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長期照顧之生活功能自立訓練

Reablement Training in Long Term Care

摘要


過去長期照顧往往是聚焦失能者之缺損,以殘補代勞式服務,投入大量資源去「照顧」失能者及其家庭,其結果造成服務需求隨著高齡和失能趨勢而不斷擴充,國家社會的負荷、失能者及其家庭的依賴日益嚴重。近年長照新趨勢轉向注重功能復原,善用個案的優勢能力來取代對照顧者的依賴,生活自立功能訓練便是在此新觀念發展出的新形態長照服務模式。由北歐啟動,在歐洲各國紮根並發揚光大,生活自立功能訓練是以個案自訂的生活目標為長照服務目標,由職能治療師、物理治療師或護理跨領域專業人員加上照顧人員一起協助並支持個案,幫助個案達成生活目標改善的結果。本文旨在介紹北歐發展生活自立功能訓練的經驗,並引述國內類似的照顧模式,期盼有意願共同發展生活自立功能訓練的專業、學者及政府部門,投入共同發展之列,扭轉長照服務的典範。

關鍵字

生活自立 北歐經驗

並列摘要


In the past, long term care often focuses on disability and invests lots of resources to take care the individual. With the growth of older and disabled population, this approach has led to the increase of national and societal resources as well as the dependence of the disabled persons and their families. The new trend in long term care has shifted to focus on functional recovery and utilizing the strengths of the individual instead of relying on care. Reablement has been developed as a new care model starting from the Nordic countries and wide spreading in Europe under this trend. Reablement aims on the personal life goals defined by the individual as the goals of long term care services. Occupational therapists, physical therapists or nursing professionals of the interdisciplinary team and caregivers help and support the case in achieving those goals. The purpose of this paper is to introduce the experience of development of reablement in the Nordic countries and the similar domestic care models. It is expected that some professionals, scholars and government sectors can jointly establish the Taiwanese reablement services and shift the long term care paradigm.

參考文獻


Hasselkus, B. R., Dickie, V. A., & Gregory, C. (1997). Geriatric occupational therapy: The uncertain ideology of long-term care. Аmerican Journal of Ocсиpational Theraру, 51, 132-139. doi:10.5014/ajot.51.2.132
Lund, A., Michelet, M., Kjeken, I., Wyller, T. B., & Sveen, U. (2011). Development of a person-centred lifestyle intervention for older adults following a stroke or transient ischaemic attack. Scandinavian Journal of Оссираtional Therapy. Early Online, 1-10. doi:10.3109/11038128.2011.603353
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Langeland, E. (2014, October). Rehabilitation of everyday function in community-dwelling adults (Hverdagsrehabilitering). An intervention Study. Paper presented at the CHARM National conference 2014: Trends in Rehabilitation Services Research, Oslo, Norway.
Tuntland, H. (2015 # 8 A). The design and system of Reablement. 於「長期照顧生活功能訓練-北歐與臺灣的對話」發表之演講 ,新北:輔仁大學醫學院國璽樓。

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