M O T S O V A N D E DAT RA DOI V d l CHAM SOC SlTC KHOE NGircn CAO TUOI Of VIET NAM HIEN NAY Phan Phuc Torn tdt: Viec chdm soc sue khoe ngu&i cao tuoi Viet Nam hiin dang dgt nhieu vdn de, nhdt Id boi cdnh thi hoa, cong nghiep hoa ddt nu&c Dua vdo ngudn tdi lieu thic cdp, bdi viet trinh bdy khdi qudt mgt so net ve sue khoe eua ngu&i eao tudi & Viet Nam hien nay, nhu su suy gidm vi ehuc ndng cua ca the, su xudt hiin cua benh tdt, nguy ca chdn thuang sinh hogt hdng ngdy; ddng th&i nhdn dien cdc nhu cdu ho tra cua ngu&i cao tudi viic ddi vai nhiing rui ro ve tinh trang sue khde Bdi viit cdng dua mdt so de xudt nhdm ndng cao vai trd cua gia dinh, cgng ddng vd nhd nudc chdm soc sue khoe ngu&i cao tuoi boi cdnh gid hoa ddn sd, thi hda vd cdng nghiep hoa dang diin ngdy cdng sdu rgng Tir khda: Chdm soc sice khoe, ngu&i cao tuoi; Viet Nam Dat van de Ngudi cao tudi d Viet Nam da va dang tiep tuc cong bien cbo sy phat trien ben viing cita dat nudc bang stic luc, tri tue va kinh nghiem lao dpng va cudc sdng Ngudi cao tudi cdn the hien vai trd nhu la mdt tam gucmg ve sy hy sinh, ve trach nhiem ddi vdi gia dinh va cdng ddng, ve niem tin ddi vdi the be mai sau Tuy nhien, chinh ngudi cao tudi lai la nhdm xa hdi yeu the dang can den sy quan tam, hd trp ciia gia dinh, cdng ddng va Nha nudc ve cham sdc stic khde nhirng tbay ddi ve the chat, tinh than nhu la mdt dien tien tu nhien ciia qua trinh lao hda ma ban than mdi ngudi cao tudi dang gap phai Thyc te hien cho thay cudc sdng ddi thudng cita ngudi cao tudi dang gap rat nhieu van de lien quan den sire khde va ddi sdng tinh than, mdi quan he ciia ngudi cao tudi vdi cac vien gia dinb va d cdng ddng bdi canh dat nudc day manh thi hda, cong nghiep hda Chang ban, nhu tinh trang sire khde the chat va tinh than cua ngudi cao tudi thay ddi ban than hp chua nhan thiic day dii de tu cham sdc giii gin sire khde; hay van de gia dinh, cdng ddng cdn thieu thdn ve ngudn lyc, bay chua cd trach nhiem tdt cham sdc, hd trg cho cudc sdng cita ngudi cao tudi, v.v Dieu dat nhieu cau hdi can tim hieu va lam ro de tir cd dinb hudng tdt ban viec hd trg va cham sdc siic khde cbo ngudi cao tudi Vai net ve tinh trang siic khoe, benh tat va nhu cau cham soc ctia nguoi cao tuoi hien 1.1 Tmh trang SUT khde, benh tat cda ngirifi cao tudi Theo quy luat ty nhien, tudi cang cao, cac chiic nang sinh hpc ciia co the nhu tieu hda, tuan hoan, van dpng, phan xa bi giam Slit Them vao dd, theo thdi gian siic de khang ciia ngudi trudc nhiing tac nhan co hai cho sire khde cung cang suy giam Trong nhiing yeu td nguy co lam phat sinh benh tat tudi cao tdn tai co the dugc tich luy qua nhieu nam, dac biet la cac yeu td lien quan den ldi sdng nhu hiit thudc la, udng nhieu rugu bia, an qua nhieu mudi, it boat ddng the luc Vi vay, ngudi cao Utoi thucmg mac nhieu loai PHAT TRlfiN B £ N V Q N G VCJNG Q U Y E N 9, S6 (6/2019) NGHIEN CCrU THyC NGHlEM - KINH NGHlEM benh khac va gap nhieu trd ngai, khd khan smh boat thudng nhat nhu an udng, tam nia, di lai Do ban che ve kba nang phdi hgp van dpng, co luc yeu va phan iing cham chap vdi nhiing tinh hudng ddi hdi su nhanh nhay nen ngudi gia cd nhieu nguy co bi chan thuong tai nan sinh boat Cac nghien ciiu gan day chi sire khde cua ngudi cao tudi gan day cd kha hem trudc, nhung bdi canh hien nhieu van de dang de dpa siic khde ngudi cao tudi (Nguyen Diic Chien va Nguyen Thi Huyen Giang 2018) Mdt sd nghien ciru khac cho thay ty le cao ngudi cao tudi gap it nhat mdt loai