N g h i § n c\j[u G i a d i n h v a G i 6 i
So 5 - 2 0 1 1
Mot so 00 sA thUG tien can quan tam trong xay dung, dieu cliinli cliinli sacli
cliam soc ngirdi cao tuoi A Viet Nam
Le Ngoc Lan
Vien Gia dinh va Gidi
T o m tat: DUa tren nhiing nghien cUu gan day ve ngUcfi cao tudi, bai viet neu len mot so' dac diem nhan khau hoc, han che cung n h u nhiJng nhu cau va nguyen vong cd ban cua ngUcii cao tudi.
Bai viet cho thay ngUdi cao tudi khong phai la mot nhom xa hoi t h u a n nhat, ho co nhflng dac trUng n h a t dinh theo gidi tinh, nhom tudi, trinh do hoc van, khu vUc cU tru... Cu the, ty le mat can bang gidi tfnh trong nhom ngUcfi cao tuoi ngay cang gia tang.
Trinh do hoc van cua ngUdi cao tudi thap va khong ddng deu gifla n a m va nfl, gifla cac viing mien. Da so' song d khu vUc nong thon trong dieu kien kinh te kho khan. Mot ty le 16n ngUdi cao tudi v i n dang lam viec de dam bao cuoc sdng cho ban than, dac biet la ngUdi cao tudi cl khu vUc nong thon. Vi nhieu ly do, ngUdi cao tuoi con it t h a m gia vao cac hoat dong cong ddng, xa hoi. Nhin chung, ngUdi cao tudi mong muon dUdc sinh sdng cung con cai nhUng cung mudn co them cac dich vu nuoi du5ng va cham soc sflc khoe de dam bao cho cuoc sdng dUdc tot hdn... Tac gia cho rang can d a n h gia lai vai tro cua gia dinh va cac td chflc xa hoi trong viec cham soc va phat huy vai tro cua ngUdi cao tudi de co sU dieu chinh thfch hdp ve mat cd che va chfnh sach.
TU k h o a : NgUdi cao tudi; Cham soc ngUdi cao tudi; Gia dinh.
4 Nghien cUu Gia dinh vi GI6I. Quyg'n 21, so 5, tr. 3-17
Co Ihi noi, cham soc va phat huy vai tro la hai mSt ca ban khi noi vi chinh sach xa h6i d6'i vdi ngu&i cao tu6i. Dieu nay duac th^ hiSn xuy6n suO't nhu m6t quan didm chu dao trong Phap I6nh Ngudi cao tu6i (2000) va Luat Ngudi cao tu6i (2009). Cham soc ngudi cao tu6i vira la trach nhidm cua gia dinh, xa hdi, ihi hi6n su tdn trong, bao dap nhiJng cd'ng hi^n cua ngudi cao tudi trong sudt cudc ddi ho, vCra la tien d^ de ngudi cao tudi cd the phat huy nhirng kinh nghifim, nhung kha nang cdn lai ciia minh cho gia dinh, cdng ddng va xa hdi. Cham soc td't la de phat huy cao hon vai trd cua ngudi cao tu6i. Phat huy duac vai trd cua ngudi cao tudi, vira khdng lang phi mdt ngudn luc xa hdi quan trong, vira ddng gdp them nhutig tien de de' gia dinh va xa hdi cham sde trd lai ngudi cao tu6i td't hon.
Tren thuc tc, da cd nhirng cudc khao sat, danh gia viec thuc hien mdt sd chfnh sach ddi vdi ngudi cao tudi d quy md va muc do khac nhau. Ket qua cua nhiing dot khao sat danh gia ciia Hdi Ngudi cao tudi, cua Uy ban qud'c gia v^ ngudi cao tudi va cac ca quan khac da gdp ph^n dieu chinh, xay dung cac chinh sach lien quan d^n ngudi cao tu6i nudc ta, ching han trong viec xay dung cac Nghi djnh thuc hien Phap lenh Ngudi cao tudi trudc day va Nghi dinh 06 (nam 2011) cua Chi'nh phii hudng dan thuc hien Luat Ngudi cao tuoi. Tuy nhien, ddi vdi timg ITnh vuc cu the' thude pham vi cua cac Bd, nganh, cSn cd su dieu chinh kip thdi, phii hap vdi dieu kien kinh te' xa hdi mdi de dap ling td't han ca hai linh vuc cham sde \a phat huy vai trd ngudi cao tuoi. Ph^n viet dudi day khdng nham danh gia \iec thuc hien cac chinh sach xa hdi vdi ngudi cao tu6i ma chi neu len mot sd can cii thuc tien, nhiing nguyen vong cua ngudi cao tudi nhu mdt ca sd nen tang de xay dung cac chfnh sach hd trg, phat huy vai trd ngudi cao tuoi trong giai doan tdi.
1. Mot so dac diem cd ban va han che cua ngudi cao tuoi
Nhan bie't nhimg dac diem nhan kh^u hpc, nhimg han che'phd bien cua ngudi cao tuoi la mdt trong nhirng can cir thuc tien de' xay dung, dieu chinh chfnh sach ngay cang sat vdi ddi tuang hudng de'n.
Mot sd dac diem nhan kh^u hoc cua ngudi cao tu6i la nhu sau:
So' lugng ngudi cao tuoi tdng di ddi vdi su gia tdng ty le mat cdn bdng gidi tinh. Ty le ngudi cao tu6i (60 tudi trd len) trong tdng dan sd da tang tir 6,9% nam 1979 len 8% nam 1999 va 9% nam 2009 (Ban chi dao TDTDS&NOTU, 2010). Du bao den nam 2050 sd luong ngudi gia d Viet Nam tir 60 tuoi trd len se chiem 26% tdng dan sd (Nguyen Dinh Our, 2008). Do ty le ngudi gia tang len trong khi ty le tre em dudi 15 tudi giam
Le Ngpc Lfin 5
manh trong 10 nam qua nen "chi sd gia hoa" cua dan sd Viet Nam da tang 11 diem ph^n tram sau 10 nam (tir 24,5% nam 1999 len 35,9% nam 2009).
