N g h i § n c\j[u<br />
Gia d i n h va Gi6i<br />
So 5 - 2 0 1 1<br />
<br />
Mot so 00 sA thUG tien can quan tam<br />
trong xay dung, dieu cliinli cliinli sacli<br />
cliam soc ngirdi cao tuoi A Viet Nam<br />
Le Ngoc Lan<br />
Vien Gia dinh va Gidi<br />
<br />
T o m tat: DUa tren nhiing nghien cUu gan day ve ngUcfi cao tudi,<br />
bai viet neu len mot so' dac diem nhan khau hoc, han che cung<br />
n h u nhiJng nhu cau va nguyen vong cd ban cua ngUcii cao tudi.<br />
Bai viet cho thay ngUdi cao tudi khong phai la mot nhom xa hoi<br />
t h u a n nhat, ho co nhflng dac trUng nhat dinh theo gidi tinh,<br />
nhom tudi, trinh do hoc van, khu vUc cU tru... Cu the, ty le mat<br />
can bang gidi tfnh trong nhom ngUcfi cao tuoi ngay cang gia tang.<br />
Trinh do hoc van cua ngUdi cao tudi thap va khong ddng deu gifla<br />
nam va nfl, gifla cac viing mien. Da so' song d khu vUc nong thon<br />
trong dieu kien kinh te kho khan. Mot ty le 16n ngUdi cao tudi v i n<br />
dang lam viec de dam bao cuoc sdng cho ban than, dac biet la<br />
ngUdi cao tudi cl khu vUc nong thon. Vi nhieu ly do, ngUdi cao tuoi<br />
con it tham gia vao cac hoat dong cong ddng, xa hoi. Nhin chung,<br />
ngUdi cao tudi mong muon dUdc sinh sdng cung con cai nhUng<br />
cung mudn co them cac dich vu nuoi du5ng va cham soc sflc khoe<br />
de dam bao cho cuoc sdng dUdc tot hdn... Tac gia cho rang can<br />
danh gia lai vai tro cua gia dinh va cac td chflc xa hoi trong viec<br />
cham soc va phat huy vai tro cua ngUdi cao tudi de co sU dieu<br />
chinh thfch hdp ve mat cd che va chfnh sach.<br />
TU khoa: NgUdi cao tudi; Cham soc ngUdi cao tudi; Gia dinh.<br />
<br />
4<br />
<br />
Nghien cUu Gia dinh vi GI6I. Quyg'n 21, so 5, tr. 3-17<br />
<br />
Co Ihi noi, cham soc va phat huy vai tro la hai mSt ca ban khi noi vi<br />
chinh sach xa h6i d6'i vdi ngu&i cao tu6i. Dieu nay duac th^ hiSn xuy6n<br />
suO't nhu m6t quan didm chu dao trong Phap I6nh Ngudi cao tu6i (2000)<br />
va Luat Ngudi cao tu6i (2009). Cham soc ngudi cao tu6i vira la trach<br />
nhidm cua gia dinh, xa hdi, ihi hi6n su tdn trong, bao dap nhiJng cd'ng hi^n<br />
cua ngudi cao tudi trong sudt cudc ddi ho, vCra la tien d^ de ngudi cao tudi<br />
cd the phat huy nhirng kinh nghifim, nhung kha nang cdn lai ciia minh cho<br />
gia dinh, cdng ddng va xa hdi. Cham soc td't la de phat huy cao hon vai trd<br />
cua ngudi cao tu6i. Phat huy duac vai trd cua ngudi cao tudi, vira khdng<br />
lang phi mdt ngudn luc xa hdi quan trong, vira ddng gdp them nhutig tien<br />
de de' gia dinh va xa hdi cham sde trd lai ngudi cao tu6i td't hon.<br />
Tren thuc tc, da cd nhirng cudc khao sat, danh gia viec thuc hien mdt<br />
sd chfnh sach ddi vdi ngudi cao tudi d quy md va muc do khac nhau. Ket<br />
qua cua nhiing dot khao sat danh gia ciia Hdi Ngudi cao tudi, cua Uy ban<br />
qud'c gia v^ ngudi cao tudi va cac ca quan khac da gdp ph^n dieu chinh,<br />
xay dung cac chinh sach lien quan d^n ngudi cao tu6i nudc ta, ching han<br />
trong viec xay dung cac Nghi djnh thuc hien Phap lenh Ngudi cao tudi<br />
trudc day va Nghi dinh 06 (nam 2011) cua Chi'nh phii hudng dan thuc hien<br />
Luat Ngudi cao tuoi. Tuy nhien, ddi vdi timg ITnh vuc cu the' thude pham<br />