khd khan ve van ddng, khd khan len xudng cau thang va khd khan dang ngdi diing day, trd ngai sinh boat hang ngay, kbd khan an udng, tam nia, mac quan ao hay ve sinh (Phan Phuc, 2018) Dieu dang quan tam la cac nghien cihi ve ngudi cao tudi thdi gian qua cung cbi nguyen nhan dan den tinh trang Pban ldn ngudi cao tudi hien van phai lao ddng qua stic de kiem sdng Neu ngudi cao tudi lao dpng vira pbai, cdng viec phit bgp vdi ngudi gia lam viec dieu kien tu tudng thoai mai, ty nguyen, khdng bi gd bd tbi cd tac dung tang cudng stic khde Trai lai, vdi nhiing ngudi lam viec qua stic minh, dac biet la ngudi cao tudi, se lam cbo stic khde giam di nhanh chdng Viec thieu dinh dudng keo dai, citng vdi lao ddng vat va ca tuoi da cao nen phat sinh nhieu benh tat (Tdng cue Dan sd va Ke hoach hda gia dinh, 2006; Vien Nghien ciiu Y xa hpi hpc, 2011; Nguyen Dire Chien va Nguyen Thi Huyen Giang, 2018) Trong nhieu cupc nghien cuu ve ngudi cao tudi cho thay hau het ngudi cao tudi dang mac benh man tinh va dau dm thudng xuyen (benh mach vanh tim, benh thupc he hd hap, dd cd benh phdi tac man tinb, nhiing bieu hien ve trang thai tinh than nhu khd ngit, lo lang ve cudc sdng hien tai, budn rau, chan 132 nan va met mdi thudng xuyen (UNFPA, 2009; Phan Phuc, 2018) Cac nhdm benh thudng gap la cac benh ve tim mach, xuong khdp, ndi tiet, tieu boa, than kinh, hd hap, than tiet nieu, tam than, thi giac Benh ve xucmg khdp ciing la mdt benh rat phd bien nbu thoai hda khdp, thap khdp, va loang xuong Ngudi mac benh thudng cd cac trieu chimg dau nhtic xuang, cac khdp va van ddng kbd khan, de bi gay xuong bi nga Tuong ty, cac berth ve giac quan nbu thi giac, thinh giac the bien rat ro su thoai hda chtic nang d co the ngudi gia Cac tinh trang sa siit ve siic khde dang ke khac d ngudi cao tudi ke ca nam gidi va nii gidi la cac benh ve npi tiet nhu benh tieu dudng va benh cua dudng tieu hda nhu loet da day, viem dai trang, nudt (Pham Thang, 2007; dan theo UNFPA, 2009; Nguydn Diic Chien va Nguyen Tbi Huyen Giang, 2018) Nhiing tinh trang benh tat nay, khdng chi gay anh hudng den site khde bdi chinh can benh ma cdn anh hudng den cac chiic nang khac ciia co the, gdp phan vao suy giam stic khde chung ciia ngudi cao tudi, dd cd siic khde ve tam than 1.2 Nhu cdu chdm sdc sire khde ngir&i cao tudi Ddi vdi nhung ngudi cd bieu hien dau 6m thudng xuyen hoac da cd benh dugc phat hien thi viec kham, chiia benh cua hg cung khdng phai khdng cd nhiing trd ngai Cac khao sat cho thay bau bet ngudi cao tudi cd benh va co nbu cau chira benh, nhung nhu cau chua boan toan dugc dap iing (UNFPA, 2009; Nguyen Dire Chien va Nguyen Thi Huyen Giang, 2018) Dieu tra ciia Benh vien lao khoa trung ucmg nam 2009 tai Ha Ndi, Thira Thien Hue va Ba Ria - Vung Tau cbo thdy, cd din 75,8% ngudi cao tudi cbo rang minh ckn duoc kham chiia benh tdt hon so vdi hien tai (Pham Thang, 2007) Dieu tra qudc gia ve ngudi cao PHAT TRIEN BEN VO'NG V U N G Q U Y E N 9, s o (6/2019) M$t s6 vdn de flat tuoi cho thay ty le ngudi cao tudi bi dau dm, chin thuong trong nam 2011 can dugc di8u b-j nhung khdng dugc dieu tri la gan 55% vdi nguyen nhan ca ban dugc chi la khong dit tien de chi tra (52,%) va khdng cd dua di benh vien (11,5%) (Vien Nghien ctiu Y xa hdi hpc, 2011) Trong mpt cudc tham dd ve kham chiia benh d Hai Duong, cd 24%) so ngudi cao tudi danh gia la chi phi kham, chiia benh rat cao va 57% sd ngudi danh gia la cao (Nguyen The Hue, 2005) Vi vay, nhieu ngudi cao tudi mac benli