How to Mitigate the Looming Senior Care Crisis如何缓解迫近的老年护理危机

Long-term and senior care in the United States is in crisis. We have over 56.4 million people over 65. There are few， if any， good insurance-covered， affordable or scalable options to meet the needs of this aging population—in everything from housing to services to care. How we care for older people is a community issue—or it should be.

美国老年长期护理陷入危机。目前美国65岁以上的老年人超过5640万。老年人口需求涵盖住房、服务、陪护等方方面面，然而美国满足老龄化群体需求的有保险覆盖、可负担或可升级的好方案如若有，也是寥寥无几。我们如何照护老年人乃社区之关切，是社区理应之责。

Our current approach of casting aside1 older adults isn’t sustainable for them， their caregivers or society. We must shift our cultural view of aging to ensure that our senior citizens are welcomed and integrated into the fabric of2 community life， not shut away3， out of sight.

我们目前对老年人置之不理，这种做法无论对老年人、他们的看护人亦或是社会来说都是不可持续的。我们必须转变在文化上对衰老的看法，确保老年人受到欢迎，被社区生活所容纳，而不是把他们隔离起来，清出视野。

Unlike other countries， seniors in the U.S. live “lonely lives separ-ated from their children and lifelong friends.” We are on the fast track to a crisis that will impact senior citizens， younger generations and our country’s long-term economic health.

美国与其他国家不同，我们的老年人“独自茕茕，与子女和终身好友异地而居” 。我们正在迅速奔赴一场危机，它将对老年人、年轻人以及我们国家经济的长远健康发展产生影响。

The sandwich generation， those raising a family while caring for their elderly parents， may face severe economic problems. If these young families support their parents， how will they save for college， buy a new car and shop for back-to-school clothes and supplies？

“夹心一代”既要抚养子女，又要照顾年迈的父母，可能因此面临严重的经济困难。这些年轻家庭若要赡养父母，他们将如何攒钱供孩子上大学、购买新车以及为孩子在返校前购买新衣服和置办用品？

By 2030， 1 in 5 Americans is projected to be 65 years old and over. As the number of senior citizens in the U.S. continues its dramatic upswing， the system’s weakest elements—healthcare， social services and housing—could stretch4 society’s resources to the point of collapse， especially if we ignore the incremental5 needs of older adults until they are unable to care for themselves.

到2030年，美国65岁及以上人口预计占1/5。随着美国老年人口数量继续大幅增加，美国体制当中的最脆弱部分（医疗、社会服务和住房）可能会把整个社会资源消耗到近乎崩溃的地步，特别是我们如果一直对老年人不断递增的需求视而不见，直到他们无法自理。

There are several challenges that an aging population presents for individuals involved with their care， as well as for policymakers. An aging population is accompanied by an increasing need for healthcare， long-term care and social services， even as some in Congress are calling for cuts to Medicare6 and Social Security7.

人口老龄化给老年人护理涉及的个人和政策制定者带来了一些挑战。即便一些国会议员呼吁削减老年医保和社会保障开支，但是人口老龄化带来的医疗、长期护理和社会服务需求只增不减。

These issues won’t be solved in the near term. But there is one challenge that we can meet head-on8 and begin resolving today： the lack of affordable or preferable9 housing options for seniors. Depending on your income and health needs， housing options today may include a 55+ retirement community， an assisted living facility10， a nursing home or staying with family.

这些问题短期内无法解决。但是，缺少可供老年人选择的廉价或较合适住房，这个问题我们今天能够直面并着手解决。目前根据个人收入和健康需要不同，有55+退休社区、安养照护机构、养老院、居家养老几种居住选择。

And depending on the region you live in， 55+ retirement companies can cost upwards of11 $5，000–$10，000 a month， which for many senior citizens is not affordable.

依据个人所在地不同，55+退休社区每月费用至少5，000—10，000美元，许多老年人负担不起。

Meanwhile， the staffing short- ages faced by nursing homes and assisted living facilities continue to impact the industry at rates severe enough to be labeled a crisis. The Bureau of Labor Statistics reports the sector has lost nearly 229，000 caregivers （or more than 14% of its workforce） since February 2020， the worst job loss among all healthcare sectors. The lack of available staff has forced more than 60% of nursing homes nationwide to limit new patient admissions. Over 500 nursing homes closed during the pandemic， frequently attributed to the challenge of recruiting workers. Among these closures， more than 40% were distinguished facilities with four or five-star ratings.

与此同时，养老院和安养照护机构面临的缺工问题将继续影响行业发展，情况严重到足以被视为一场危机。美国劳工统计局称，该行业自2020年2月以来已经流失近22.9万名护理人员（占该行业劳动力的14%以上），为所有医疗行业离职之最。全美60%以上养老院因人手不足，迫不得已限制收容新患者。疫情期间，500多家养老院多因招工难而歇业。在这些歇业的养老院当中，超过40%为4星级或5星级知名养老机构。

I believe a viable solution is to create and support intergenerational communities. However， it will require the support of business leaders and policymakers.

我认为，打造并支持跨代社区是一个可行的解决方案。然而，这需要企业领袖和政策制定者的支持。

A public-private partnership could build intergenerational communities.

公私联手打造跨代社区。

These communities can help resolve the social care crisis older adults face while boosting the supply of affordable housing for students and young families and ensuring reliable and high-quality preschool education for working parents.

跨代社区有助于解决老年人面临的社会养老危机，同时为学生和年轻家庭提供更多可担负得起的住房以及保障工薪阶层父母为子女提供可靠、高质量的学前教育。

One of the best examples is a housing project on the waterfront in Aarhus， Denmark’s second-biggest city. Pioneering an innovative intergenerational living concept， the House of Generations is a 300-unit mix of retirement and nursing homes， family homes， youth flats and apartments for disabled people. Retirement and nursing homes make up the majority of housing and also come with the necessary additional care. Indiv- iduals or couples living in retirement homes receive daily visits from a care worker， while those in the nursing home units receive more substantial medical support.