vi cua cac Bd, nganh, cSn cd su dieu chinh kip thdi, phii hap vdi dieu kien<br />
kinh te' xa hdi mdi de dap ling td't han ca hai linh vuc cham sde \a phat<br />
huy vai trd ngudi cao tuoi. Ph^n viet dudi day khdng nham danh gia \iec<br />
thuc hien cac chinh sach xa hdi vdi ngudi cao tu6i ma chi neu len mot sd<br />
can cii thuc tien, nhiing nguyen vong cua ngudi cao tudi nhu mdt ca sd nen<br />
tang de xay dung cac chfnh sach hd trg, phat huy vai trd ngudi cao tuoi<br />
trong giai doan tdi.<br />
1. Mot so dac diem cd ban va han che cua ngudi cao tuoi<br />
<br />
Nhan bie't nhimg dac diem nhan kh^u hpc, nhimg han che'phd bien cua<br />
ngudi cao tuoi la mdt trong nhirng can cir thuc tien de' xay dung, dieu<br />
chinh chfnh sach ngay cang sat vdi ddi tuang hudng de'n.<br />
Mot sd dac diem nhan kh^u hoc cua ngudi cao tu6i la nhu sau:<br />
So' lugng ngudi cao tuoi tdng di ddi vdi su gia tdng ty le mat cdn bdng<br />
gidi tinh. Ty le ngudi cao tu6i (60 tudi trd len) trong tdng dan sd da tang<br />
tir 6,9% nam 1979 len 8% nam 1999 va 9% nam 2009 (Ban chi dao<br />
TDTDS&NOTU, 2010). Du bao den nam 2050 sd luong ngudi gia d Viet<br />
Nam tir 60 tuoi trd len se chiem 26% tdng dan sd (Nguyen Dinh Our,<br />
2008). Do ty le ngudi gia tang len trong khi ty le tre em dudi 15 tudi giam<br />
<br />
Le Ngpc Lfin<br />
<br />
5<br />
<br />
manh trong 10 nam qua nen "chi sd gia hoa" cua dan sd Viet Nam da tang<br />
11 diem ph^n tram sau 10 nam (tir 24,5% nam 1999 len 35,9% nam 2009).<br />
Sd luang ngudi cao tudi nii gidi ludn cao han so vdi nam gidi. Phan tfch<br />
cac nhdm tudi cua nhirng ngudi cao tudi tiong Di^u tra gia dinh Viet Nam<br />
2006 cho tha'y, ngoai triic nhdm tudi 61-65, ty le ngudi cao tudi nam va nir<br />
bang nhau, ddi vdi cac nhdm tudi cao han, nii gidi chie'm ty le cao hem,<br />
52,3% so vdi 47,7% d nhdm tudi 66-70, 54% so vdi 46% d nhdm tudi 7175, va 61,8% so vdi 38.2% d nhdm tudi 76 trd len. Cang d nhdm cao tudi<br />
han, ngudi cao tudi cd ty le sd'ng vdi vg chdng ft hem, tir 73,2% d nhdm<br />
61-65 tudi giam xudng 61,2% d nhdm 66-70 tudi, 53,3% d nhdm 71-75<br />
tudi va 34,8% d nhdm 76 tudi wb len (Le Nggc Lan va Tr^n Quy Long,<br />
2009). So sanh sd lieu Tdng dieu tra dan sd va nha d nam 1999 va 2009,<br />
sd lugng chenh lech gifla nam va nii cao tudi nam 1999 la 1.089.957<br />
ngudi, de'n nam 2009, miic chenh lech cdn cao han vdi 1.350.812 ngudi.<br />
Dac biet, mii:c chenh lech ve gidi tfnh ngudi cao tudi cd xu hudng ngay<br />
cang gia tang d cac nhdm tudi cao, tir 80 trd len.<br />
Mgt ty le ldn ngUdi cao tuoi vdn dang ldm viec de ddm bdo cudc sd'ng<br />
cho bdn thdn, ddc biet Id ngudi cao tudi dkhu vifc ndng thdn. Cdn mdt ty<br />
le kha cao ngudi cao tudi v&n cdn lam viec dudi nhieu hinh thiic khac<br />
nhau. Xet theo khu vuc, ngudi cao tudi sd'ng d khu vuc ndng thdn chie'm<br />
ty le cao trong sd ngudi cao tudi cdn lam viec. Ty le phu nir cao tudi lam<br />
viec thap han so vdi nam gidi cao tudi. Ty le lam viec cua ngudi cao tudi<br />
dang sd'ng vdi vg/chdng hoac ngudi cao tudi khdng ket hdn cao hom ngudi<br />
cao tudi goa. Ngudi cao tudi trong cac hd gia dinh ma hg lam chu hd hoac<br />