Sd luang ngudi cao tudi nii gidi ludn cao han so vdi nam gidi. Phan tfch cac nhdm tudi cua nhirng ngudi cao tudi tiong Di^u tra gia dinh Viet Nam 2006 cho tha'y, ngoai triic nhdm tudi 61-65, ty le ngudi cao tudi nam va nir bang nhau, ddi vdi cac nhdm tudi cao han, nii gidi chie'm ty le cao hem, 52,3% so vdi 47,7% d nhdm tudi 66-70, 54% so vdi 46% d nhdm tudi 71- 75, va 61,8% so vdi 38.2% d nhdm tudi 76 trd len. Cang d nhdm cao tudi han, ngudi cao tudi cd ty le sd'ng vdi vg chdng ft hem, tir 73,2% d nhdm 61-65 tudi giam xudng 61,2% d nhdm 66-70 tudi, 53,3% d nhdm 71-75 tudi va 34,8% d nhdm 76 tudi wb len (Le Nggc Lan va Tr^n Quy Long, 2009). So sanh sd lieu Tdng dieu tra dan sd va nha d nam 1999 va 2009, sd lugng chenh lech gifla nam va nii cao tudi nam 1999 la 1.089.957 ngudi, de'n nam 2009, miic chenh lech cdn cao han vdi 1.350.812 ngudi.
Dac biet, mii:c chenh lech ve gidi tfnh ngudi cao tudi cd xu hudng ngay cang gia tang d cac nhdm tudi cao, tir 80 trd len.
Mgt ty le ldn ngUdi cao tuoi vdn dang ldm viec de ddm bdo cudc sd'ng cho bdn thdn, ddc biet Id ngudi cao tudi dkhu vifc ndng thdn. Cdn mdt ty le kha cao ngudi cao tudi v&n cdn lam viec dudi nhieu hinh thiic khac nhau. Xet theo khu vuc, ngudi cao tudi sd'ng d khu vuc ndng thdn chie'm ty le cao trong sd ngudi cao tudi cdn lam viec. Ty le phu nir cao tudi lam viec thap han so vdi nam gidi cao tudi. Ty le lam viec cua ngudi cao tudi dang sd'ng vdi vg/chdng hoac ngudi cao tudi khdng ket hdn cao hom ngudi cao tudi goa. Ngudi cao tudi trong cac hd gia dinh ma hg lam chu hd hoac hd gia dinh chi cd ngudi cao tudi cd ty le lam viec cao hom ngudi cao tudi trong cac nhdm hd gia dinh khac. Trong hd gia dinh ma ngudi cao tudi sdng phu thude, khoang 20% ngudi cao tudi dang lam viec. Xet theo nhdm tudi, ty le ngudi cao tudi trong nhdm tiir 60-64 tudi vin cdn lam viec chie'm khoang 60%. 6 nhiing nhdm tudi cao hem, ty le nay tha'p hem. Nhin chung, nhiing ngudi cao tudi sd'ng d thanh thi, ngudi goa, phu nii, nhiing ngudi tren 70 tudi va nhiing ngudi sd'ng phu thude cd ty le lam viec tha'p hom cac nhdm khac (Giang Thanh Long va Wade donald Pfau, 2007). Theo sd lieu Tdng dieu tra dan sd va nha d nam 2009, ty le ngudi tir 60 tudi trd len tham gia luc lugng lao ddng chie'm khoang tii 30-40%, trong dd nam gidi cao tudi tham gia vao thi trudng lao ddng nhieu hem nQ gidi. Ngudi 60 tudi trd len d ndng thdn chie'm ty trgng ldn hom trong luc lugng lao ddng so vdi ngudi d khu vuc thanh thi.
Mdt sd han che' thudng tha'y d nhdm ngudi cao tudi la:
6 Nghien cUu Gia dinli vi Gidi. Quyen 21, so 5, tr. 3-17
Bang 1. Tinh trang henh tM cua ngudi cao tudi theo ddc diem nhdn khdu hoc (%)
Chung Gidi tinh**
Nam NO Dp tudi*
60-65 tu6i 66-70 tu6i 71-75 tudi tren 75 tudi
Khong CO l)6nh 35.0 44,0 28,6 39,6 36,8 40,0 25,6
C6 1 b^nh 27.3 28.8 26.3 22,0 22,1 25,5 38,4
Co 2 benh 21.0
15.2 25,1 24,2 29,4 16,4 14,0
Tren 2 benh 16.7 12,0 20,0 14,3 11,8 18,2 22,1 Ngu6n: Sd lieu dieu tra ngudi cao tudi tai th^nh phd Hd Chf Minh, 2010 Ngifdi cao tudi cd ty le sifc khde yeu vd ty le mdc benh cao. Dieu tra cua Uy ban qudc gia ve ngudi cao tudi Viet Nam tai 7 tinh tren ca nudc (2007) cho tha'y ty le ngudi cd tinh trang siic khde td't chiem khoang 5,3%;
ngudi cd siic khde yeu chiem 42% va ngudi cd sire khde trung binh chie'm 52,7%. O nhdm tudi cang cao, siic khde cang giam siit rd ret. Nghien ciiu cung ddng thdi chi ra rang tinh trang siic khde cCia ngudi cao tudi cd su khac biet giira nam va nii. Ty le cac cu dng cd sire khde tdt la 7,5%, cao ga'p hai \in so vdi cu ba trong khi ty le ngudi cd sire khde yeu d cu ba la 46,5%, cao hom 10,9% so vdi nhdm cu dng. Trong tdng sd 2.878 ngudi cao tudi dugc khao sat tai 7 tinh, cd den ba phin tu sd cu mic ft nha't mdt benh, trong dd cd 14,1% ngudi mic tir hai benh trd len. Cac cu ba cd xu hudng mic nhieu benh han eac cu dng nhung sd benh tat mic phai d mdi ngudi dudng nhu khdng phu thude vao do tudi (Uy ban qud'c gia ve ngudi eao tudi Viet Nam, 2007).
Phan tfch sau v^ tinh trang benh tat d ngudi eao tudi trong ke't qua dieu tra tai thanh phd Hd Chf Minh (2010) cung cho tha'y ty le ngudi cao tudi mic ft nha't mdt benh chiem ty le kha cao. Cd 65% ngudi cao tudi dugc khao sat mic ft nhi't mdt benh va cd 16,7% ngudi mic tren 2 benh.
Cd 22,1% ngudi d dd tudi tren 75 mic 3 benh va ty le nay giam din theo do tudi, de'n nhdm tudi 60-65, ty le nay giam xudng cdn 14,3%. Nhu vay, ddi vdi cac nhdm tudi cao hom, viec cham sde siic khde cho ngudi cao
Le Ngoc Lan 7
tudi can phai dugc quan tam hem.
