台灣社區式老人照顧的解構與再建構

Deconstruct and Reconstruct the Community-Based Care for Elders in Taiwan

李人杰(Jen-Chieh Lee)

指導教授 ： 陳武宗

高雄醫學大學/健康科學院/醫學社會學與社會工作學研究所/碩士(2008年)

https://doi.org/10.6832/KMU.2008.00115

摘要

我國老年人口比例在1993年超過7%，昔日偏重於機構式的老人照顧措施，負擔壓力將隨人口日益老化而加重，長期照顧體系的發展更顯重要。順應西方先進國家「去機構化」思潮後，台灣於1993年底引進自英國發展的社區照顧，並結合社區發展的基礎，以及九二一地震後民間投入的力量，演變為台灣今日的社區式照顧風貌。
研究者運用歷史比較，以及深度訪談社區工作者等方法，解構與再建構現行的社區式照顧方案，藉比對台灣社區式照顧方案與英國原先的社區照顧概念，以突顯台灣現有服務的特點。同時亦探討這些服務是否有助服務使用者實現在地老化，以作為長照體系在概念演進與實務方案兩方面未來發展之參考。
研究發現台灣的社區式照顧採用方案模式，以社區組織為服務輸送平台與服務承擔者。實務工作者原則上支持該策略，認為「在地人服務在地長輩」是正確方向，方案也朝實踐「在地老化」理念前進。針對尚待解決的困境，研究者提出社區式照顧的再建構，以新承載模組結合在地組織與社福專業組織的能量，加上相關配套建議，期待能朝長者在地老化的理想更邁進一步。

關鍵字

社區式照顧 ； 社區照顧 ； 社區日托

並列摘要

Taiwan's ratio of elderly population was more than 7% in 1993. With the dependent needs of elderly increased, follow by rapidly societal change, the burden of original institution-based care was getting heavier than ever. To reform the long-term care system in order to fulfill the needs of society is growing importance.

There were three historical turning points of reform to urge elderly care system changed from institution-based to “aging in place”. They are the impact of “deinstitutionalization” movement imported from United Kingdom at the end of 1993, the foundation of community development practices for last three decades, and the drastically community reform experience from earthquake “Sep. 21”. Taiwan’s specific style of community-based care for elderly was emergence.

Researcher conducted qualitative data triangulation by using historical and comparative analysis of literature and programs, combined with in-depth interviews on 6 managers of community-based care program to answer the proposed aims of this research including a. to explore the specific characteristics of community elder care in Taiwan, b. to verify if such characteristics match with the ideal of “aging in place”, and c. to offer suggestions for better elderly care program reform.

The finding indicated that Taiwan has no long-term official plan for community-based elderly care. By carrying out the projects, the community organizations play the platform of delivering service was recognized by those managers. They agreed that "Local citizens serviced to local elders" is a right strategy, and the implementation of the project is also in the practice of "Aging in place" concept forward. In order to resolve some difficulties, the researcher proposes to re-construct Taiwan's community-based care for the elderly by a new load module and some relevant supporting proposals.

並列關鍵字

community-based care ； community care ； community day-care

參考文獻

吳淑瓊、莊坤洋（2001）。在地老化：台灣二十一世紀長期照護的政策方向。臺灣公共衛生雜誌，20(3)，192-201。

陳世明、陳柏宗（2006）。社區組織參與老人社區照顧之研究：以臺南市長榮社區為例。社會政策與社會工作學刊，10(1)，49-113。

一、中文部分：

內政部（1991）。社區發展工作綱要。

內政部（1996）。推動社會福利社區化實施要點。