建構「高齡友善城市」：從活躍老化到在地老化的重要課題－以社區照顧關懷據點為例

Construction of Aging-friendly City: The Important Issue of "Active Aging" to "Aging in place"-Beginning from Solving the Problems of the Community Care Station

郭登聰(Teng-Tsung Kuo)

《輔仁社會研究》 4期 (2014/01) Pp. 1-42

摘要

近年來少子化及老化的議題已成為國家發展及社會福利的重要課題，尤其是老化的現象及延伸的各類問題。如何營造老人良好的生活空間和照顧環境，使老人得以安養天年，更是考驗著國內相關對策的能力及條件。對於高齡者的照顧，在2007年，WHO已開始推動建構高齡友善城市，而其重要的工作即是讓老人得以享有活躍老化的核心價值，並能夠得到舒適的生活環境，進而到在地老化的境界。對此國內除了原有的台灣健康社區六星計畫即以社區照顧關懷據點做為主要的推動方案之外，2009年通過的老人福利法也強調老人福利服務需要重視全人照顧、在地老化及多元連續服務原則。當年度行政院核定「友善關懷老人服務方案」，以「活躍老化」、「友善老人」、「世代融合」為三大主軸。由此顯示政府對於如何讓老人得以安享高齡並生活在友善環境且得到充分照顧的用心和努力。然對於真實情境的發展卻未必如此樂觀和完善。尤其是以老人能否享有在地老化的各種條件和資源欠缺妥善的規劃及完整照顧方案的執行，特別是以政府現正推動的老人社區照顧關懷據點更充斥各種問題和困境。如此又何以讓老人得以在社區實現在地老化的可能，顯見整體友善環境的配合因素和條件是欠缺和不紮實。本文目的即在探討面對高齡社會如何打造高齡友善城市做為其生活居住環境的必然趨勢，同時如何落實高齡友善城市的核心價值，也就是從活躍老化開始到在地老化的實現。老人在地老化的課題則觸動現行各項政策及各種社會資源的有效彙整和發揮，另民間非營利組織或現行社區組織將如何扮演積極的角色及有效的功能則將成為高齡者在地老化的重要考驗和挑戰。讓老人安享晚年有賴於整體社會的友善環境和空間的創造，而落實老人的在地老化更寄望於整體照顧政策及相關方案的體現，再配合社會資源的充分發揮才得以完成。反之高齡者的在地老化將會是一種遐想與迷思。

關鍵字

活躍老化 ； 在地老化 ； 社區照顧關懷據點 ； 高齡友善城市 ； 健康城市

並列摘要

In recent years, low birth rate and aging issues have become the important issues of national development and social welfare, especially the phenomenon of aging and its various extended problems. How to create a good living space and environment for elders is a challenge for governmental policies. In 2007, aging-friendly city was promoted by WHO, which was to create active aging, to let the elderly live in a comfortable environment, and to achieve the goal of aging in place. At the same time, the domestic government has had Taiwan Healthy Community Six Stars Program for caring the elderly, which provide the community care station as the main point. In 2009, the Executive Yuan passed the ”Senior Citizens Welfare Act” which emphasizes on holistic care, aging in place and multiple principles of continuous service. Meanwhile, it also passed the ”Friendly Care Services for the Elderly Program” with three main key points: Active Aging, Friendly Aging, and Generation Fusion. It demonstrated how the government makes an effort on better environment for the elderly. However, the reality is not quite optimistic due to lots of conditions and resources that cannot integrate well, especially on ”The Community Care Station” program. The purpose of this article is to confirm the importance and necessity of the Aging-friendly City in Taiwan, and how to implement the core values of aging-friendly city that begins with active aging to aging in place. Aging in place needs a lot of resources and collaborative conditions, but whether it can adequately achieve this objective will depend on the effectiveness of the community care station. Otherwise, the aging in place will be an illusion.

並列關鍵字

Active Aging ； Aging in Place ； the Community Care Station ； Aging-friendly City ； Healthy Cities