Trinh dp hpc van ciia ngu'di cao tudi thd'p vd khdng ddng diu giiia nam va nii, giiia cac viing mi^n, sd cd trinh dd hge va'n, chuyen mdn cao ft.
Chang han, ke't qua Tdng dieu tra dan sd va nha d 2009 eho tha'y: cd 15,8%
dan sd ngudi eao tudi chua tiing di hge (nam 6,4% va nO 22,3%); 51,9%
mdi dat bac tieu hge (nam 43,1% va nii 58,0%); 19,2% hge he't trung hge ca sd (nam 27,8% va nii 13,2%); 9,3% tdt nghiep trung hge phd thdng (nam 15,4% va nii 4,9%) va 4% dat trinh do cao ding trd len (nam 7,4%
va nii 1,5%). Ty le cd hge vin cao giam din theo nhdm tudi.
Ke't qua khao sat ve ngudi cao tudi tai TP Hd Chf Minh (2010) cung cho nhiing ket qua tuang tu va hiu he't ngudi cao tudi khdng cd trinh dd chuyen mdn hoac khdng dugc dao tao chuyen mdn (83,6%). Chi cd mdt sd ft ngudi cao tudi cd trinh dd sa cip (4,0%). trung cip (3,7%), cdng nhan ky thuat (4,4%). cao ding hoac dai hge (4,0%) va tren dai hge (0,3%).
O Viet Nam, da sd'ngudi cao tuoi sd'ng d ndng thon vd trong dieu kien kinh te'khd khdn. Ke't qua Di^u tra gia dinh Viet Nam 2006 cho tha'y ngudi eao tudi chii ye'u sd'ng phu thupc kinh te'vho con chau. Nhieu ngudi cao tudi vin tiep tue lam viec sau khi nghi huu hoac d do tudi nghi huu do nhiing khd khan ve kinh te'. Tuy nhien do siic khoe ye'u va do nhiing han che' ve trinh do, chuyen mdn, tudi tac, hg rat khd tim dugc cdng viee sau khi nghi huu hoac d do tudi cao (Bd Van hda. The thao va Du lich va cac ca quan khae, 2008).
Vi nhieu ly do, nhieu ngudi cao tudi cdn it tham gia vdo cdc hogt ddng cpng ddng, xd hpi. Ngudi cao tudi edn it hieu bie't vi chinh sdch, ngay ca nhiing chfnh sach lien quan de'n quyen led cua hg. Ket qua khao sat tai TP.
Hd Chl Minh cho thiy cd 37% ngudi eao tudi khdng bie't chfnh sach nao lien quan den hoac danh cho ngudi eao tudi. Ty le ngudi biet nhilu ve cac ehinh sach cua Nha nudc ddi vdi ngudi eao tudi tang din theo trinh do hge vin eua ngudi cao tudi. Dieu nay dac biet ed y nghia vi ngudi cao tudi cd trinh do hge vin cao thi nhan thiic cua hg ve cac quyen lgi va tiep can vdi cac dich vu, hd trg cua Nha nude nham nang cao chit lugng cudc sd'ng cua hg cang cao.
Ve tdm ly, ngudi eao tudi phuang Ddng cung nhu d Viet Nam eoi viee phu thupc vdo con cdi Id mdt mong mudn mang tinh dgo ly va tham ehi hg cdn mong mudn dugc phu thude vao con cai hom la he thdng phiic lgi eua Nha nudc. Dieu nay the hien qua mdt ty le ldn ngudi cao tudi hien nay vin mudn sdng chung vdi con chau "de nuomg tua va giup dd lin nhau". Trong
8 Nghien cijfu Gia dinh vi Gi6i. Quyen 21, so 5, tr. 3-17
khi dd, ngudi cham sde (con cai) thudng gap phai vin di khd xir/miu thuin khi mdt mit hg dang gap nhiing khd khan, thie'u cac didu kien de cham sde; mat khac hg bi rang budc bdi nghia vu budc phai cham soc.
Ngudi cao tudi thudng dugc coi la nhiing ngudi khd tfnh, hay cau bin, tfnh each hay thay ddi. Trong sinh hoat hang ngiy, ngudi cao tudi cQng cd nhiing die'm khac biet vdi cac the' he con, chau ma n^u con, chau khdng hidu va thdng cam thi rit de xay ra xung ddt. Vdi ldp ngudi gia, suy nghT ciia hg cd the' d linh trang lin ldn, khdng rd rang, de tdn thuang...
2. Mot so nhu ciu, nguyen vpng cd ban cua ngirdi cao tuoi Viet Nam
•Ben canh vice hidu dugc dac didm va han che' ciia ngudi cao tudi thi viec can eii vao nhu ciu nguyen vgng cua ngudi cao tudi di diiu chinh va xay dung chfnh sach cho ngudi cao tudi la he't sure cin thie't. Chfnh sach se de dang di vao thuc te ne'u dap img dugc nguyen vgng ciia ddng dao ddi tugng hudng lgi tir chfnh sach. Mdt sd nguyen vgng lien quan de'n nai sinh sdng, eae hd trg eua Nha nude dugc nhieu ngudi cao tudi neu ra la:
Nguyen vpng vi nai sinh sd'ng
Hien nay, phin ldn ngudi eao tudi dang sd'ng ehung ciing ngudi thin.
Ket qua dieu tra 399 ngudi cao tudi tai Bic Bd cho thi'y, ed 53,4% ngudi eao tudi dang sdng ehung, an chung vdi con chau, 27.3<T: ngudi cao tudi sd'ng rieng hai dng ba va 14% sd'ng rieng mdt minh, 5% sd'ng chung vdi con nhung an rieng (Sd lieu Dieu tra ngudi cao tudi d Bic Bd, 2008). Tuy md hinh dich vu nha dudng lao da xuit hien song chua thuc su phat trie'n.
Ddi vdi dich vu nha dudng lao tu nhan, phin ldn ngudi cao tudi sinh sd'ng tai day deu phai ed dieu kien kinh te' vi chi phf mdt thing tai nai nay thip nha't eurtg khoang tir 2-3 trieu ddng. Ca sd bao trg xa hdi thudng chi danh cho cae ddi tugng chfnh sach, bao gdm nhiing ngudi cao tudi cd dan, khdng nai nuomg tua.
