從大台北地區三家失智老人專門照顧機構之現況調查探討失智老人群體生活照顧單元理念之居住場所設計

Study on the Design of Dwelling Originated from the Concept of Group Living Care Unit of the Elderly Who Suffers from Dementia on Basis of Field Survey of Three Specialized Care Facilities for the Elderly of Dementia in Taipei Metropolis

尹聖道(Sheng-tao Yin)

指導教授 ： 陳政雄

中原大學/設計學院/建築研究所/碩士(2005年)

https://doi.org/10.6840/cycu200500703

摘要

【摘要】

本研究以本土性研究之角度出發，對台灣實行「單元照顧」理念之具體做法，以實務設計之操作過程，企圖從現況環境及失智者行為模式的瞭解中，探討群體生活照顧單元理念，運用於失智老人照顧機構空間改造之設計操作，且期望從整體設計論文之研究過程，達到下列各項研究目的：
(一)瞭解受調失智老人專門照顧機構，環境設施現況於軟、硬體層面之相關課題。
(二)從失智老人於機構中各項行為模式，討論有關群體生活照顧單元理念各項設計原則。
(三)以群體生活照顧單元理念之各項原則，進行實務之設計操作，並從中瞭解實際環境與理論施行之各項限制及條件。

本研究以文獻回顧法、觀察法、問卷調查法、訪談法、詮釋法等相關研究方法之運用，提出相關研究成果。

研究成果除呈現以群體生活照顧單元理念，進行設計操作之實際方案外，並提出相關結論與建議：

一、於環境設施上之相關課題

1.既有空間容量與收案人數，使個室化之寢室空間安排受限；2.護理站之設置方式，難以形成家庭般之場所氣氛；3.懷舊的意義是在於強調過去之生活經驗；4.機構之服務範圍應具有在地性，且能與社區進行良好之互動。

二、失智老人照顧專區內行為場景特徵

1.機構內失智者以自由行為發生之比例最高2.問題行為之發生與持續，和照顧者之處理態度有關；3.家屬及親友來訪，會增加失智住民間之互動；4. 失智者間之交談以小團體之型態展現；5.貼身的照顧行為，會增加照顧者與失智者間之互動；6.行為場景雖受半固定物件之支持，但交談行為則由非固定物件引發；7. 中央交誼及用餐空間行為發生比例最高；8.照顧服務員之移動區位分佈於該樓層全區。

三、既有建築群體生活照顧單元環境規劃策略建議

1.小規模之空間區劃；2.明確的空間層次；3.具有彈性的空間規劃；4顧及隱私的寢室空間；5.家庭化之家具擺設；6.無障礙環境之設置；7.引導及維持失智者發揮個人的價值及能力；8.以失智者需求為導向之照顧環境；9.隨者住民病況惡化，有良好的轉介體系；10.持續不斷改善的積極態度。

關鍵字

失智症 ； 群體生活照顧單元 ； 生活重心及生活據點 ； 治療性環境 ； 失智老人專門照顧機構

並列摘要

【 Abstract】
In this research, we try to discuss the idea of group health care unit based on practical design and operation as well as understanding of current environment and behavior of senile patients, from the viewpoint of localized research and the mode of unit care implemented in Taiwan. We try to apply these ideas in the architecture of health care center for dementia patients and list the following items as goals of this research:
(1) Understand the requirement of senile dementia patients’ health care center, its environment, facilities, hardware, and software.
(2) Discuss the design principles from the behaviors of dementia patients.
(3) Put the design principles of group health care unit into practical operation and find out the limitations and conditions.
We adopt the methods of literature review, observation, questionnaire, interview, and annotation in this research.

The result shows the concept of group health care unit and practical operation solution, besides, the following conclusions and suggestion are proposed:

1.Environment and facility related
(1)Available space and reception capacity, making the room limited
(2)Nursing station like setup without sense of home
(3)The meaning of reminiscence is emphasizing the past experience
(4)The service should be localized, and interacts with the society well

2.Characteristics of behaviors
(1)Free behaviors can be most commonly observed.
(2)The occurrence and persistence of trouble are related to the attitude of caregiver.
(3)The visits by family and relatives can promote the interactions among patients.
(4)The communications among patients are based on small groups.
(5)Close care may promote the interactions between caregiver and patient.
(6)The behavior can hardly be supported by semi-fixed objects, but the communications are arisen from non-fixed objects.
(7)Centralized friendship and behaviors in dining room can be most commonly observed.
(8)The motion of caregivers covers the entire region.

3.Suggestions on environment layout strategies for current constructions
(1)Small-scale space layout
(2)Explicit arrangements
(3)Flexible space
(4)Room space with attention paid to privacy
(5)Familial furnishings
(6)Barrier free design
(7)Direct and keep the patients exerting their personal value and capability
(8)Care environment directed by the requirements of dementia patients
(9)A good transfer system in case of illness worsening
(10)An active attitude with continuous improvement

並列關鍵字

group care unit ； therapeutic environment ； living core and beachhead ； dementia ； specialized care facilities for the elderly of Dementia

參考文獻

2002，《阿茲海默氏症病人的路徑測試表現與視覺空間功能之相關》，職能治療學會雜誌

2002，《長期照護之概說》，當代醫學

2001，《失智概念認知調查與老人團體照護模式之探討》，身心障礙研究

2001，《失智症病人的庭園設計》，科學農業

2000，《台灣失智者的照護現況與展望》，應用心理研究