Mutual Assistance in Aging Issues and Countermeasures in the Central Urban Area of Chongqing

: As the aging population intensifies, the service supply of elderly care institutions such as nursing homes and community elderly care service centers is relatively insufficient, failing to adequately address the diverse elderly care needs. The combination of mutual assistance elderly care and the framework of “Family + Community + Institution” enables the elderly to have a better elderly care experience within their familiar environment. This approach better fulfills the demands of home-based elderly care and optimizes the efficient allocation of elderly care resources. It is a new elderly care model widely accepted by urban community residents. A survey of mutual assistance elderly care practices across nine districts of the main city of Chongqing revealed representative models of community mutual assistance elderly care, including community mutual care organizations, “time bank” mutual care models, elderly care service organizations, and elderly community universities. Some practices and innovations in urban mutual assistance elderly care in Chongqing have provided useful exploration for actively addressing the issue of aging. However, there are still issues such as an incomplete urban community mutual assistance elderly care system, poor management and supervision, low social participation, and resource scarcity. Hence, this study seeks to explore the developmental obstacles encountered by mutual assistance and elderly care in Chongqing urban communities. It aims to propose practical and feasible suggestions and plans, ultimately promoting the healthy and sustainable development of the mutual assistance and elderly care model in urban communities in Chongqing.


Introduction
With the rapid economic development and the exacerbation of population aging, the demand for home elderly care is on the rise.Chongqing, in particular, hosts a substantial elderly population.To be specific, the number of elderly people aged 60 and above reached 712.11 million at the end of 2022, an increase of 123% compared to 2020.This demographic group now constitutes 22.16% of the city's total population, ranking second in the world.Moreover, as the aging process deepens, the elderly population in Chongqing will continue to increase, which will inevitably result in substantial demands for elderly care services.However, the current supply of elderly care institutions such as nursing homes and community elderly care service centers is relatively insufficient, thereby failing to adequately address the diversified needs of the elderly population.In response, mutual elderly care initiatives within urban communities have emerged as a viable solution.
The urban communities, characterized by a relatively dense elderly population, offer favorable conditions for the implementation of elderly care.The elderly can obtain better elderly care experience in their familiar environments (home and community), which can supplement the shortcomings of family and institutional elderly care to some extent.The mutual elderly care mode based on "family + community + institution" can take full advantage of the three components and transform the role of a service "recipient" into a service "provider".Through the development of mutual elderly [1] care in communities, urban areas in Chongqing can effectively address the challenges posed by population aging.This approach promises to improve the quality of elderly care services, promote community development, and contribute to social harmony and stability.

Research Analysis of Mutual Elderly Care in Chongqing City's Downtown Areas
Chongqing has actively practiced mutual elderly care in urban communities, exemplified by several prominent models.These models encompass community mutual assistance organizations, "time bank" mutual assistance models, elderly care service organizations, and elderly community universities.

Community Mutual Assistance Organizations for Elderly Care
Chongqing encourages residents to organize mutual assistance groups or communities in the community, where they can jointly address elderly care needs, such as mutual care, shopping assistance, social activities, etc.

Huxi Garden Community in Hugexi Subdistrict of Chongqing's High-tech Zone
This community has deepened the social governance brand of "Mutual Assistance at the Wate's Edge".By strengthening cooperation and concerted governance, this community collectively provides caring and warm homebased elderly care services for residents aged 60 and above.The community informs eligible elderly people through various channels, including community screens, notice boards, grid groups, and phones.In this way, they can make appointments for services.Community staff need to pre-approve these appointments.Upon the successful confirmation of an appointment, community grid members in red vests will deliver "one-to-one" services.

Mutual Assistance Elderly Care Service Model in Jinjia Community of Banan District
The Jinjia Community of Banan District has implemented the mutual assistance elderly care service model through a social worker-driven volunteer team-building program.This program has been implemented to assist a certain number of neighbors in each block [2] .Meanwhile, social workers have established regular training and teambuilding mechanisms to equip volunteers with the requisite service knowledge and skills.Through a monthly supervision mechanism, they can grasp the dynamic situation of volunteer services and have established an incentive mechanism by combining volunteer points redemption mechanisms.

Community Mutual Assistance Brought by "Yi Cang"
The introduction of "Yi Cang" in the Jiulongpo District has created a local brand project that cooperates with the non-profit foundation network supported by the nationally acclaimed social work brand project "Yi Cang".The project's core concept is to borrow the idea of a community-driven mutual assistance system based on Yi Cang culture.Its overarching goal is to cultivate local brand projects.

