互助性养老服务的现实困境、结构缺陷与发展反思OACHSSCD

Against the backdrop of rapidly accelerating population aging,low fertility rates and large-scale population mobility in China,the supply-demand imbalance of elderly care services in rural areas has become increasingly prominent.Characterized by low costs and localized operation,mutual-aided elderly care is regarded by policymakers and academia as a vital solution to rural elderly care dilemmas.Relevant pilot programs have been carried out for more than a decade,yet large-scale and sustainable expansion remains elusive,with most projects merely developed as"ornamental demonstration spots".Existing research and policies tend to idealize this model while overlooking its inherent structural flaws and the transformations of its social foundations.Based on the essential logic of mutual aid behavior,this paper systematically defines the conceptual scope and institutional positioning of mutual-aided elderly care,sorts out its policy evolution and shifts in social foundations,analyzes its inherent structural defects and practical predicaments,and clarifies its proper place within the elderly care service system,so as to offer theoretical references for policy optimization and standardized practice. By exploring the core attributes of mutual aid,this paper identifies four key features:equality,two-way reciprocity,voluntary informality,and low-cost public welfare.It distinguishes mutual aid from charity and volunteer services,and defines mutual-aided elderly care as a service model mainly participated by the elderly.Exchanging non-monetary resources such as time,skills and emotional experience through intergenerational or peer reciprocity mechanisms,the model provides accessible daily care and spiritual comfort for seniors.It is further divided into scattered spontaneous type and centralized organized type according to the degree of institutionalization. Historically,closed acquaintance communities,long-term reciprocal expectations and individuals'heavy reliance on communities laid the groundwork for mutual aid in traditional rural societies.However,modernization has systematically eroded such foundations through the establishment of social security systems,massive population migration,the deteriorating demographic structure of rural seniors,and the penetration of market logic.China's policies on mutual-aided elderly care have gone through three phases:conceptual proposal and initial exploration,model promotion and full-scale piloting,and systematic arrangement and standardized development.A stark contrast exists between vigorous policy advocacy and sluggish practical popularization;most centralized pilot projects have deviated from the core logic of mutual aid due to institutionalized operational alienation. This study identifies four innate structural defects of mutual-aided elderly care.First,the irreversible physical decline of the elderly breaks the balance of two-way reciprocity,creating an asymmetry between rights and responsibilities that undermines long-term sustainability.Second,its intermittent and informal supply fundamentally clashes with the demand for consistent,stable elderly care,failing to serve the core groups of disabled and semi-disabled seniors.Third,modernization has dismantled the social prerequisites for mutual aid,making it impossible to simply replicate traditional mutual-aid culture in contemporary society.Fourth,its operational logic inherently conflicts with the pillars of the modern elderly care system,disqualifying it as a primary strategy to cope with population aging.Practically,the model also confronts tangible challenges including insufficient participation incentives,formalism in policy implementation,distorted operation modes,and poor adaptability between urban and rural contexts. Based on the above analysis,this paper confirms that mutual-aided elderly care only serves as an auxiliary supplement within China's elderly care system and a component of social elderly services.Its functions should be strictly limited to basic services such as emergency assistance and emotional companionship for self-care elderly,with differentiated implementation tailored to local conditions.The research suggests abandoning idealized perceptions and campaign-style promotion of mutual-aided elderly care,guiding it back to its original form of neighborhood mutual assistance.Meanwhile,a multi-stakeholder collaborative modern elderly care system should be constructed to consolidate the institutional foundation of rural elderly security.