Da cd nhieu y kie'n ban luin ve viec ngudi cao tudi nen sd'ng d nha dudng lao hay sdng tai gia dinh se td't hom. Ve mit chfnh sach, Nha nudc ehii truang liy gia dinh la trung tim chim sde, nudi dudng ngudi cao tudi.
Ddng thdi, Nhi nudc cung khuye'n khfch xiy dung cac ca sd cdng lip va tu nhin cham sde nudi dudng ngudi cao tudi. Muc 3 Dilu 20 Luit Ngudi cao tudi quy djnh "Nha nudc khuye'n khfch, td chiic, ca nhin diu tu xiy dung ca sd chim sde ngudi cao tudi; diu tu ca sd vat cha't va hd trg kinh phf hoat ddng cho ca sd chim soc ngudi cao tudi cdng lip; hd trg kinh phi cho ca sd cham sde ngudi cao tudi ngoai cdng lap nudi dudng ngudi cao tudi quy dinh tai khoan 2 Dilu 18 cua Luit nay". Ca sd cham soc ngudi
Le Ngpc Lan 9
cao tudi tai khoan 2 Dieu 18 gdm: Ca sd bao trg xa hdi; Ca sd tu vin, dich vu cham sde ngudi cao tudi; Co sd cham sde ngudi cao tudi khac. Nghi dinh 06/2011 cua Chfnh phu cung khuye'n khfch cac thanh phin xa hdi tham gia linh vuc nay va tren thuc te', mdt sd gia dinh vdi cae ly do, hoan canh khac nhau ciing ed nhu ciu siur dung loai dich vu xa hdi dd.
Vay thuc te', nguyen vgng vd nai sinh sd'ng cua ngudi cao tudi cung nhu nguyen vgng cua ngudi cao tudi vl viec phat tridn cac trung tam nudi dudng, cham sde ngudi cao tudi la nhu the nao? Khi dugc hdi ve viec ngudi cao tuoi nen sd'ng rieng hay sd'ng chung vdi con cdi dd lap gia dinh, ke't qua Dilu tra gia dinh Viet Nam 2006 cho thiy y kiln kha da dang. Ty le ngudi cao tudi cho ring nen sd'ng chung la 51,5% va nen sd'ng rieng la 46,5%; ty le cdn lai cho ring khd Ua ldi hoac khdng bilt. 6 dd tudi cang cao, y kie'n cho ring nen sd'ng chung cang thd hien rd rang hem. Mong mudn sd'ng chung thd hien rd hom d ngudi cao tudi d ndng thdn va d ngudi cao tudi nii. Mong mudn nay dac biet rd d cac nhdm cd thu nhap thip hem.
Ngudi cao tudi mudn sd'ng chung chii ye'u vi mudn dugc con chau giiip dd, vi coi dd la each duy tri dao ly gia dinh, cung nhu vi su vui viy ben eon chau. Ddi vdi nhiing ngudi mudn sd'ng rieng, ngudi cao tudi d thanh phd nha'n manh hem den su tu do thoai mai ciia ca hai ben. Trong khi dd, ngudi cao tudi d ndng thdn lai nhan manh hom den su ddc lap vl kinh te (Bd Van hda. The thao va Du lich va cac ca quan khae, 2008).
Khao sat tai TP. Hd Chi Minh cung cho ke't qua tuong tu. Khi dugc hdi vl nhiing ky vgng vao con eai, chi cd 13,7% sd y kie'n tra ldi "khdng ky vgng gi ca" cdn phin ldn la "ky vgng con cai hd trg ca vl vat chit va tinh thin" (59,2%); con eai cham sde khi dm dau (13,4%). 6% ky vgng con cai la chd dua vl tinh thin liic tudi gia va chi cd 2,3% chi ky vgng vao su hd trg ve vat chit eua con cai.
Theo sd lieu Dilu tra ngudi eao tudi tai Bic Bd (2008), cd 57,1% ngudi cao tudi bie't vl trung tam hay dich vu nudi dudng chim sde ngudi eao tudi.
Cd 69,4% ngudi cao tudi cho ring cac trung tam dich vu nudi dudng cham sde siic khde ngudi cao tudi rit cin thie't cho ngudi cao tudi; 24,8% danh gia d miic cin thiet. 94,7% ngudi cao tudi cho rang nen khuyin khich phat trien cac dich vu nay cho ngudi cao tudi. Sd lieu Dilu tra ngudi cao tudi tai TP. Hd Chl Minh cho thi'y cd 72,7% ngudi cao tuoi cho rdng Nhd nudc nen khuyen khich phdt trien cdc trung tdm nudi duang, chdm sde sAc khde ngudi cao tudi Nam gidi cd xu hudng ddng tinh vdi vin dl nay cao hom nii gidi (79% so vdi 67,4%). Ngudi cd trinh do hge vin cao ddng tinh nhilu hon: 58,1%; 70,9%; 80,4%; 84,8% - tuang ling vdi trinh dd hge vin tieu
10 Nghien cUu Gia dinh vi Gidi. Quyd^n 21, so 5, tr. 3-17
hge, trung hge ca sd, trung hge phd thdng va cao ding/dai hge.
Nhin chung, mong mudn dugc sinh sd'ng ciing con eai la nguyin vgng cua so ddng ngudi cao tudi, dac biet la ngudi cao tudi d nhdm tudi cao.
Tuy nhien, hg cung mong mudn cd thim cac dich vu nudi dudng va cham sde sure khde dd dam bao eho cudc sd'ng cua ngudi cao tudi dugc td't han.
Viec da dang hda cac loai hinh djch vu cham sde dd ngudi cao tudi, cac gia dinh lua chgn la cin thilt va dap ling dugc cac nhu ciu xa hdi.
Mong mucin ndng cao ddi sd'ng vdt chdt vd linh thdn
Tim hidu vl mong mudn cua ngudi cao tudi. kit qua Dilu tra gia dinh Vict Nam (2006) cho thiy da sd ngudi cao tudi mong mudn Nha nudc cd
Bang 2. Miirc do tham gia cac hoat dong/huomg thu vdn hoa, giai tri ciia nguiA cao tudi
Hoat dong Docs^ch/
bao Xem tivi/
nghe dai Sang hang xom chcfi Di tham ho hang/ban be/ddng nghiep cQ Dixem phim/ca nhac...