hd gia dinh chi cd ngudi cao tudi cd ty le lam viec cao hom ngudi cao tudi<br />
trong cac nhdm hd gia dinh khac. Trong hd gia dinh ma ngudi cao tudi<br />
sdng phu thude, khoang 20% ngudi cao tudi dang lam viec. Xet theo nhdm<br />
tudi, ty le ngudi cao tudi trong nhdm tiir 60-64 tudi vin cdn lam viec chie'm<br />
khoang 60%. 6 nhiing nhdm tudi cao hem, ty le nay tha'p hem. Nhin chung,<br />
nhiing ngudi cao tudi sd'ng d thanh thi, ngudi goa, phu nii, nhiing ngudi<br />
tren 70 tudi va nhiing ngudi sd'ng phu thude cd ty le lam viec tha'p hom cac<br />
nhdm khac (Giang Thanh Long va Wade donald Pfau, 2007). Theo sd lieu<br />
Tdng dieu tra dan sd va nha d nam 2009, ty le ngudi tir 60 tudi trd len tham<br />
gia luc lugng lao ddng chie'm khoang tii 30-40%, trong dd nam gidi cao<br />
tudi tham gia vao thi trudng lao ddng nhieu hem nQ gidi. Ngudi 60 tudi trd<br />
len d ndng thdn chie'm ty trgng ldn hom trong luc lugng lao ddng so vdi<br />
ngudi d khu vuc thanh thi.<br />
Mdt sd han che' thudng tha'y d nhdm ngudi cao tudi la:<br />
<br />
6<br />
<br />
Nghien cUu Gia dinli vi Gidi. Quyen 21, so 5, tr. 3-17<br />
<br />
Bang 1. Tinh trang henh tM cua ngudi cao tudi<br />
theo ddc diem nhdn khdu hoc (%)<br />
Co 2 benh<br />
<br />
Tren 2 benh<br />
<br />
Khong CO l)6nh<br />
<br />
C6 1 b^nh<br />
<br />
35.0<br />
<br />
27.3<br />
<br />
21.0<br />
<br />
16.7<br />
<br />
Nam<br />
<br />
44,0<br />
<br />
28.8<br />
<br />
15.2<br />
<br />
12,0<br />
<br />
NO<br />
<br />
28,6<br />
<br />
26.3<br />
<br />
25,1<br />
<br />
20,0<br />
<br />
39,6<br />
36,8<br />
<br />
22,0<br />
22,1<br />
<br />
24,2<br />
29,4<br />
<br />
14,3<br />
<br />
40,0<br />
25,6<br />
<br />
25,5<br />
<br />
16,4<br />
<br />
11,8<br />
18,2<br />
<br />
38,4<br />
<br />
14,0<br />
<br />
22,1<br />
<br />
Chung<br />
Gidi tinh**<br />
<br />
Dp tudi*<br />
60-65 tu6i<br />
66-70 tu6i<br />
71-75 tudi<br />
tren 75 tudi<br />
<br />
Ngu6n: Sd lieu dieu tra ngudi cao tudi tai th^nh phd Hd Chf Minh, 2010<br />
<br />
Ngifdi cao tudi cd ty le sifc khde yeu vd ty le mdc benh cao. Dieu tra<br />
cua Uy ban qudc gia ve ngudi cao tudi Viet Nam tai 7 tinh tren ca nudc<br />
(2007) cho tha'y ty le ngudi cd tinh trang siic khde td't chiem khoang 5,3%;<br />
ngudi cd siic khde yeu chiem 42% va ngudi cd sire khde trung binh chie'm<br />
52,7%. O nhdm tudi cang cao, siic khde cang giam siit rd ret. Nghien ciiu<br />
cung ddng thdi chi ra rang tinh trang siic khde cCia ngudi cao tudi cd su<br />
khac biet giira nam va nii. Ty le cac cu dng cd sire khde tdt la 7,5%, cao<br />
ga'p hai \in so vdi cu ba trong khi ty le ngudi cd sire khde yeu d cu ba la<br />
46,5%, cao hom 10,9% so vdi nhdm cu dng. Trong tdng sd 2.878 ngudi cao<br />
tudi dugc khao sat tai 7 tinh, cd den ba phin tu sd cu mic ft nha't mdt benh,<br />
trong dd cd 14,1% ngudi mic tir hai benh trd len. Cac cu ba cd xu hudng<br />
mic nhieu benh han eac cu dng nhung sd benh tat mic phai d mdi ngudi<br />
dudng nhu khdng phu thude vao do tudi (Uy ban qud'c gia ve ngudi eao<br />
tudi Viet Nam, 2007).<br />
Phan tfch sau v^ tinh trang benh tat d ngudi eao tudi trong ke't qua dieu<br />
tra tai thanh phd Hd Chf Minh (2010) cung cho tha'y ty le ngudi cao tudi<br />