da khdng den dugc cac CO sd y te de kham, dieu tri Thay vao dd, chau hp ty mua thudc de udng tai nha ma khong cd don thudc hay hudng dan ciia bac sT Khdng chi la chi phi anh hudng den viec tiep can CO sd y te ma cac yeu td khac nhu di lai khd khan hay kha nang dap ung cita ca sd y te hi ban che Dieu tra cita Benh vien lao khoa trung uong (2009) cho thay, nhieu ly khien ngudi cao tuoi khdng dugc kham chiia benh, ly chinli la klidng dii kba nang kmh te (45,3%), d i k kien di lai khd khan (17,3%), dieu kien y te dia phuong khdng dap iing dugc 16,5%' Hien nay, nhieu ngudi cao tudi, khoang 74%, da cd the bao hiem y te la ngudi nghi buu, ngudi thudc hd gia dinb ngheo, gia dinb chinh sach dugc nha nudc cap hoac mua bao hiem y te tu nguyen (Vien Nghien ciiu Y xa hpi hpc, 2011) Day la mot nhijng 6ihu kien rat tdt de ngudi cao tudi cd nhieu co hpi de dugc cham sdc sire klide Tuy nhien, nhiing ban che chat lupng dich vu y te va quyen lgi kham chiia benh chua dam bao da anh hudng den viec tiep can dich vu y te ciia ngudi gia thap ban so vdi nhu cau cao v^ cham sdc siic khoe cua bp Vi the, nhiing su ho trg khac tir gia dinh va cdng ddng la rat can thiet de ngudi cao tudi dugc cham sdc sti'c khde day dit bon, cd chat lugng tdt ban Vai trd cua gia dinh, cong dong va nha niro'c cham sdc cua ngirdi cao tuoi 2.1 Vai trd cua gia dinh chdm sdc ngu-&i cao tudi Ngudi Viet Nam van dang tri cau tnic gia dinh da the he vdi ty le 62% ngudi cao tudi sdng chung vdi chau va ciing khoang 60% ngudi cao tudi dang sdng ciing vdi vg hoac chdng (UNFPA, 2011) Vdi truy6n thdng dao diic va quan he gia dinb cua ngudi Viet Nam, cai thudng bet Idng hieu thao vdi cha me va ludn cd y thiic ve sy bao hieu de den dap cdng lao sinh thanh, dudng due nen hp ludn chii ddng gitip da cha me cd khd khan cudc sdng C) Viet Nam, gia dinh hien van dang ddng vai trd chinh viec cham sdc stic khde ngudi cao tudi (Tong cue Dan sd va Ke hoach hda gia dinh, 2006; Phan Phuc 2018) Hau nhu ciing biet, ngudi cao tudi thudng it nhieu cd rdi loan ve tam ly, hoac it la nhiing uu tu, phien mudn cudc sdng cd thay ddi Them vao do, phan xa khdng cdn nhanh nhay, tri nhd giam siit ma ngudi cao tudi cd cd bieu hien tu xa lanb ngudi khac vdi y nghi la ngudi vd dung, la ngudi thua gia dinh, xa hdi Khi hdi ve tam trang ngudi cao tudi cupc sdng hang ngay, ket qua mdt nghien ciru cbo thay chi cd 52% so ngudi cao tuoi tra ldi cd tam trang binh thudng, thoai mai, 31% sd ngudi cao tuoi tra ldi ddi thay co don va cd tdi 17% sd ngudi cao tudi tra ldi thudng xuyen thay cd dan (Tdng cue Dan sd va Ke hoach hda gia dinh, 2006) Trong bdi canh ay, su quan tam, chia se ciia ngudi than va nhiing ngudi chung quanh se giiip hp an tam, chap nhan nbCmg thay ddi la qua trinh lao hda, tudi tac de lai ma rdi ciing gap phai Trong pham vi gia dinh, kbi cd nhirng cau chuyen can chia se, sd ddng ngudi cao tudi thudng tam sy vdi trai •http//www.suckhoedoisong.vn/2009261i34516p0c8 PHAT T R | £ N BEN VCfNG V U N G Q U Y E N 9, s o (6/2019) 133 NGHIEN C(f\J THU'C NGHIEM - KINH NGHIEM (45%), vdi vg hoac chdng (35%), vdi gai (25%), vdi dau, re (15%) (Hoang Mdc Lan, 2011) Khi xay dau dm hay chan thuang, nhiing ngudi than gia dinh nhu vg chdng, trai, gai, dau, cac chau la nhiing ngudi cham sdc chinh Dieu tra qudc gia ve ngudi cao tudi cho thay ty le ngudi cao tudi dugc cham sdc dau dm, chan thuang rat cao, tren 95% va nhirng ngudi giiip do, cham sdc nhieu nhat la vg, chdng (26%), trai 21,7%, gai (26,8%), dau (15,3%) (Vien Nghien ciru Y xa hdi hpc, 2011) Cung theo ket qua nghien ctiu Tdng cue Dan sd va Ke hoach hda gia dinh (2006), hdi ve gia dinh, chau ddi xir vdi ngudi cao tudi nhu the nao thi cd tdi 87% ngudi cao tudi ndi rang gia dinh, chau ddi xu vdi ngudi cao tudi la tdt, dd cd 48% ngudi cao tudi ddi CO nhung viec cy the chua hai long vdi chau Dang cbii y nhat la cd 6% sd ngudi cao tudi that su khdng hai Idng vdi chau Ket qua nghien ciiu cita Nguyen Dtic Chien va Nguyen Thj Huyen Giang (2018) cho thay nhieu ngudi cao tudi td budn tiii ve ung xu cua chau, hp khdng cdn dupe quan tam cham sdc va de cao vai trd nhu trudc Nhiing chi sd the hien kha ro dac trung ciia cac mdi quan he tren ca phuong dien huyet thdng, cau trite gia dinb va sy gan giii ddi sdng Chinh sy kinh trpng va sy quan tam ciia ngudi than se giiip ngudi cao tudi thich nghi vdi cudc sdng ciia minh, khdng mang mac cam nao Klii ngudi gia sdng vui, sdng khde lai trd niem ty hao ciia gia dinh, eon chau Tuy nhien, thyc te da cho thay rang, neu nhu cau cua ngudi cham sdc khdng dugc dap img, tdn trpng, mdt thdi gian dai se anh hudng den sire khde, tam ly, tinh cam ciia ban than ngudi cao tudi va ca cac vien gia dinh Sy hieu biet, tinh than trach nhiem va sy chia se lan giiia nhiing ngudi than se la dieu kien co ban nhat va co 134 hdi tdt nh4t dl nhiing boat ddng the chat va tinh than cita ngudi cao tudi, giiip hp them nhieu by vpng ve sdng lau vdi cudc sdng an vui vdi chau, ngudi than va ban be ctia minh 2.2 Vai trd cua cgng ddng vd Nhd nir&c chdm soc ngirdi cao tudi Ngudi cao tudi hien la Idp ngudi da timg tham gia boat ddng d nhieu ITnh vyc, co ca hdi tiep xiic va gay dyng mdi quan he kha rdng rai ngoai pham vi gia dinh Tuy nhien, cac mdi quan be cbii yeu van tap trung vao cac quan he gia dinh va than tdc Mdt sd cudc dieu tra ve boat ddng xa bpi va quan be xa hpi cita ngudi cao tudi da cho thay mdt sd hinh thiic va each thiic tri cac mdi quan he cua ngudi cao tudi Nhieu ngudi cao tudi van tri viec di tham bp hang va dugc hp hang tdi tham vdi tan suat gap gd hang la 27%, bang tuan 27%, bang thang va hang quy la 20%, tir mdt den hai quy la 15%, tir thang den mdt nam la 13yo Vdi cac mdi quan be ngoai gia dinh, than tpc, thi ngudi cao tudi vin cd mdt ban che dang ke, dd la sd ngudi khdng cd ban be than thiet chiem mpt ty le kha cao Cd 30% so ngudi cao tudi khdng cd ban than, sd ngudi cd den ban than la 18%, sd ngudi cd tir den ngudi ban than la 20% va sd ngudi cd tren nam ban than la 32 Tuy vay, cung lai cd tdi 50% sd ngudi cao tudi cd tham gia frong tre giiip chau, ke ca chau ciia hang xdm va 13% sd ngudi cao tudi dugc cdng ddng (xdm, thdn, xa) bdi y kien cac cdng viec quan trpng ciia cdng ddng (Hoang Mdc Lan, 2011) Nhiing ket qua nghien cuu va nhiing danh gia tren day cho tbay phan Idn ngudi cao tudi d Viet Nam hien cd cupc sdng dn djnh tren ca sd nen tang truyen thdng gia dinb va su anh budng lan nbau giiia cac thS he theo tinh than "Tri cgy cha, gid cgy " Tren phuong dien xa hdi va cpng ddng, ciing vdi tinh thdn PHAT TRIEN BEN V O N G V O N G Q U Y E N 9, s o (6/2019) M^t so van deflatra Phan Phyc doan ket, ngudi cao tudi cdn nhan dugc su tdn kinh, biet on cita the he tre va hp cdn xem viec danh su tdn trpng ddi vdi the he cha dng la ciing cbinb la phuang cham sdng de dugc sdng lau hon, khde hon nhu cau ngu "Kinh ldo ddc thg" ma nhieu ngudi tam dac Dieu cung khang dinh rang truyen thdng dao diic xa hdi, gia dinh Viet Nam, le