"Time Bank" Mutual Elderly Care
Guided by the Civil Affairs Bureau of Shapingba District, the Chenjiaqiao Subdistrict has actively introduced thirdparty social work institutions to pioneer and promote the novel model of "Time Bank" mutual elderly care.This initiative is operated and managed by Chongqing AI XIN Social Work Service Center, which has organized a group of home care volunteers.These volunteers offer regular home care, household assistance, companionship, and other services to the elderly, help them address daily difficulties, and provide emotional support and care.The Jiansheng Town JianXin Community in Dadukou District has learned from other excellent elderly community experiences and launched a "Time Bank" specifically serving the homebound elderly aged 80 or above, as well as those aged 60-79 with disabilities or limited mobility.Since its inception, the program has garnered increased participation from elderly residents, receiving favorable feedback However, due to the lack of a unified and universally applicable action plan, operational challenges have emerged, including low participation, insufficient volunteer numbers, single service methods, and incomplete service standards [3] .

Driven by Elderly Care Service Organizations
In Chongqing's Jiulongpo District, a community mutual elderly care public welfare service platform has been established to facilitate the integration of various public welfare services for the elderly, including mutual elderly care, information, and cultural dissemination.Through this platform, residents can publish their elderly care needs, allowing warm-hearted people to proactively offer assistance.This platform enhances the elderly's access to community support and assistance.Notably, this platform has received strong support from the China Social Work Development Foundation.
Chongqing actively promotes resident engagement in mutual elderly care funds.Residents are encouraged to make contributions to establish a mutual fund pool to provide temporary assistance, emergency relief, and other services.In 2019, the Chongqing Charity Foundation introduced the "Community Sunshine Fund", which was jointly initiated and established by China Petroleum and the Chongqing Charity Foundation.This fund primarily serves to aid impoverished people in urban communities and extend support to residents facing temporary or sudden hardships, emphasizing a mutual assistance approach with supplementary aid as necessary.The number and effectiveness of mutual assistance elderly care participants in each central urban area are shown in Table 1, with the more stars, the better the effect.3 Challenges in the Practices of Mutual Elderly Care in Chongqing

Weak Government Support
Firstly, the government's pension policy does not include mutual assistance for the elderly, primarily because the current mutual assistance for the elderly relies predominantly on voluntary principles and is operated by informal organizations.From a macro-management perspective, Chongqing has only conducted some preliminary initiatives focused on mutual support policies for the elderly in rural areas.However, specific policies, regulations, and safeguard and supervision systems for mutual support for the elderly in urban communities have not been formulated yet, such as a strategic development plan, a standardized mutual support mechanism for the elderly, supportive supervisory frameworks, and promotional strategies for mutual assistance among the elderly.In terms of micro-services, the current community-based mutual-aid elderly care is still dominated by the government, which has a competitive relationship with other entities.This competitive relationship has resulted in inadequate management capacity, poor service effectiveness, and a lack of social entities in the operation of community-based mutual-aid elderly care.
Secondly, the development of community mutual assistance for the elderly requires collaborative efforts among the community, the Aging Office, the Civil Affairs Bureau, and other departments.Unfortunately, the current modular approach employed by the government has resulted in the fragmentation of elderly care resources [4] .As a result, the efficiency of integrating and coordinating resources across multiple government departments, such as civil affairs, urban construction, and the disabled federation, is notably low.

Low Social Participation
Community mutual elderly care often relies on increased participation from elderly individuals to enhance their practicality.Currently, the popularity and social awareness of community mutual elderly care in Chongqing are not high.However, in Chongqing, there is currently a lack of widespread popularity and social awareness regarding these initiatives [5] .This lack of awareness is exacerbated by the rapid development of the Internet and the market economy, which has resulted in urban elderly individuals displaying greater independence but weaker ties to their local communities.The traditional moral standard of "neighbors helping neighbors" has waned, and interpersonal connections among residents have cooled.Many elderly people initially express curiosity and enthusiasm for mutual elderly care but gradually lose interest over time, resulting in a shorter duration of community mutual assistance.Moreover, there is a lack of relevant services and living facilities for mutual elderly care in the community, such as barrier-free elderly-friendly facilities, which negatively impacts the enthusiasm of elderly people participating in community mutual elderly care.With the improvement of material living standards and educational levels, contemporary elderly people have not only basic material needs but also psychological wellbeing, including social participation and gaining respect.Consequently, there is a growing demand for diversified services that cater to these evolving needs, which is often insufficient in the current community-based mutual elderly care offerings.
Additionally, the community has not placed sufficient emphasis on mutual elderly care, resulting in many elderly people being unaware of it and not actively participating.Last but not least, traditional beliefs, which emphasize familial or professional institutional care for the elderly, can also discourage some individuals from engaging in mutual elderly care.Concerns about potential disputes and conflicts that may arise during the participation process can further deter elderly individuals or their families from embracing these initiatives.Consequently, due to a combination of these factors, the participation rate in urban mutual elderly care remains relatively low in Chongqing.