mic ft nha't mdt benh chiem ty le kha cao. Cd 65% ngudi cao tudi dugc<br />
khao sat mic ft nhi't mdt benh va cd 16,7% ngudi mic tren 2 benh.<br />
Cd 22,1% ngudi d dd tudi tren 75 mic 3 benh va ty le nay giam din<br />
theo do tudi, de'n nhdm tudi 60-65, ty le nay giam xudng cdn 14,3%. Nhu<br />
vay, ddi vdi cac nhdm tudi cao hom, viec cham sde siic khde cho ngudi cao<br />
<br />
Le Ngoc Lan<br />
<br />
7<br />
<br />
tudi can phai dugc quan tam hem.<br />
Trinh dp hpc van ciia ngu'di cao tudi thd'p vd khdng ddng diu giiia nam<br />
va nii, giiia cac viing mi^n, sd cd trinh dd hge va'n, chuyen mdn cao ft.<br />
Chang han, ke't qua Tdng dieu tra dan sd va nha d 2009 eho tha'y: cd 15,8%<br />
dan sd ngudi eao tudi chua tiing di hge (nam 6,4% va nO 22,3%); 51,9%<br />
mdi dat bac tieu hge (nam 43,1% va nii 58,0%); 19,2% hge he't trung hge<br />
ca sd (nam 27,8% va nii 13,2%); 9,3% tdt nghiep trung hge phd thdng<br />
(nam 15,4% va nii 4,9%) va 4% dat trinh do cao ding trd len (nam 7,4%<br />
va nii 1,5%). Ty le cd hge vin cao giam din theo nhdm tudi.<br />
Ke't qua khao sat ve ngudi cao tudi tai TP Hd Chf Minh (2010) cung<br />
cho nhiing ket qua tuang tu va hiu he't ngudi cao tudi khdng cd trinh dd<br />
chuyen mdn hoac khdng dugc dao tao chuyen mdn (83,6%). Chi cd mdt<br />
sd ft ngudi cao tudi cd trinh dd sa cip (4,0%). trung cip (3,7%), cdng nhan<br />
ky thuat (4,4%). cao ding hoac dai hge (4,0%) va tren dai hge (0,3%).<br />
O Viet Nam, da sd'ngudi cao tuoi sd'ng d ndng thon vd trong dieu kien<br />
kinh te'khd khdn. Ke't qua Di^u tra gia dinh Viet Nam 2006 cho tha'y ngudi<br />
eao tudi chii ye'u sd'ng phu thupc kinh te'vho con chau. Nhieu ngudi cao<br />
tudi vin tiep tue lam viec sau khi nghi huu hoac d do tudi nghi huu do<br />
nhiing khd khan ve kinh te'. Tuy nhien do siic khoe ye'u va do nhiing han<br />
che' ve trinh do, chuyen mdn, tudi tac, hg rat khd tim dugc cdng viee sau<br />
khi nghi huu hoac d do tudi cao (Bd Van hda. The thao va Du lich va cac<br />
ca quan khae, 2008).<br />
Vi nhieu ly do, nhieu ngudi cao tudi cdn it tham gia vdo cdc hogt ddng<br />
cpng ddng, xd hpi. Ngudi cao tudi edn it hieu bie't vi chinh sdch, ngay ca<br />
nhiing chfnh sach lien quan de'n quyen led cua hg. Ket qua khao sat tai TP.<br />
Hd Chl Minh cho thiy cd 37% ngudi eao tudi khdng bie't chfnh sach nao<br />
lien quan den hoac danh cho ngudi eao tudi. Ty le ngudi biet nhilu ve cac<br />
ehinh sach cua Nha nudc ddi vdi ngudi eao tudi tang din theo trinh do hge<br />
vin eua ngudi cao tudi. Dieu nay dac biet ed y nghia vi ngudi cao tudi cd<br />
trinh do hge vin cao thi nhan thiic cua hg ve cac quyen lgi va tiep can vdi<br />
cac dich vu, hd trg cua Nha nude nham nang cao chit lugng cudc sd'ng cua<br />
hg cang cao.<br />
Ve tdm ly, ngudi eao tudi phuang Ddng cung nhu d Viet Nam eoi viee<br />
phu thupc vdo con cdi Id mdt mong mudn mang tinh dgo ly va tham ehi hg<br />
cdn mong mudn dugc phu thude vao con cai hom la he thdng phiic lgi eua<br />
Nha nudc. Dieu nay the hien qua mdt ty le ldn ngudi cao tudi hien nay vin<br />
mudn sdng chung vdi con chau "de nuomg tua va giup dd lin nhau". Trong<br />
<br />
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