Di du lich/
nghi m^t Tham gia IB h6i/ di chua/
nhath6 Tap thd due, th^thao Sinh hoat cSu lacbd
Hang ngky Toan qudc 15,8 72,5 25,0 1,8
0,2
1.8
35,8 3,2
Tp.
HCM 27,3 86,6 27,5 10,5
1,7
Vai l^n/tudn To&n qudc 8,2 13,4 32,3 6,4
0,4
0.4 4.0
3,7 1,3
Tp.
HCM 11,4
7,0 29,9 10,1
0.7
Vai lin/th^g Vai thing/I^ Khong Toan
qudc 7.0 3,1 18.6 20.4
0,5
0.1 15.3
1,3 8,2
Tp.
HCM 152
1.7 20,8 21.6
0,4 92
T o ^ qudc 6.3 2.1 13.1 46.4
7.9
11.4 29,3
1,0 28,5
Tp.
HCM 6.9 0.7 11,7 33.1
6,3
37.0 47,8
Tosin qudc 62.8 9.0 11,0
25
91,0
88,1 55,3
58,2 58,8
lin nao Tp.
HCM 39,1
4.0 10,1 24,7
93,7
62,6 40,6
Ngudn: Sd lieu Didu tra gia dinh Viet Nam 2006 \h. sd lieu Didu tra ngudi cao tudi tai TP. Hd Chf Minh 2010
Le Ngoc Lan 11 ehinh sach bao dam cudc sd'ng eho ngudi cao tudi (65%) va mong cd nhilu loai hinh dich vu cham soc siic khde (58,3%). Ty 11 ngudi cao tudi mong mudn dia phuang cd nhilu hinh thiic sinh hoat van hda/tinh thin la 39,1%. Sd lieu thu dugc cho thiy hoat ddng van hda, giai trf chii ylu hang ngay cua da sd ngudi cao tudi la xem tivi. Cd 72,5% ngudi cao tudi xem tivi/ nghe dai hang ngay (Bd Van hda, Thd thao va Du lich va cac ca quan khac 2008). Ty le nay qua kit qua khao sat d TR Hd Chf Minh la 86,6%.
Ty le ngudi cao tudi tham gia cac hoat ddng van hda, giai trf xem phim/ca nhac/du lich rit ft (chi khoang 10%- 20%).
Dilu tra ciia Uy ban qud'c gia vl ngudi cao tudi (2007) cQng cho thiy ddi vdi ngudi cao tudi, viec cham sde sii'c khde la ylu td dugc quan tam hang diu. Nhilu ngudi mong mudn dugc cip the bao hidm y t l tii 70, 80 tudi. 22,2% mong duge tham kham siic khde dinh ky; tang miie trg cip va giam tudi dugc hudng tig cip hang thing (32,3%) - dilu nay da dugc dap ling khi Luat Ngudi cao tudi (2009) cd hieu luc. Ngoai ra, cac nhu ciu ca nhan nhu mong ludn manh khde, con chau hiiu thao, thudng xuyen dugc tham hdi... duge nhung ngudi cao tudi quan tam (Uy ban qud'c gia vl ngudi cao tudi Viet Nam, 2007).
Rd rang la, trong bdi canh ngudi cao tuoi vdn dang gap phdi nhimg khd khdn vi kinh te trong viec ddm bdo cudc sd'ng sinh hogt cua bdn thdn cung nhu viec chdm sde sde khde, nhu cdu hudng thu vdn hda, tinh thdn se it ducyc quan tdm han so vdi nhdng nhu cdu tra giiip kinh tevd chdm soc sifc khde.
Bang 3. Mong muon ciia ngu6i cao tudi ve chfnh sach - chia theo gidi tinh (%)
Mong mudn cua ngudi cao tudi Nam Niir Chung Dia phuoiig md rCng them nhidu hoat ddng van hoa 35,4 41,1 38,6 tinh Xhin
xay dung them cac khu vui choi giai tri c6ng c6ng Tro cSfp cho ngudi cao tudi trong gia dinh ngheo Cho ngudi cao tudi vay vdn dd san xua^t kinh doanh Md them cac dich vu cham sde siic khoe ngudi cao tudi Md rdng dien hd trO bao hidm y td cho ngudi cao tudi Giao due ldp tre quan tam va cd trach nhiem cham soc ngudi eao tudi
Ngudn: Didu tra ngudi cao tudi tai TP. Hd Chf Minh, 2010 39,4 52,5 4,0 53,5 39,4 7,1
33,9 62,9 3,2 52,4 37,9 8,9
36,3 58,3 3.6 52,9 38,6 8,1
1 2 Nghien ciiru Gia dinh v^ Gidi. Quyen 21, so 5, tr. 3-17
Bang 4. Mong mudn ci nhdn cija ngudi cao tudi
Mong mudn/ Nhdm tuoi Ductc con c^i l<i'nh trong
Con cai quan tflm nu6i dudng tdt hern Khdng phai lao dOng vfl't va kidm sdng Co ti6n/didu kifin chfla bfinh
Mong dudc khoe manh Mong mudn khdc
60-65 27.3
8,0 13,6 19,3 89,8 9,1
66-70 35,8
6,0 13,4 13,4 89,6 11,9
71-75 35,8
17,0 15,1 17,0 88,7 5,7
76 + 30,6 14,1 9,4 17,6 90,6 3,5
l o n g 31,7 10,9 12,6 17,1 89,8 7,5
Ngudn: Didu tra ngirdi cao tudi tai TP Hd Chf Minh, 2010
Vdi eac nguyen vgng, mong mudn ca nhan, kl't qua Dilu tra gia dinh Viet Nam 2006 cho thiy cd khoang 30% ngudi cao tudi khi dugc hdi mong mudn dugc con cai kinh trgng, cham soc nudi dudng td't han. Dilu nay mdt mat phan anh cdn mdt ty le cac gia dinh ma con cai "chua cham sde nudi dudng td't cha me" nhung cung phan anh mdt thai do, mdt nhu ciu "dugc cham sde, nudi dudng td't hem hien tai". Nhiing ngudi cao tudi dTP. Hd Chf Minh chu yeu cung "mong dugc khde manh" (89,8%); mong dugc con chau kfnh trgng (31,7%); mong cd tiln, cd dilu kien chiia benh (17,1%) va mong khdng phai vit va kiem sd'ng (12,6%); mong con cai quan tam nudi dudng td't hem (10,9%).