sdng ciia ngudi Viet Nam, thuan phong my tyc ctia ngudi Viet Nam van dugc bao tdn va phat huy Tuy vay, ngudi cao tudi ciing cd nhung ban khoan, lo lang bdi nhiing khd khan ve vat chat van cdn deo dang mdt bp phan khdng nhd nhiing ngudi cao tudi Theo nghien ciiu ciia Nguyen Diic Chien va Nguyen Thi Huyen Giang (2018), nhiing chuan myc dao dire, ldi song, ke ca nhijng mau thuan phat sinh xa hdi dang cd nhiing chuyen manh me da cd tac ddng den tam ly ciia ngudi cao tudi Trong dieu kien xa hdi dang cd nhijng thay ddi, lai them nhiing mdi quan he mang tinh cdng ddng chua tucmg xting vdi truyen thdng vdn cd lau ddi cita ngudi Viet Nam, mdi ngudi tre tudi, moi vien gia dinh, cdng ddng can nhan dien nhung thach thiic ay va cd nhung hanh ddng cu the de dam bao nhiing ngudi cao tudi sdng khde, thich nghi vdi dieu kien mdi Ngudi cao tudi co nhu cau ddi boi va cung cd nguyen vpng ma bp mong dugc dap iing khong chi tir gia dinh, cdng dong ma cdn tir nhiing cbinb sach ciia nha nudc Khi tim bieu ve mong mudn cua ngudi cao tudi, 39% sd ngudi dugc boi mong dugc sy quan tam, cham soc hon niia cita nha nudc, 25% mudn dugc bd sung che dp chinh sach hd trg cudc sdng ngudi cao tudi, sd ngudi mudn cd co hdi de tao them viec lam len tdi 22% (Hoang Mdc Lan, 2011) Nhieu ngudi cho rang cac che dp, cbinb sach cita nha nudc nen ap dung cho nhiing ngudi tir 70 tudi trd len thay vi 80 tudi nhu bien (UNFPA, 2011; NguySn Diic Chien va Nguyen Thi Huyen Giang, 2018) Viec md rdng ddi tugng ngudi cao tudi nhan dupe bd trg tir nha nudc khdng cbi la each thirc "din an dap nghia" vdi cdng lao ciia the he da cd nhieu ddng gdp cac cudc khang chien va dyng xay dat nudc ma cdn la co hdi de nhieu ngudi cao tudi thuc sy dugc dam bao chat lugng cupc sdng ve gia Vdi nhieu ngudi, viec nhan dugc su cham sdc tir gia dinh hien dang cang gap nhieu khd khan dieu kien kinh te, cdng viec ctia cai muu sinh xa que va khdng phai khdng cd nhirng thay ddi cd phan sa siit ve quan he truyen thong, trach nhiem giiia cac the he, dd cd xu hudng ngudi cao tudi sdng vdi cai dang giam dan Su hd trp khdng phai chi the hien d sy tiep nhan true tiep cac gia tri vat chat ma cdn the hien d chat lugng boat ddng ctia Hdi Ngudi cao tudi, ciia cac td chiic cung cap dich vu xa hdi, cham sdc siic khde cho ngudi cao tudi d gia dinh va cpng ddng Chiing ta hien dang cdn thieu nhiing can bd, nhan vien cdng tac xa hdi cd tinh chuyen nghiep ve cham sdc ngudi cao tudi, co sd y te danh rieng cho cham sdc stic khoe ngudi cao tudi ciing cdn han che ve ca sd lugng va chat lugng, kbi xu hudng gia hoa dan sd dang hien hiiu cang rd net d Viet Nam vdi viec sd ngudi cao tudi tang cao 30 nam qua He thdng y te dugc bieu nbu mdt tdng the, bao gdm cac chinh sach vT md ve cham sdc stic khde nhan dan, cham sdc sire khde ddi vdi nhiing ngudi thudc nhdm yeu the xa hdi, cd nhom ngudi cao tudi, cac boat ddng truyen thdng, giao due sire khde va cac can thiep chuyen mdn ve dy phdng va kham chiia benh Hien cbi cd nhdm ngudi ve huu dugc kham chiia benh tdt ban cac nhdm khac nhd hieu biet ve cham sdc siic khde va sir dung tdi da cbinb sach ve bao hiem y te, nhdm ngudi gia nong thon van tiep tuc tham gia lao ddng, nhdm ngudi cd don khdng noi nuong tua, ngudi cao tudi ngheo dugc nha PHAT TRIEN BEN VLTNG VUNG Q U Y E N 9, SO (6/2019) 135 NGHIEN CO'U THU'C NGHIEM - KINH NGHlEM nude cap the bao hiem y te mien phi, nhung viec sij dung the bao hiem y te cdn rat ban che va kem hieu qua Ket qua nghien ciiu