2016年06月四级第1套长篇阅读匹配原文翻译及答案

A) When your elderly relative needs to enter some sort of long-term care facility — a moment few parents or children approach without fear — what you would like is to have everything made clear.

当你年迈的亲戚需要进入某种长期护理机构时——这是一个父母或孩子都难免感到恐惧的时刻——你所希望的是一切都得以明确。

B) Does assisted living really mark a great improvement over a nursing home, or has the industry simply hired better interior designers? Are nursing homes as bad as people fear, or is that an out-moded stereotype (固定看法)? Can doing one's homework really steer families to the best places? It is genuinely hard to know.

辅助生活设施是否真的比护理院有重大改进，还是该行业只是聘请了更好的室内设计师？护理院是否如人们所担心的那样糟糕，还是那是一种过时的固定看法？做足功课真的能引导家庭找到最佳场所吗？这确实很难知道。

C) I am about to make things more complicated by suggesting that what kind of facility an older person lives in may matter less than we have assumed. And that the characteristics adult children look for when they begin the search are not necessarily the things that make a difference to the people who are going to move in. I am not talking about the quality of care, let me hastily add. Nobody flourishes in a gloomy environment with irresponsible staff and a poor safety record. But an accumulating body of research indicates that some distinctions between one type of elder care and another have little real bearing on how well residents do.

我将使事情更加复杂化，因为我建议老年人居住的设施类型可能不如我们假设的那样重要。而且，成年子女在开始寻找时所关注的特点，未必是对即将入住者真正重要的方面。让我赶紧补充，我指的不是护理质量。在阴暗的环境、不负责任的员工和糟糕的安全记录中，没有人能茁壮成长。但越来越多的研究表明，不同类型的老人护理之间的某些区别对居住者的实际表现影响甚微。

D) The most recent of these studies, published in The journal of Applied Gerontology, surveyed 150 Connecticut residents of assisted living, nursing homes and smaller residential care homes (known in some states as board and care homes or adult care homes). Researchers from the University of Connecticut Health Center asked the residents a large number of questions about their quality of life, emotional well-being and social interaction, as well as about the quality of the facilities.

最近发表在《应用老年学杂志》上的一项研究，调查了150名居住在康涅狄格州的辅助生活设施、护理院和较小的居住护理之家（在某些州称为寄宿护理之家或成人护理之家）的居民。康涅狄格大学健康中心的研究人员询问了居民大量关于生活质量、情感健康、社会互动以及设施质量的问题。

E) "We thought we would see differences based on the housing types," said the lead author of the study, Julie Robison, an associate professor of medicine at the university. A reasonable assumption—don't families struggle to avoid nursing homes and suffer real guilt if they can't?

“我们原以为会看到基于住房类型的差异，”该研究的主要作者、大学医学副教授朱莉·罗比森说。这是一个合理的假设——难道家庭不是努力避免护理院，并在无法避免时深感内疚吗？

F) In the initial results, assisted living residents did paint the most positive picture. They were less likely to report symptoms of depression than those in the other facilities, for instance, and less likely to be bored or lonely. They scored higher on social interaction.

在初步结果中，辅助生活设施的居民确实描绘了最积极的画面。例如，他们比其他设施的居民更少报告抑郁症状，更少感到无聊或孤独。他们在社会互动方面的得分更高。

G) But when the researchers plugged in a number of other variables, such differences disappeared. It is not the housing type, they found, that creates differences in residents' responses. "It is the characteristics of the specific environment they are in, combined with their own personal characteristics—how healthy they feel they are, their age and marital status," Dr. Robison explained. Whether residents felt involved in the decision to move and how long they had lived there also proved significant.

但当研究人员纳入其他多个变量时，这些差异消失了。他们发现，并非住房类型导致了居民反应的差异。“是他们所处特定环境的特点，结合他们自身的个人特征——他们感觉自己有多健康、年龄和婚姻状况，”罗比森博士解释道。居民是否感觉参与了搬迁决定以及居住时间的长短也被证明是重要的。

H) An elderly person who describes herself as in poor health, therefore, might be no less depressed in assisted living (even if her children preferred it) than in a nursing home. A person who had input into where he would move and has had time to adapt to it might do as well in a nursing home as in a small residential care home, other factors being equal. It is an interaction between the person and the place, not the sort of place in itself, that leads to better or worse experiences. "You can't just say, 'Let's put this person in a residential care home instead of a nursing home—she will be much better off,'" Dr. Robison said. What matters, she added, "is a combination of what people bring in with them, and what they find there."