Theo Uy ban qud'c gia vl ngudi cao tudi (2007), ngoai nguyen vgng ve cham sde sire khde va nang cao ddi sd'ng van hda/tinh thin va nguyen vgng ca nhan, mdt sd nguyen vgng khae cung dugc ngudi cao tudi quan tim.
Dd cd the la viec nen td chirc dinh ky gap mat dd trao ddi kinh nghilm giiia ngudi cao tudi vdi nhau vc each lam an, day dd con chau (8,8%); la tang cudng sinh hoat hdi de trao ddi y kiln (15,1%); la khdi phuc cac nghi truyin thdng dd ngudi cao tudi tham gia (10,4%) va cho vay vdn lai suit thip dd tao viec lam (7,7%). Tai TP Hd Chf Minh (2010), loai de nghi duge nhilu ngudi cao tudi quan tim nhi't la "thuc hiin td't Phap lenh va Luit Ngudi cao tudi (57,8%); tao dilu kiln dd Hdi Ngudi cao tudi phat huy vai trd (47,6%); cd chi'dd dai ngd hgp ly cho ngudi cao tudi tham gia cdng tie (40,6%); ed ehinh saeh thu hiit, van ddng ngudi cao tudi tham gia cdng tie xa hdi.
Le Ng9c Lan 1 3 3. Mot SO Cd sd thiTc tiln kliac
Qud trinh gid hda ddn sd'tien den ddn sd'gid thudng keo theo cdc hieu img xd hpi. Din sd gia hda la xu hudng biln ddng din sd phd biln d cac nudc phit tridn cd td'c dd tang trudng kinh te' cao. Gia hda dan sd cd lien he mat thie't vdi cac vin dl kinh tlva xa hdi. Mdt mit nd danh diu nhiing thanh qua cua su phat trien, bao gdm ca khoa hge, cdng nghi; mat khac nd ciing dat ra nhilu thaeh thire vl chfnh sach. Viet Nam dang bude vao thdi ky gia hda dan sd, vdi tren 9% ngudi cao tudi. Nhip dd tang dan sd cao tudi nhanh hom cac nhdm dan sd khac va tuy tudi thg trung binh d nudc ta ngay cang nang cao, nhung tudi thg khde manh vin d miic thip 66 nam; sd nam dm dau trung binh len tdi 7,3 nam (xem them Giang Thanh Long, 2010).
Tmh hinh nay ciing din din nhiing he qua xa hdi khic, nlu khdng quan tam giai quyet kip thdi, chi phf xa hdi se ngay cang nang nl hom, tham chi cd nguy ca "khung hoang nhan dao" Dd la:
Su bie'n ddi ea ciu hd khien sd hd gia dinh chi cd ngudi cao tudi tang ien theo thdi gian. Hd cao tudi va ngudi cao tudi tang cao din den md hinh va nguyen nhan benh tit thay ddi: Theo tinh toin cua cic nha chuyen mdn, chi phi trung binh cham sde ngudi cao tudi cao hem 7-8 lin ehi phi trung binh cham sde tre em. Xuat hien tinh trang "cham sde tre em mdi". Nhung thuc te', kha nang tie'p can cac dich vu y te' lai khic nhau trong cac nhdm dan so cao tudi, ganh ning thudng tnit len nhdm cao tudi ngheo hem.
Vdi thuc trang ddi sd'ng kinh t l cua ngudi cao tudi nhu hien nay, tinh trang "gia trudc khi giau" trd nen phd biln ciing la mdt thaeh thiic. Nhdm cang cao tudi, cang cd ty le ngheo cao hem. Cac chuomg trinh trg cip xa hdi tuy ngay cang md rdng, nhung kha nang tiep can eiia nhdm dan sd eao tudi (nha't la d khu vuc ndng thdn, miln niii, nhdm cao tudi nii) cdn thip.
Tmh trang nghi huu sdm cdng vdi tang tudi thg, se keo theo ginh nang cho ngudn quy bao hiem xa hdi, y tl.
Ddi sd'ng van hda tinh thin cho ngudi cao tudi cdn ngheo nan; su suy giam vai trd/quyin luc va su phu thude vao su trg giiip ciia gia dinh tang theo chilu tang ciia dd tudi. Ne'u khdng dugc ddi xir diing muc, ngudi cao tudi dl rai vao trang thai met mdi, khung hoang din tdi "mdt bd phan xa hdi" mdi met. Dd thuc su la nhiing he luy cd the cd nlu khdng ed su chuin bi, dap ling bang cac chinh sach xa hdi.
Tren thuc tiin, cdc gia dinh dang gap nhiiu khd khdn trong cham sdc.
14 Nghien curu Gia dinh vi Gidi. Quyg^n 21, so 5, tr. 3-17
nudi dudng ngudi cao tudi. Vc luat va chfnh sach, chiing ta cho ring gia dinh la nai cham sdc chinh ngudi cao tudi cdn cac hinh thiic khac la hd trg. 1'uy vay, ciing vdi qua trinh cdng nghiep hda va dd thi hda, xu the'giam din cac chiic nang ciia gia dinh la khd tranh, do dd, xa hdi cin chuin bi td't cho lie thdng an sinh xa hdi, cd tfnh den su tham gia ciia cac chu thd kiiac nhau vao vice cung ci'p dich vu hoac hd trg cham sdc ngudi cao tudi ciing nhu iiidi lien he cac tac ddng qua lai ciia cac chii thd nay.
Ket qua cudc tiicu tra ngudi cao tudi khu vuc ddng bing Bic Bd (2008) cho thiy chi'nh sach liy gia dinh lam trung tim trong viec cham sde, phung dudng ngudi cao tudi nhin dugc su ung hd cao cua ngudi cao tudi. Khdng cd .su khac hict nhilu giii'a cac nhdm tudi, gidi tfnh, khu vuc sinh sd'ng va trinh do hge v;in cua ngudi cao tudi. Tra Idi cau hdi "gia dinh cd trach nhiem nhu thi nao trong viec cham sde, phung dudng ngudi cao tudi", 85,0% ngudi cao tudi cho ring gia dinh chju trach nhiem ehii ye'u trong viec phung dudng, cham sdc ngudi cao tudi (ty le nay d TP. Hd Chi Minh la 87%); 13,8% cho ring gia dinh chi chiu trach nhiem mdt phin (9% dTP Hd Chi Minh) va 1,3% eho ring gia dinh khdng phai ehiu trach nhilm chii ylu trong viec cham sdc, phung dudng ngudi cao tudi 4% d TP. Hd Chf Minh khang dinh nha nude/xa hdi nen la ngudi cham sdc chfnh (So lieu Dilu tra ngudi cao tudi tai ddng bing Bic Bd, 2008; TP HCM, 2010).
