目標:了解社區失能老人居住安排及日常生活活動協助未滿足需求現況及影響因素。方法:從「建構長期照護體系先導計畫」實驗社區後測調查,選取1,616位65歲以上日常活動失能老人為樣本,調查其居住安排及基本日常生活活動、行動及工具性日常生活活動未滿足需求,以邏輯斯迴歸檢驗未滿足需求影響因素。結果:具任一項基本日常生活活動、行動及工具性日常生活活動未滿足需求的比率為10.8%、22.6%及8.0%;獨居老人身體功能較佳但未滿足需求較高,行動及工具性日常生活活動未滿足需求以無偶及有使用社區式服務者較高。控制其他變項後發現,居住安排為一重要影響未滿足需求之因素;較之與子女或他人同住,獨居者之未滿足需求勝算比達3-5倍之多。結論:居住安排為影響失能老人未滿足需求重要因素,獨居老人為未滿足需求高危險群,政策應加強社區服務資源以滿足失能老人日常生活活動協助需求。
Objectives: This study aims to examine the relationship between living arrangement and unmet needs of assistance in BADL (Basic Activities of Daily Living), Mobility and IADL (Instrumental Activities of Daily Living), and to identify factors associated with unmet needs. Methods: Data came from post test survey of the ”Pilot Program for the Development of Long Term Care System”. A total of 1,616 community-dwelling elders who required assistance in at least one item of ADL or IADL were included. Subjects were interviewed by constructed questionnaire for their ADL and IADL assisted needs and unmet needs. Results: The prevalence of unmet needs among elderly in the community was 10.8%, 22.6% and 8.0% on BADL, Mobility and IADL assistance, respectively. Elderly who lived alone were the most vulnerable group on unmet needs, although their functional performances were better than lived with spouse or others. Results of logistic regression analyses indicated that living arrangement was a significant predictor of unmet needs on BADL, Mobility and IADL assistance (reference to live with others, OR=2.74, 5.98, 3.46). In addition, age, education and number of disability were associated with BADL unmet needs. Conclusions: Living arrangement plays an important role in unmet needs of assistance in daily living. Disable elderly live alone are found as at high risk of unmet needs, especially on mobility. Policy maker should pay attention to unmet needs of the most vulnerable group of disabled elderly, aiming at keeping them in the community as long as possible.