因此，一位自称健康状况不佳的老年人，在辅助生活设施中可能并不比在护理院中更少抑郁（即使她的子女更倾向于辅助生活设施）。一个对搬迁地点有发言权并有时间适应的人，在护理院中的表现可能和在小型居住护理之家一样好，其他因素相同。是人与地点的互动，而非地点类型本身，导致了更好的或更差的体验。“你不能只是说，‘让我们把这个人安置在居住护理之家而不是护理院——她会好得多，’”罗比森博士说。她补充说，重要的是“人们自身带入的因素与他们在那里的发现相结合。”

I) Such findings, which run counter to common sense, have surfaced before. In a multi-state study of assisted living, for instance, University of North Carolina researchers found that a host of variables—the facility's type, size or age; whether a chain owned it; how attractive the neighborhood was—had no significant relationship to how the residents fared in terms of illness, mental decline, hospitalizations or mortality. What mattered most was the residents' physical health and mental status. What people were like when they came in had greater consequence than what happened once they were there.

这类与常识相悖的发现之前也出现过。例如，在一项对辅助生活设施的多州研究中，北卡罗来纳大学的研究人员发现，一系列变量——设施的类型、规模或年龄；是否为连锁所有；社区的吸引力——与居民在疾病、智力衰退、住院或死亡率方面的表现没有显著关系。最重要的是居民的身体健康和心理状况。人们入住时的状态比入住后发生的事情影响更大。

J) As I was considering all this, a press release from a respected research firm crossed my desk, announcing that the five-star rating system that Medicare developed in 2008 to help families compare nursing home quality also has little relationship to how satisfied its residents or their family members are. As a matter of fact, consumers expressed higher satisfaction with the one-star facilities, the lowest rated, than with the five-star ones.(More on this study and the star ratings will appear in a subsequent post.)

正当我考虑这一切时，一份来自受人尊敬的研究公司的新闻发布稿传到我桌上，宣布医疗保险在2008年开发的五星评级系统旨在帮助家庭比较护理院质量，但与居民或其家庭成员的满意度关系不大。事实上，消费者对一星设施（最低评级）的满意度高于五星设施。（关于这项研究和星级评级的更多内容将在后续文章中出现。）

K) Before we collectively tear our hair out—how are we supposed to find our way in a landscape this confusing?—here is a thought from Dr. Philip Sloane, a geriatrician (老年病学专家) at the University of North Carolina:"In a way, that could be liberating for families."

在我们集体抓狂之前——在如此令人困惑的境况中我们该如何找到方向？——这里有一个来自北卡罗来纳大学老年病学专家菲利普·斯隆博士的想法：“在某种程度上，这对家庭来说可能是一种解脱。”

L) Of course, sons and daughters want to visit the facilities, talk to the administrators and residents and other families, and do everything possible to fulfill their duties. But perhaps they don't have to turn themselves into private investigators or Congressional subcommittees. "Families can look a bit more for where the residents are going to be happy," Dr. Sloane said. And involving the future resident in the process can be very important.

当然，子女们希望参观设施、与管理人员、居民和其他家庭交谈，并尽一切可能履行他们的职责。但也许他们不必把自己变成私家侦探或国会小组委员会。“家庭可以更关注居民在哪里会快乐，”斯隆博士说。并且让未来的居民参与这个过程可能非常重要。

M) We all have our own ideas about what would bring our parents happiness. They have their ideas, too. A friend recently took her mother to visit an expensive assisted living/nursing home near my town. I have seen this place—it is elegant, inside and out. But nobody greeted the daughter and mother when they arrived, though the visit had been planned; nobody introduced them to the other residents. When they had lunch in the dining room, they sat alone at a table.

我们都有关于什么能给父母带来快乐的想法。他们也有自己的想法。一位朋友最近带她的母亲参观了我镇附近一家昂贵的辅助生活/护理院。我见过这个地方——它里里外外都很优雅。但当他们到达时，尽管访问已经安排好，没有人迎接女儿和母亲；没有人把他们介绍给其他居民。当他们在餐厅吃午饭时，他们独自坐在一张桌子旁。

N) The daughter feared her mother would be ignored there, and so she decided to move her into a more welcoming facility. Based on what is emerging from some of this research, that might have been as rational a way as any to reach a decision.

女儿担心她的母亲在那里会被忽视，因此她决定把她搬到一个更受欢迎的设施。根据一些研究的新发现，这可能是一种同样合理的决策方式。