Mac dii da sd ngudi cao tudi mong mudn gia dinh chiu U-ach nhilm ehfnh trong viec phung dudng hg song tren thuc te. gia dinh dang gap nhilu khd khan trong viec thuc hien cdng viec nay. Hien cd de'n tren 70%
sd gia dinh cho ring hg dang gap khd khan, nhit la \ l kinh te' hoac thdi gian cham sde. Viec con cai khdng cd thdi gian cham sdc cha me mdt mat phan inh nhirng khd khan tren con dudng muu sinh, ngoai viec cd thd hg ban biu trong viec cham sdc gia dinh nhd ciia minh. Nhiing gia dinh cd ngudi cao tudi d khu vuc ndng thdn gip khd khin cao hom d dd thj. Mit khac, viec Nha nudc tap trung vao viec phat huy cac gia tri ciia gia dinh vao viee phung dudng, cham sdc ngudi cao tudi va rang budc trach nhiem cua gia dinh bing luat phap din din tinh trang Nha nudc chim cd chinh sach ddi phd kip thdi khi gia dinh giam siit vai trd truyin thdng va khi ty 11 ngudi cao tudi trong dan sd ting len nhanh chdng do tie ddng ciia bien ddi kinh te' xa hdi. Dilu dd din din khoang u-dng trong cac ke hoach xiy dung cac nha cham sdc ngudi cao tudi tai cdng ddng, phat trien cac dich vu y tl, dich vu cham sdc sire khoe ngudi cao tudi, phat huy nhiing mat tfch cue cua ngudi eao tudi.
Thuc te' cdn cho thiy, gia dinh trong qua trinh cdng nghiep hda, dd thi
L§ Ngoc Lan 1 5
Bang 5. Ty le phu thuoc (%) ciia Viet Nam qua cac nam 1979,1989, 1999 va 2008
Ty le phu thude tre em (0-14) Ty le phu thude ngudi gia (60+) Ty le phu thude ehung
1979 84.5 14.0 98.5
1989 73.0 13.3 86.3
1999 56,3 13.7 69.9
2008 38.4 15,2 53.7 Ngudn: Tdng didu tra dan sd Viet Nam 1979, 1989. 1999; Didu tra bidn
ddng dan sd va kd hoach hda gia dinh 2008
hda dang cd nhiing biln ddi manh me ve ciu triic, qui md va cic mdi quan he trong gia dinh. Kit qua khao sat miic sd'ng hd gia dinh 2008 cho bilt nhin khau binh quin mdt hd chung ca nudc nam 2008 la 4,12 ngudi, giam din qua cac ky dilu tra (nam 2002 la 4,44 ngudi, nam 2004 la 4,36 ngudi va nam 2006 la 4,24 ngudi). Xu hudng nay diln ra ddi vdi ca khu vvtc thanh thi va ndng thdn, cac vimg va cac nhdm thu nhap. Nguyen nhan cua su thu nhd qui md gia dinh la ty le phu thude tre em (0-14 tudi) trong gia dinh cd xu hudng ngay cang giam.
Su thu hep quy md gia dinh vdi su suy giam dang ke ty le phu thude tre em mdt mat giam ganh nang tai chinh cho gia dinh song nd lai dat vin dl cham sdc ngudi gia trudc mdt nguy ca mdi. Dd la su thie'u hut luc lugng cham sdc ngudi gia trong gia dinh, dac biet khi sd lugng ngudi cao tudi cd xu hudng tang. Su giam sd con trong gia dinh se lam giam ngudn hd trg eua cha me khi tudi gia, ddng thdi lam tang nghia vu ciia eon eai trong viec cham sdc cha me, dac biet vl mat kinh tl. Bdi it con, ca hdi de nhiing ngudi con nay san se trach nhiem phung dudng cha me gia se ft hom.
Qua trinh cdng nghiep hda, dd thj hda cung gdp phin day manh ludng di cu ndi chung, di cu ndng thdn - dd thj ndi rieng. Qui trinh di cu vdi cac hinh thiic da dang cd anh hudng manh me din quan he con cai vdi cha me gia, dac biet la viec phung dudng cha me gia. Trudc hit, xu hudng con cai trudng thanh rdi gia dinh di lap nghiep d eac thanh phd ldn khiln khdng it ngudi cao tudi phai sd'ng trong canh khdng ed su cham sdc hang ngay cua con eai mac du cd the hg vin thudng xuyen nhan dugc su trg giiip vl kinh te ciia con cai. Ket qua dilu tra 399 hd ngudi cao tudi tai Bac Bd cho tha'y cd 27,3% ngudi cao tudi sdng rieng hai dng ba va 14% sd'ng rieng mdt minh. Ben eanh dd, ty le nQ gidi trong do tudi lao ddng tham gia vao
16 Nghidn ciiru Gia dinh v^ Gidi. Quydn 21, so 5, tr. 3-17
ludng di cu ngay cang cao. Sir gia tang ca hdi cd ngudn thu nhap da thu hut lao ddng nu din lam viec d cac thinh phd ldn va ea d nhirng qud'c gia khiic. Dilu tra di cu Viet Nam 2004 cho tha'y phin ldn nir gidi di cu trong dd tudi 20-34 (66,3%). Thdng thudng, nhiing phu nu da ke't hdn trong dd tudi lao ddng dugc ky vgng cdng viec chim sdc cac thanh vien gia dinh ndi chung, trong dd cd cham sdc ngudi cao tudi. Viec di cu dd tham gia vao thj trudng lao ddng da lam giam kha nang cham sdc ngudi gia eua nhung ngudi phu nii nay.