ctia Giang Tbanh Long (2008) cho thay, d Viet Nam ngudi cao tudi tap trung chit yeu d ndng thdn, 81,2% sd ngudi cao tudi timg lam viec linh vuc ndng nghiep, lao dpng don gian va nhieu ngudi van phai tiep tyc lao dpng de cd thu nhap Do nhiing dieu kien mang tinh lich sir, chien tranh keo dai nen trinh dp hpc van cua ngudi cao tudi ndi chung la thap, cd den hon 59% ngudi cao tudi da khdng co dieu kien hpc hanh ddy dit, chi cd 0,21%i co trinh dp trung hpc trd len, nen nhiing bieu biet ve y hpc thudng thiic, cac bien phap luyen tap, phdng benh, tiep can dich vu y te de kham benh va chiia tri ciia ngudi cao tudi cdn nhieu ban che Mang ludi cac co sd y te can dugc phat trien, md rong de ngudi cao tudi tiep can dich vy thuan tien Cimg vdi cac CO sd y te thuc hien kham, chiia benh cd thu vien phi hay bao hiem y te, thi viec td chiic cac boat ddng kham chiia benh nhan dao, ttr thien cho ngudi cao tudi se giiip nhiing ngudi kho khan cd ca hpi dugc cham sdc sire khoe binh dang va cdng bang hem Thyc te cho thay cd den 50% sd ngudi cao tuoi bay td nguyen vpng dugc hd trg dm dau, benh tat va gan 31 % mong mudn dugc tao dieu kien de kham chiia benh thudng xuyen Hp ciing mong mudn cac ca sd y te phai chii ddng ban tiep can de cung cap dich vu kham chiia benh cho ngudi cao tuoi ban la viec "ngdi chd" hp den vdi CO sd ciia minh, bdi phan ldn ngudi Viet Nam chi den berth vien dau bieu benh tat da kha rd rang hoac cac bien phap Ur diSu tri khdng dem lai ket qua Nghien ciiu ciia Tran Thi Mai Oanh (2010) dugc thyc hien tai mdt so cdng ddng ndng thdn cho thay phin ldn ngu'di cao tudi khdng biet cac bieu hien ciia cao huyet ap (66,5%), khdng biet nguy ca nao dan den tang huyet ap (84,1%) va khdng bi8t 136 each phdng chdng dau xuong khdp (74,6%) Bang viec cbii ddng ti^p can, cac ca sd y te cd the phat hien, chiia berth sdm cung nbu nhiing Idi khuyen ve cac bien phap phdng ngira nham giam benh tat, tan ph6 kbi tudi gia, tir dd phat huy hieu qua va nang cao chat lugng cupc sdng ngudi cao tudi Mpt so vanfledat Tuoi thp ngudi Viet Nam cang cao la ket qua cua sy phat trien ve kinh te, xa hpi va chat lupng ciia cdng tac bao ve va cham sdc siic khde nhan dan Chimg ta rat ty hao ve tudi thp ciia ngudi Viet Nam cao hem nhiing nudc cd cung dieu kien kinh te Nhung viec gia boa dan sd vdi sd lugng ngudi tir 60 tudi trd len gia tang nhanh chdng ciing dat nhieu thach thiic, vi Viet Nam dugc xem la qu6c gia "gid tru&c gidu" Mdt nhiing thach thiic dd la van de siic khde va cham sdc siic khoe ddi vdi ngudi cao tudi, dam bao chat lugng cudc sdng cua ngudi cao tudi theo phuang cham "sdng vui, sdng khde" nhu chinh ban than ngudi cao tudi, gia dinh va cdng ddng mong mudn Ngudi cao tudi Viet Nam hien cho du tudi thp kha cao nhung sd ngudi cao tuoi khoe manh cdn ban che Ngudi cao mdi thudng mac nhieu loai benh chiic nang boat ddng ciia ca the suy giam va qua trinh tich liiy theo thdi gian cac yeu td bat lgi cho sue khoe Hp thudng phai ddi mat vdi nhieu loai benh de dpa den chat lugng cupc song va tinh mang nliu benh ve tim mach, hd bap, xuong khdp, rdi loan chuyen hda va nguy co cua cac chan thuong sinh boat hang Cbo dit viec "tudi cao" ludn dugc xem nhu di ben vdi "siic yeu" va "benh tat" nhu la mdt quy luat tu nhien, thi viec mdi ca nhan thuc hanh giii gin sue khde, tiep can cham sdc y te day dii va tri tdt cac mdi quan he xa hpi se tac ddng tich cue den quy luat tu nhien ay tren phuang dien kiem che nguy co xuat hien benh, ban chS