higher income and higher educational level hope to have more activities, more equipment, more learning activities, and so on. At the same time, the needs of elderly people in different types of community are not the same. The elderly in old districts often have a high demand for living care, while the district of staff& their family has a greater emotional demand.

The survey of the layout of community home care centers showed that most elderly people were not satisfied with it. They think that the regional division of the center is not reasonable and the functional area is not clear. The problems show like the personal area is too small, which leads to difficulties in protecting personal privacy. The lack of partitions between public activities and restaurants often results in functional conflict. The low utilization area has larger area, and affects the utilization of functional space with high utilization rate. These problems make it impossible for the elderly to receive community services though they need them, and also cause a waste of resources.

2.2 Research on Community Home Care Center

This research investigated the services provided by community home care centers in 8 communities, including 20 items, such as food service, service facilities, and personal cleaning, etc. The study mainly investigates the demand for services and facilities, the supply situation, and the utilization of these services and facilities for the elderly. Table 2 shows part of the needs, supply and utilization of different services and facilities for the elderly. Use the service demand ratio (D) minus the service supply ratio (S) can be the difference between demand and supply, is called “Difference of demand”, the greater the difference shows the greater the gap between supply and demand. Similarly, service supply ratio (S) minus the service utilization ratio (U) is called “Difference of Utilization”, which shows the oversupply of service.

Table 2. Demand supply and utilization of community home care center project (N = 816) (%)
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Table 2 shows that the elderly have the highest demand for the Bed supply of the community home care center, up to 68.3%, followed by the demand for supply of sports equipment, which is 60.7%. The difference of demand and supply shows that community home care system currently exists the problem of oversupply of service. Although these community home care centers have a comprehensive, diversified service supply, but the demand and the utilization rate of the elderly for these services are not high. From the difference of service supply and service utilization, we can know that the service provided by the community home care center usually more than the service utilization. But in the process of investigation, it is found that due to the uneven distribution of resources and the mismatch of resources, the real demand is not satisfied, and the supply of existing services is far from being utilized.

3 Comparison of Two Community Home Care Centers

3.1 Comparison of the Elderly with Different Life Styles

This paper choose two community home care centers from A and B community as a comparative case, for A and B community are close and the elderly from two communities have different life style. This paper makes a series of comparative analysis and research on the layout, service supply and utilization rate, elderly service demand and service satisfaction of community home care center.

Most of the elderly in A community are retired workers in a shipyard, their education level is not high and have low income level. Their demands are mainly reflected in life care and medical care. The services they receive are relatively simple and think that basically meet the basic needs of life is enough. Most of the elderly in the B community are retired faculty members in a university, who have a high level of education and a better economic situation than the elderly in the A community. Their needs are not only the basic needs, but also the spiritual needs.

3.2 Comparison of the Community Home Care Centers

The community home care center of A community is not large, can only make 4 elderly living. (see Fig. 1) The living form is close to the housing, make the elderly communicate with each other easily, and can also reduce the resistance to the community home care service center.

Fig. 1.
figure 1

A community home care center.

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In addition to long-term care, the center also provides daytime care for the elderly, with up to 20 elderly could stay here during the daytime. In the leisure area, hall and recreation room are separated, the recreation room is set to a semi public space.In addition, the center has a chess and card room. In this chess and card room, the elderly can play cards or have a short rest in it. Because the area is too small, it can not provide more services for the elderly. The layout of the center is difficult to meet all kinds of needs of different disabilities, and the service content is single, and the pension function is not perfect. But in the actual survey, it is found that the elderly people in the A community have a higher satisfaction with the community home care center. The reason is that the service accepted by the elderly is the service they need. The service utilization rate is high, the supply and demand is matched.

B community home care service center is larger than the A community. The building is divided into three layers, which can accommodate more elderly people. (see Fig. 2) The service it provide include life care, entertainment, health care, and so on. There are many kinds of service content and professional staff, which belong to the medical and health care unit. Although the facilities of the B community home care center are more perfect and the nursing staff are more professional, the satisfaction of the elderly in the B community is low. For example, the high density of living reduces the personal privacy. The lack of consideration of the physiological state of the elderly in different situations has also caused a lot of inconvenience. Part of the functional area is large and empty, and it also increases the loneliness of the elderly.

Fig. 2.
figure 2

B community home care center

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3.3 Suggestions for Promotion

Through the comparison of the layout and functional configuration of home service centers in two different communities, we can find the phenomenon of the mismatch between the supply and demand of the service. In order to improve the utilization rate of service resources and enhance the satisfaction of the elderly, we need to start from the actual needs of the elderly, plan the layout suitable for the elderly of different lifestyles and fit the functional configuration of the elderly in the community.

First, Classify the elderly in different life forms in the community, and provide community characteristic service content supply according to the service demands of the elderly in different communities. According to the characteristics of the whole community, we should make reasonable allocation of resources and improve the utilization rate of services, so as to avoid the problem of low utilization rate happened in the community home care service centers.

Second, merge the functional areas of low utilization into a new multifunctional area and make full use of the limited space. In this way, it is possible to avoid unused functional partitions with low utilization, can change the function of space flexibly.

Third, the pension resources should be allocated according to the needs of several communities in a certain range. The flow of service resources can not only achieve resource interchange, efficient utilization, reduce idle and waste, but also help the elderly to communicate between different communities, so as to achieve shared economy and shared service resources. For example, in two adjacent communities, the A community lacks a pension service, while the B community’s service resource is just idle or the utilization rate is low, which allows the elderly in A community to accept the services provided by B community, so as to achieve the mutual flow of pension resources.

4 Conclusion

Based on the study of community home care service centers in 8 communities in Gulou District, Nanjing, Jiangsu, we found that there are more or less the current situation of community home care centers, which do not conform to the different life styles of the elderly. The content of service supply can not keep up with the demand for the elderly, and the utilization rate of service is far below the content of service supply, the phenomenon of lagging development and contradiction between supply and demand is formed. Then, through the comparison of two home care centers in different communities, it is found that the functional allocation of community home care centers should be classified according to the different life styles of the elderly in the community, so as to provide services for the elderly with practical needs and improve service utilization. In addition, the layout of the service center should be miniaturized, diversified and scattered. Through cross regional resource integration, complement functions with other service centers, can we make the centers miniaturized and specialized, so as to meet the different needs of the elderly.