研究背景：随着我国社会经济发展，人口平均寿命的不断增加，老龄化问题日益严重。与癌症、艾滋病并称为“世界最可怕的三大疾病之一”的认知症的人数也在急剧增加，中国目前已成为全世界认知症老人数量最多的国家。由于我国人口结构的变化，认知症的照护问题已成为社会焦点和难点。伴随着认知症照护需求的增加，越来越多的认知症照护型老年公寓在养老市场上崭露头角，但由于认知症的照护工作繁重、照护周期长、照护专业度要求高，并且国内对于认知症照护和机构运营经验的欠缺，认知症照护型老年公寓的服务质量问题的尚面临很多未知。因此，本文的研究问题是：当前我国认知症照护型老年公寓的服务质量现状如何？认知症照护型老年公寓服务质量的问题产生的原因有哪些？

研究方法：本文以北京市四家认知症照护型老年公寓为研究对象，采用随机抽样方式选取208位符合要求的认知症老人及家属填写调查问卷进行满意度测评，了解各测评维度的分布与差距。为了更真实的更深入了解照护服务质量需求和评价，本研究进一步采用目的抽样方式选取了5位老人、5位家属、10位老年公寓工作人员，按照“结构-过程-结果”（Structure-Process-Outcomes Model）模型中对服务结构和服务过程的评价流程与服务供需双方加以深度访谈，详细了解当前认知症照护型老年公寓在服务结构设计和服务提供过程中存在的问题及其产生的原因。

研究结果：认知症照护型老年公寓的服务质量存在诸多问题：环境设施难以适应、老人对员工素质和服务水平接受度低、康复服务没有效果、参与文化娱乐活动的积极性差、心理精神慰藉服务缺失、对服务过程沟通交流方式敏感排斥、身体和认知恢复情况欠佳，剖析出设施内部装饰有待完善、团队培训和建设不到位、服务理念落后不够人性化、服务内容单一、服务特色欠缺等原因。

研究结论：当前老年公寓提供的服务主要适用于普通老年人，对于照护难度较高的认知症老人来说，当前的服务质量现状不足以满足这一特殊群体的需求。他们受疾病的影响比普通的老年人敏感、脆弱、自卑、孤独，情绪变化无常，需要更专业、有针对性和个性化的照料服务，在服务质量的提升方面需要充分考虑认知症老人的需求和特殊性，实现“以人为中心”。

对策建议：根据研究结果，本研究分别从服务结构和服务过程层面提出了一些对策建议，认知症照护型老年公寓在结构设层面需要充分考虑认知症老人需求打造内部环境、建设专业人才队伍以塑造良好服务形象，在服务提供过程中坚持“以人为中心”的照护理念、努力丰富精神文化层面的相关服务内容、引入非药物照护疗法强化服务特色等。通过对服务各层面的综合提升，最终实现服务结果即服务质量的提升。

Background With the development of China's social economy, the average life expectancy of the population continue increasing, and the aging problem is becoming increasingly serious. Along with cancer and AIDS, the number of Dementia, which is called ‘one of the three most terrible diseases in the world’, is also increasing sharply. China now has the largest number of elderly people with Dementia in the world. Due to the change of population structure in China, the care of cognitive syndrome has become a social focus and difficulty. Along with the growing demand for the Dementia care, more and more type of cognitive disorder care elderly apartment in the pension market, work hard, but as a result of Dementia care, long cycle, high care professional degree requirements, and the domestic for cognitive disorder the lack of care and institutions operating experience, Dementia care of elderly apartment service quality problem is still facing a lot of unknown. Therefore, the research question of this paper is: what is the current situation of the service quality of the cognitive care apartment for the elderly in China? What are the reasons for the service quality problems in the apartments for the elderly with cognitive syndrome care?

Methods Taking four Dementia care apartments for the elderly in Beijing as the research object, this paper selects 208 cognitive elderly people and their families who meet the requirements to fill in the questionnaire for satisfaction evaluation by random sampling, to understand the distribution and gap of each evaluation dimension. In order to have a more authentic and in-depth understanding of the needs and evaluation of the quality of care services, this study further selected 5 elderly people, 5 family members and 10 elderly apartment workers by the method of targeted sampling. According to the Structure-Process-Outcomes Model, the evaluation process of service structure and service process as well as the service supply and demand parties are interviewed in depth, so as to understand in detail the problems existing in the service structure design and service provision process of the cognitive-symptom care-oriented apartment for the elderly and the causes thereof.

Results There are many problems in the service quality of the Dementia care apartment for the elderly: It is difficult to adapt to the environment and facilities, the elderly have a low acceptance of staff quality and service level, no effect of rehabilitation services, poor enthusiasm to participate in cultural and entertainment activities, lack of psychological and spiritual comfort services, sensitivity to and rejection of communication methods in the service process, poor physical and cognitive recovery. Analyzed the reasons of the facility interior decoration to be improved, the team training and construction is not in place, the service concept is backward and not humanized, the service content is single, the service characteristics are lacking, etc.

Conclusions The current services provided by the apartment for the elderly are mainly suitable for the ordinary elderly. For the elderly with Dementia who are difficult to care for, the current service quality is not enough to meet the needs of this special group. They affected by illness than normal old people sensitive, fragile, inferiority, loneliness, mood changes, need more professional, targeted and personalized care services, should fully consider the cognitive disorder old man needs and particularity of humanistic concern, in terms of quality of service promotion needs taking into full consideration the needs of cognitive disorder man and particularity, the realization of ‘Person-centered’.

Advice According to the results of the study, some countermeasures and suggestions were put forward from the level of service structure and service process. At the level of structure design, the needs of the elderly with cognitive syndrome care should be fully considered to create an internal environment and build a team of professional personnel to create a good service image. In the process of service provision, we should adhere to the concept of ‘Person-centered’ care, strive to enrich the relevant service contents at the spiritual and cultural level, and introduce non-drug care therapy to strengthen the service characteristics. Through the comprehensive improvement of all levels of service, the final result of service is the improvement of service quality.