社區組織參與老人預防照顧體系之社區治理分析

Community Organizations Participating in Preventive Elderly Care System: An Analysis of the Community Governance Perspective

蕭文高(Wen-Kao Hsiao)

《臺大社會工作學刊》 40期 (2019/12) Pp. 131-166

https://doi.org/10.6171/ntuswr.201912_(40).0004

摘要

為滿足民眾照顧需求，協助長者在地老化，政府逐步補助社區組織提供老人照顧服務，此不僅改變公私部門互動模式，亦影響社區之永續發展。因此，本研究目的在整理運用社區治理觀點，瞭解社區發展協會參與老人預防照顧面臨之挑戰，進而提出實務性建議。經彙整相關文獻後，本文分析社區組織在老人預防照顧體系之角色及組織特性，統整社區治理理論分析架構，歸納出長照2.0計畫建立照顧型社區目標面臨下列挑戰：（1）政府在政策量化績效與尊重社區自主性間產生社區主義價值抉擇兩難；（2）社區組織所獲支援不足，承擔過高照顧風險；（3）為確立服務品質與責信之管控機制，造成志工服務疏離感；（4）社區組織經歷政治力干擾、志工人力老化，以及服務排他性等失靈危機。基於前述發現，本研究建議公部門應提供社區組織足夠支持及影響評量訊息，改革績效管考機制，委託辦理專業督導計畫，並協調社區所需空間與服務支援，以增進計畫成效。

關鍵字

社區組織 ； 社區治理 ； 照顧服務

並列摘要

In order to satisfy citizens' care needs and help older people to age in place, the government gradually subsidized community organizations to delivery care services for older adults. Within this system, there have been significant changes in the public-private sector interaction and effects on community-based sustainable development. Therefore, this study aimed to examine community governance perspectives, analyze challenges of community development associations participating in preventive elderly care, and outline some practical implications and suggestions. Through a literature review, this article discusses the roles and characteristics of community organizations in the preventive elderly care system and explores four challenges of Long Term Care Plan 2.0 (LTCP2) with the objective of building a caring community: (1) Government is facing the communitarian dilemma between seeking quantitative policy performance and respecting community autonomy; (2) Community organizations are bearing the risk in caregiving because of insufficient support; (3) Mechanisms of quality control and accountability increase volunteers' service alienation; (4) Failures of community organizations occur during political disturbance, aging volunteers, and community exclusion. Based on the research findings and for the purpose of enhancing the effectiveness of LTCP2, this paper suggests that the government should provide sufficient support and impact assessment information for community organizations, improve management mechanisms, contract out professional supervision program, and arrange space and service support for communities.

並列關鍵字

community organizations ； community governance ； care services

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