Lack of Resources for Urban Community Mutual Elderly Care
Urban community mutual elderly care resources primarily consist of professional service funds and infrastructure construction for the development of urban community mutual elderly care.
Firstly, the current funding source for the operation of the mutual elderly care model in Chongqing's urban areas is relatively single, mostly from government grants.However, government funding is limited, and mutual elderly care has yet to be integrated into the government's budget allocation.There is a lack of government investment in aspects such as organizational design, mutual content design, and personnel management of mutual elderly care in communities.
Secondly, basic facilities for mutual elderly care in urban communities in Chongqing are also inadequate.The city's unique geographical layout, characterized by mountains and urban sprawl, presents challenges such as steep slopes and physical barriers.These geographical factors have resulted in a clear deficit of facilities that would enable elderly individuals to participate in mutual activities within their communities.According to the survey data, 67.98% of the elderly people interviewed believe that the current sports and fitness facilities in their communities are far insufficient to meet their current health and exercise needs.

Lack of Professional Talent
Currently, urban community mutual elderly care primarily relies on the active participation of resident volunteers, including volunteers and caring participants [5] .Most of them are not professional caregivers or domestic helpers, lacking professional knowledge of medicine, sociology, and psychology.Typically, these volunteers receive only basic training and are subsequently engaged in providing care services.Additionally, given the disparities in the age, educational level, and learning ability of volunteers, it is impossible to guarantee the quality of training.Many volunteers lack professional expertise in elderly care nursing and managing emergencies, which can compromise the quality of care provided.Moreover, the existing elderly care service system and operation mechanism contribute to challenges in managing mutual elderly care service personnel such as insufficient regular training and the development of the workforce lagging behind advancements in facility construction.

Inadequate Evaluation and Supervision of Mutual Elderly Care
Currently, in the central urban area of Chongqing, community-based mutual elderly care services are primarily operated by private entities, independently implemented by local communities, and involve voluntary participation from elderly individuals.The municipal government has not established a relatively standardized evaluation mechanism, which hinders the accurate assessment of community mutual elderly care in meeting the elderly's needs for care services and enriching their later years of life.Meanwhile, there is a lack of standardized management and record-keeping procedures for tracking the participation time and specific activities undertaken by elderly individuals and volunteers within the community management processes.Current records typically involve simple table statistics, making it difficult to ensure the standardization of mutual activities.Furthermore, due to aging or illness, elderly people are prone to accidents and dangers during mutual activities, which can lead to disputes and blame among participants, thereby complicating efforts to ensure the standardization and effectiveness of the mutual elderly care process.

Defining Government Responsibilities and Eslishing a Long-term Mechanism
Firstly, the government should prioritize the implementation of the mutual elderly care model in urban communities, promoting its further development in positive ways.This entails integrating mutual elderly care into the entire elderly care service system, defining its positioning and development direction, and improving the relevant policy support system.At the micro level, various relevant government departments, such as community management, the Aging Office, and the Civil Affairs Bureau, should collaborate to establish a comprehensive system for the standards, management, and supervision of mutual elderly care in urban communities.
Secondly, it is imperative to define the government's role, encourage social participation, and diversify the sources of funding.In the early stage of the mutual elderly care development in urban communities, adjustments should be made to the financing structure for elderly care.This can involve offering incentives to attract various social actors to participate and invest, thereby expanding the social footprint of mutual elderly care initiatives and alleviating the financial burden on the government.