Danh gia viec thuc hien Chuomg trinh hanh ddng qud'c gia vl ngudi cao tudi giai doan 2005-2010 cho thiy:
Chi tilu 1: phi'n diu 95% ngudi cao tudi duac cdi thien ddi sd'ng vdt chdt vd tinh than. Tuy he thdng ehfnh sach an sinh xa hdi da dugc cai thien, tinh hinh kinh le - xa hdi ciia dit nudc cd nhilu biln chuydn, nhung muc tieu nay vin chua dat. Kit qua khao sat 2007 cho thiy chi ed 57% hd gia dinh ngudi cao tudi sd'ng mirc trung binh trd len. Chi tieu 2: 100%
ngudi cao tudi duac khdm chifa benh vd duac hudng chdm sdc ciia gia dinh, cdng ddng... Ke't qua khao sat cho thiy da cd 93,9% ngudi dugc kham chiia benh va hudng cham sdc cua gia dinh. Chi tieu 3: 100% ngudi cao tudi cd dan khdng cd ngudn thu duac hudng tra cdp xd hpi, duac khdm chda benh mien phi. Hiu hit nhumg ngudi cao tudi thude diln nay da dugc hudng trg cip, duge khim ehiia benh miln phi. Tren thuc te', miic trg cip nhu hien nay cdn thi'p so vdi nhu ciu cudc sd'ng tdi thidu cCia ngudi cao tudi... Chi tieu 4: trg cip xa hdi cho 100% ngudi cao tudi td 90 tudi trd len khdng cd luang huu vd tra cap xd hdi khdc vl ca ban da dat dugc. Tuy nhien, vl do tudi va miic trg cip thi vin cdn nhilu y kiln (den thdi diem nay da giam khoang 2 tudi so vdi Phap lenh Ngudi cao tudi 2000). Riing chi tieu 5 (100% ngudi khdng phdi sd'ng trong nhd tam) va chi tieu 6 {80%
cdc xdlphudng cd Quy chdm sdc ngudi cao tuoi vd hogt ddng co hiiu qud) la chua dat dugc d miic cao. Theo kit qua khao sat nay, nim 2007 vin cdn
18% ngudi cao tudi dang phai d trong nhiing cin nha tam (Uy ban qud'c gia vl Ngudi cao tudi, 2007).
Theo danh gia eua Bd Lao ddng, Thuong binh va Xa hdi, diln ddi tugng dugc hudng trg ci'p xa hdi trong ca nudc cdn thi'p, sd ddi tugng dugc trg giiip xa hdi thudng xuyen hiin chi chie'm khoang 1,23% din sd' - la miie rit thi'p so vdi nhilu nudc trong khu vuc (khoang 2,5-3%). Miic chuin di tfnh mirc trg cip cdn thip, chi bang 32,5% so vdi chuan ngheo va ehua bao dam dugc mire sd'ng td'i thidu cua mdt sd' lugng ldn ddi tugng.
Le Ngoc Lan 1 7 Nghiin Cliu vl tic ddng cua chfnh sach ddi vdi ngudi cao tudi va nhu'ng ca sd thue tiln xay dung, dilu ehinh chfnh sach cham sdc, phat huy vai trd ciia ngudi cao tudi budc diu ggi md mdt sd vin d l cin quan tim: Ngudi cao tudi khdng phai la mdt nhdm xa hdi thuin nhi't, hg cd nhiing dac trung nhit dinh theo gidi tfnh, nhdm tudi, trinh dd hge vin, khu vuc cu trii... Cac chfnh saeh xa hdi nin cd su quan tam vl nhiing dac trung nay dd cd nhiing ndi dung phu hgp. Ddng thdi, cin danh gia lai vai trd ciia cac chu the (gia dinh, cae td chiic xa hdi,...) trong viec phung dudng cham sdc ngudi cao tudi, td chiic cac dich vu cham sdc trong bdi canh cdng nghiep hoa, hien dai hda dd cd su dilu chinh vl mat ca chl, chfnh sach xa hdi. Ben canh dd, cin quan tim din nhiing nhu ciu, khdng chi ciia ban than hg, dac trung cho cac nhdm xa hdi cua tudi gia ma cdn la nhiing nhu ciu thilt thuc, tao dilu kien de hg tham gia hoat ddng, vira cd'ng hiin vira duy tri su van ddng thd chit va tinh thin va phat huy the manh cua minh ngay cang cd hieu qua hom trong gia dinh, cdng ddng va xa hdi.B
Tai lieu tham kliao
Ban chi dao tdng dieu tra dan so va nha d trung uong. 2009. Bdo cdo ket qud suy rgng mdu tdng dieu tra ddn sdvd nhd d 1/4/2009.
Bd Lao dpng Thuong binh Xa hoi. 2009. Du thao chidn luge an sinh xa hdi."Hdi thao tai Hai Phdng.
Bd Van hoa, The thao va Du Ijch, Vien Gia dmh va Gidi, Tdng cuq thdng ke va Unicef. 2008. Ke't qud dieu tra gin dinh \ iet Nam ndm 2006.
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Giang Thanh Long. 2010. Gia hda dan sd d Viet Nam: thaeh thiic ciia mdt nude thu nhap trung binh. Tham luan Hdi thao Vuot qua bdy thu nhdp trung binh:
CO hgi vd thdch thifc ciia Viet Nam. Hd Ngi.
Nguydn Dinh Cir. 2008. "Co ciu dan sd Vidt Nam cd gi mdi?" Tgp chi Cgng sdn sd 168.
Le Nggc Lan va Trin Qu5^ Long. 2009. Bdo cdo phdn tich sd lieu dieu tra gia dinh 2006: Quan he giifa ngudi cao tudi vd cdc the he trong gia dinh. Vien Gia dinh va Gidi.
Le Ngoc Lan va ddng nghidp. 2010. Mdt sd vin dd eo ban vd ngudi cao tudi Viet Nam, giai doan 2010-2020. Bao cao dd tai cip Bd. Vidn Gia dinh va Gidi. Ha Ndi.
Qud'c hdi nudc cdng hda xa hdi chu ngWa Vidt Nam. 2009. Lugt ngudi cao tud'i.
Uy ban qud'c gia vd ngudi cao tudi Vidt Nam. 2007. Bdo cdo ket qua khdo sdt thu thgp, xif ly thdng tin ve ngudi cao tuoi d Viet Nam. Ha Ndi.
Vien Gia dinh va Gidi. 2008-2010. Sd lidu didu tra ngudi cao tudi tai khu vuc ddng bang Bac bd va thanh phd H6 Chi Minh.
