中低收入老人特別照顧津貼施行問題之探討

論文摘要有鑑於我國在民國八十二年間65歲以上的老年人口即高達149萬餘人，占總人口數的7.1％，已正式邁入聯合國所定義的「高齡化社會」，且國人平均餘命逐年延長，這意謂著台灣地區老年人口的照護需求與日俱增，且老人照護複雜又多元，包括老人退休後的生活調適問題；罹患長期慢性病、經濟安全、居住問題、老年教育、休閒及與家屬間互動等問題，對老人、家庭及社會均產生連動影響。本研究主要探討政府推動「特別照顧津貼」制度，以家庭照顧勞務有酬化為誘因，鼓勵家屬離開工作職場照顧家中失能老人，提供其非正式照顧體系的經濟支持，該制度之施行是否真能秉持發揮照顧弱勢之目的及實現立法意旨？本研究採用文獻分析法與深度訪談法蒐集研究資料，設定家庭照顧者與受照顧者及政府執法者為受訪對象進行深度訪談，共計訪談十七位受訪者，其中家庭照顧者有六位、受照顧者有五位、地方政府受理承辦特別照顧津貼人員有六位，再依據所蒐集的資料進行分析，並彙整與制度相關的議題討論，最後提出研究發現、結論與建議。研究發現中低收入老人特別照顧津貼施行之問題如下：（一）津貼的原始立意被漠視，相對的使民眾受益權被稀釋；（二）強化家庭照顧責任卻相對的將獨居老人排除照顧之列；（三）將照顧者年齡視同照顧能力，忽略個別差異；（四）補助類別多元相對的使受惠人數產生互斥；（五）金錢給付挑戰家庭成員關係的轉變；（六）地方政府人力不足，津貼給付類別多，資格審核工作吃力；（七）地方政府承辦人員更迭頻繁，對法令熟悉度不足；（八）地方政府預算編列落差大，致影響民眾領取人數。歸納老人特別照顧津貼實施所發現的問題，本研究得到以下重要結論：（一）老人自主權未被重視；（二）受惠對象未普及化；（三）家庭照顧者之資格限制太嚴苛；（四）家庭照顧者年齡深受工作能力思維的牽制。根據本研究發現的老人特別照顧津貼實施問題與重要結論，得出的政策建議與研究建議分別為：一、政策意涵：（一）政府應對當前少子化、不婚族、離婚、分居現象等趨勢所造成之人口群到老時無配偶、無子女可提供照顧之老人提早佈局規劃照顧政策。（二）建構照顧者支持體系，針對需要受照顧之失能者與家庭照顧者給予必要之支持、輔導及協助，重視受照顧者與照顧者的需求。二、研究意涵：被法令排除致無法申請成功的個案對象及外籍配偶，是類家庭照顧成員亦值得研究探討，這是對未來研究方向的建議。

關鍵字

高齡化社會、平均餘命、特別照顧津貼、非正式照顧、家庭照顧者

並列摘要

Abstract The senior citizens population in Taiwan was around 1.5 million people, about 7.1% of the total populations in 1993. Our society has thus become what UN defined “aging society” in that year. In addition, life expectancy at birth increases year after year. All of these facts suggest that the needs for taking care of senior citizens would increase and involve more complex and multiple problems, such as how senior citizens being used to their retirement life. Other problems include chronic diseases, economic security, senior citizen home safety, accommodations, education for the old age, leisure time activities, and interactions among family members, those would affect the old age, the families and even the whole society. This research mainly explored the "special allowance" system that was driven by Taiwan government. The system provides very little economic support to urge family caregivers quitting their jobs to take care of their unable senior family members to form an informal care system. Does this system really achieve the goal of taking care of the minority and fulfill the legislation intention? I adopted both literature review and in-depth interview methods to do this research. I interviewed family caregivers, people who have been taken care of, and government law executors. Data were gathered from seventeen interviewees which included six family caregivers, five care-receivers, and six local government staffs who were in charge of special allowance. Thirteen interviewed results have been chosen to be analyzed for this thesis. This research had the following findings: (1) The original goal of the special allowance was depreciated and therefore the qualified people's benefits were disregarded. (2) Family care programs did not pay enough attention to more and more elderly people living alone. (3) Regardless of individual differences, there is a problem of considering the caring ability of the caregivers being equal to their age. (4) Various programs of allowances are resulted in the mutual exclusion of benefited people. (5) Money payment system may influence the relationship between the caregivers and other family members. (6) Manpower shortage of local government staffs, too many types of allowance payments confusing the public, and the heavy duties of clients’ qualification screening by the government staffs all have contributed to the problems of special allowance system. (7) The frequent replacement of local government staffs leaves no enough time for them to be familiar with the related laws. (8) An overall lack of local government budget affects the number of people who can receive the allowance. Our research conclusions included the four points as follows: (1) The autonomy of the old age was disregarded.(2) Subjects who were in special allowance system were restricted to a limited number. (3) The qualification restrictions of family caregivers were too inconsiderate. (4) The qualification restriction of the age of family caregivers was not flexible enough. Policy and research implications for this study included the following: (1) Our government should plan caring policies in advance for the people who will be affected by some current trends like decreasing birth and marriage rate, increasing divorce rate and family members living separately. (2) Government should offer more financial support and guidance for family caregivers system. (3) For researchers who are interested in this research question may further think of those failed in applying this system and the role of foreign spouses in Taiwan’s elderly home care system.