biln P H A T TRIEN B E N VU'NG VUNG Q U Y E N 9, SO (6/2019) M^t so van de dat chiing nang cua benh tat, ngan ngira dau ddn va tan phe, giam tir vong sdm va tren bet la chat lugng cudc song cua ngudi Dieu dang quan tam hien la ty le ngudi cao tudi Viet Nam sdng khde hoac hai Idng vdi siic khde cua minh cdn thap, nhieu ngudi cdn cd nhiing ban che ve siic khde van cdn gap khd khan tiep can dich vy y te cac nguyen nhan ve kinh te, dieu kien sdng khd khan, thilu su hd trg can thiet tir gia dinh va xa hdi Nhung bang chimg khoa hpc va kinh nghiem cudc sdng dugc diic ket cho thay, van de trpng tam nhat cham sdc siic khoe cho ngudi cao tudi la cham sdc stic khoe the chat Mdi ngudi cao tudi ciing cd the ty cham sdc stic khde cbo minh thdng qua dinh dudng hgp ly, tap luyen the luc hoac lam viec nhe nhang, tri trang thai thoai mai ve tinb than, tham gia vao cac boat ddng xa hpi, hpat dpng tin ngudng va van hda, thiet lap cac mdi quan he xa hpi tai cpng ddng Viec ty cham sdc sue khoe khdng bao gid la mudn, ke ca tudi da cao van dem lai nhihig gia tri rat tich cue Tuy nhien, ngudi cao tuoi rat can mdi trudng hd trg hoac tao dieu kien de hp thyc hien dugc viec ty giir gin siic klide va tiep can co sd y te 6m dau, benh tat Gia dinh, cdng ddng can cd nbirng hilu bilt nhat dinh ve sy thay ddi tam ly, nhiing suy giam chiic nang ca the, nhiing ban che van ddng cua ngudi cao tudi de cd nhiing bien phap ho trg phit hgp Vdi mdi ngudi Viet Nam ndi chung va ngudi cao tudi ndi rieng, gia dinb van la nai hg dugc bd trg va cham sdc nhieu nh4t dm dau, benh tat, chan thuong Do dd, tinh thuang yeu va bieu biet lan nhau, tinh thdn trach nbiem ciia con, chau viec cham sdc cha me, dng ba, ciing nhu vai trd cham sdc, day dd chau cita cha me, dng ba dugc phat huy mdi gia dinb la mdi trudng hai hda va binh an ddi vdi mdi ngudi cao nien Quan be gia dinh va than tdc, tinb doan ket, sy quan tam ciia Nha nudc va cdng ddng, phucmg thiic boat ddng hieu qua ciia Hdi Ngudi cao tudi va cac Hpi ma ngudi cao tudi tham gia la vien chinh la nhirng dieu kien mang tinh xa hdi, la vdn xa hdi de ngudi cao tudi dugc cham sdc stic khde tdt hon Vdn xa hdi ay ket tinh tu dao ly "udng nudc nhd ngudn", tir truyen thdng "kinh lao dac thp" cita ngudi dan Viet Nam van dang phat huy hieu qua rd ret bao ve va cham sdc siic khoe ngudi cao tudi Trong bdi canh xa hdi hien tai, gia dinb, cdng ddng, Nha nudc can cd nhirng hanh ddng phii hgp de dap img nhiing nhu cau, nhung nguyen vpng ciia ngudi cao tudi Dd la viec tao dieu kien de ngudi cao hjoi tham gia vao cac hoat ddng kinh te, tang thu nhap phit hgp vdi sire khde va sd trudng ciia mdi ngudi Viec cd them thu nhap, cting vdi co che ve bao hiem xa hdi cbo ngudi cao tudi va diic tinh tiet kiem, danh dum von cd cua ngudi cao hioi Viet Nam se ban che sy le thudc cua ldp ngudi cao tudi vao the he chau Chinh phu, cac CO quan nha nudc, cac td chiic xa hdi can cd cac chinh sach, co che, chuong trinh bd trg, nang cao chat lugng boat ddng ciia Hdi Ngudi cao tudi, cac Hdi ma ngudi cao tudi tham gia nhu Hdi Cuu chien binh, Hdi Phu nij giup ngudi cao tudi cd ca hdi dugc tham gia cac boat ddng xa hpi, ca bdi dugc chia se kmh nghiem cupc sdng lam phong pbii them ddi s6ng ciia minh, lap day cac khoang trdng tinh than va tao su dn djnb ve trang thai tam ly vdn rat de dao ddng ciia ngudi cao tuoi Tuong tu, cac td cbiic cung cap dich vu xa hdi, cham sdc siic khde cho ngudi cao tudi ciing can cd nhiing chuyen vien cd day