Integrating Community Resources and Improving Supporting Facilities
The community serves as both the primary hub for mutual elderly care and a valuable resource integration center.Therefore, it is necessary to properly plan the construction of community elderly care facilities as far as physical facilities are concerned.The construction of these facilities should be integrated into specific public service plans tailored to the actual requirements of the elderly population.Idle land and buildings should be effectively utilized for improvement, to create a community elderly care service center that integrates accommodation, elderly care, entertainment, and healthcare functions.Emphasis should be placed on leveraging digital resources, actively applying big data technology, and establishing an information-based elderly care service platform catering to the individual needs of the elderly.
It is essential to comprehensively promote the government's reform and innovation in the management of the "Internet +" community mutual elderly care industry, actively utilize big data technology, and build an information-based elderly care service platform for elderly people's individual needs to provide precise services.This entails the creation of a software-based care information service platform to address their unique requirements and deliver precise services.This platform should serve as a comprehensive community-based elderly care hub, fostering connections between government, social organizations, and family resources, to achieve connectivity between various elderly care programs and effectively match the demand and supply of elderly care services.

Strengthening Publicity and Enhancing Public Awareness
To align with the genuine needs of local elderly communities, targeted publicity should be undertaken.This approach encompasses the following strategies: Firstly, policy advocacy should be carried out to popularize relevant laws and regulations.Secondly, the cultural education function of "community forum" and "moral forum" should be leveraged to encourage the promotion of correct values.Thematic activities centered around values such as "caring for the elderly" and "respecting the elderly" can be organized to encourage community residents to draw inspiration from virtuous individuals and exemplary deeds, fostering a robust culture of emulation and mutual assistance within the elderly group.Thirdly, to foster a supportive social environment, efforts should be made to cultivate grassroots units that promote mutual elderly care.
Identifying and utilizing the untapped potential of the elderly population allows them to make meaningful contributions during their later years.Enhancing the incentive structure for social entities participating in elderly care services is key to effectively harnessing and mobilizing available social resources.Finally, there is a need to reframe the community's core responsibilities in service to enhance service quality.

Strengthening the Construction of Professional Service Teams and Improving Service Levels
Firstly, it is necessary to strengthen cooperation between government, industry, enterprises, and universities.The government department can take the lead in negotiating and communicating with universities offering majors such as elderly care and management and social work.This collaboration aims to promote mutual elderly care initiatives within urban communities.Attracting highly professional college students to participate in the construction of urban mutual elderly care as part of their social practice projects can create a mutually beneficial partnership between schools and the urban community.
Secondly, the establishment of a comprehensive personnel training system is crucial.This system should include the implementation of a career qualification and technical-level management system.Regular vocational training and skill competitions should be conducted to enhance the service standards and overall quality of professional personnel in the field of elderly care.At the same time, it is vital to create an incentive mechanism for volunteer mutual assistance.Introducing models like the "time bank" compensation incentive model can boost psychological satisfaction and provide material feedback to mutual elderly care volunteers, further motivating their engagement.

Establishing a Diverse Assessment and Supervision System with Society as the Platform
Firstly, it is crucial to clarify the division of responsibilities in mutual elderly care.This involves establishing a diverse assessment system under government leadership, and formulating authoritative evaluation indicators as the basis for supervision.At the same time, drawing on the experience and practices of mutual elderly care at home and abroad, there should be a significant emphasis on supervision and evaluation and subsequent work, and the development of adaptable evaluation mechanisms with a primary focus on elderly satisfaction.
Secondly, it is necessary to build a diversified evaluation system, allowing government departments such as civil affairs and finance to play a leading role in the evaluation process while involving various participants in mutual elderly care and third-party professional evaluation institutions.Furthermore, it is necessary to further improve and standardize the formulation of evaluation indicators.The main focus is on evaluating relevant policies implemented, including quantitative indicators such as government and social investment in mutual elderly care, the number of participants, and the length of mutual assistance time.Additionally, evaluation criteria should address community management ability, the content, and quality of services provided by mutual assistance parties for elderly people, elderly satisfaction, and publicity effectiveness.

Conclusion
Some practices and innovations in urban mutual assistance elderly care in Chongqing have provided beneficial exploration for actively addressing the issue of aging, but there are still problems such as incomplete urban community mutual assistance elderly care system, poor management and supervision, low social participation, and resource scarcity.It is recommended that the government establish a long-term mechanism, integrate community resources, improve supporting facilities, strengthen public opinion promotion, and establish a diversified evaluation and supervision system to promote the sustainable and healthy promotion of the mutual aid elderly care model in the central urban area of Chongqing.

Table 1
Participation scale of mutual aid elderly care model in the central urban area of Chongqing