dit tinh chuyen nghiep, chuyen sau va nhiing hieu biet ve tam sinh ly, sire khde ngudi cao tudi ciing vdi nhirng thyc hanh dua tren cac chuan myc dao diic, xa hdi Cac ca sd y te, thdng qua cac chinh sach ve cham sdc sire khde ngudi cao PHAT T R I E N BEN VIJNG VUNG Q U Y E N 9, SO (6/2019) 137 NGHIEN CCJ'U T h y c NGHlEM - KINH NGHIEM tudi, chinh sach bao hiem y te can xitc tien viec phat hien, chira benh sdm cung nbu tien hanh cac bien phap phdng ngira benh tat, tai nan ddi vdi ngudi gia Cac dich vy y t l pbai hudng den tinh chii ddng, thudng xuyen va su thuan tien tiep can, phong phii ve hinh thiic nhu td chirc kham stic khde dinh ky, td chtic boat ddng truyen thdng tryc tiep, cham sdc sire khde tai nha, ke ca kham chiia benh tir thien v.v Tai lifu tham khao Giang Thanh Long (2008) Chinh sach xa hpi va viec sir dung ca sd kham chiia benh cua ngudi cao tuoi Viet Nam Tap chi Bdo hiim xd hgi, so Hoang Mpc Lan (2011) D&i song tinh than cua ngu&i eao tuoi a Viet Nam hien Bao cao tai Hpi thao Van h6a loan cau h6a - thach thiic va phat tnen Dai hpc Khoa hpc xa hpi va Nhan van Dia chi tren internet: http//www.socialwork.vn/2011/06/05/2195 Nguyen Diic Chien va Nguy6n Thi HuyIn Giang (2018) Rdo edn chdm sdc ngu&i eao tuoi d ndng thdn vung Dong Bdc, Quyen cua ngudi cao tuoi Viet Nam Nxb Dai hpc quoc gia Nguyen The Hue (2005) Thuc trang sire khde vd dai sdng ngu&i eao tuoi & Hdi Duang Qudng Binh vd Dak Lak www.goptp.gov.vn Pham ThSng (2007) Dieu tra dich tl hpc ve tinh hinh benh tat, nhu cau cham soc y te va xa hpi ciia ngudi cao tuoi Viet Nam Tap chi Ddn so vd Phdt trien, Tong cue dan so, so Phan Phuc (2018) Su tham gia cua ngu&i cao luoi tgi cgng ddng (Nghien cuu trudng hgp tgi phuang 8, qudn Tdn Binh, Tp Ho Chi Minh) Luan van Thac sy Xa hpi hpc, Hpc vien Khoa hpc xa hpi Tong cue DS& KHHGD (2006) Hien trang cong tac cham soc ngudi cao tuoi Tgp chi Ddn so & Phdt triin (so 1/2006) Tai tir: www.gop^.gov.vn Tran Thi Mai Oanh (2011) Sice khoe chdm soc sicc khde cua nguai cao ludi vd thir nghiem mo hinh can thiep & Chi Linh, Hdi Duang Bao cao nghien ciiu cita Dai hpc Y te cong cpng UNFPA Viet Nam (2009) Chinh sdch chdm sdc sicc khde nguai cao luoi thich ung v&i thay ddi ca edu tudi & VietNam Tai tii: https://vietnam.unfpa.org/vi 10 UNFPA Viet Nam (2011) Gid hoa ddn sd vd nguai cao tuoi a Viet Nam - Thuc trgng, du bdo vd mot so khuyen nghi ehinh sdch https://vietnam.unfpa.org/vi 11 Vien nghien ciru Y xa hpi hpc - IRC (2011) Dieu tra quoc gia ve ngu&i eao tuoi Hpi Lien hiep Phu nii Viet Nam, http://baochinhphu,vn/Hoat-dong-Bo-nganh/Cong-bo-Dieu-tra-quoc-gia-ve-nguoi-cao-tuoiViet-Nam Thong tin tac gia: Phan Phuc, Th S - Dan V! cong tac Can bo Phircmg 8, quan Tan Binh, TP Ho Chi Minh 138 Ngay nhan bai: 26/4/2019 Ngay nhan ban sira: 18/5/2019 ^^^y duyet dang: 25/5/2019 PHAT TRIEN BEN V O N G V U N G Q U Y E N 9, s o (6/2019) ... cbo thay chi cd 52% so ngudi cao tuoi tra ldi cd tam trang binh thudng, thoai mai, 31% sd ngudi cao tuoi tra ldi ddi thay co don va cd tdi 17% sd ngudi cao tudi tra ldi thudng xuyen thay cd dan... dinh nhu vg chdng, trai, gai, dau, cac chau la nhiing ngudi cham sdc chinh Dieu tra qudc gia ve ngudi cao tudi cho thay ty le ngudi cao tudi dugc cham sdc dau dm, chan thuang rat cao, tren 95% va... nhu chinh ban than ngudi cao tudi, gia dinh va cdng ddng mong mudn Ngudi cao tudi Viet Nam hien cho du tudi thp kha cao nhung sd ngudi cao tuoi khoe manh cdn ban che Ngudi cao mdi thudng mac nhieu