最適長照機構成立之研究–以苗栗後龍某長照機構為例

台灣社會人口結構的快速老化下，長期照護是一直被重視的議題。少子化的趨勢、扶養比的降低與家庭結構改變種種原因，使得愈來愈多的獨居高齡者。身體機能退化、生活無法自理的老人，必須藉由不同的長期照顧服務來提供必要的支持。但長期照護的項目與需求所涵蓋的範圍多元且複雜，如何健全長期照護體系與維護長期照護品質已是刻不容緩之事。本論文採質性研究，從人口結構老化的改變情形所帶來的長照需求面探討，整理老年照護人口與機構需求的相關聯性，將長期照護的新舊法相互比較，以及新法實施後機構應包含的長照服務內容與最適設立型態進行文獻的整理與討論。最後綜合居家照護服務的專業護理服務結合送餐服務、社區照護服務的日照服務及喘息服務再加上強調沐浴照護及心靈層面注重的機構住宿式照護服務為研究的核心架構，從機構設立的地點、氣候、人口結構及醫療資源四個因素加以分析、歸納出一條龍式全方位綜合型長照機構為最適型態。並選擇新法實施後在苗栗後龍建構一個全新的長照機構為目標，結合跨專業領域的健康促進方案、前瞻性的產學合作、高齡照護體驗課程與代間學習等做為機構特色與永續經營的核心競爭力，為在地老化與活耀老化提供一個可行的方案。未來研究可以進一步探討中央及地方主管機關在新法實施後對於長照機構的改革助益，以及長照機構資源不足區域的改善情形，作為台灣因應超高齡社會來臨及進入長照產業蓬勃發展時期的參考。

關鍵字

一條龍全方位綜合型長照機構；老人健康促進；前瞻性產學合作；高齡模擬體驗；代間學習

並列摘要

Under the rapid aging of Taiwan’s social demographic structure, long-term care is an issue that has always been valued. The trend of a declining birthrate, the reduction of dependency ratio and the changes in family structure have made more and more elderly people living alone. Old people who are degraded and unable to take care of themselves must rely on the necessary support through different long-term care services. However, the scope of long-term care terms and needs are diverse and complex. Therefore, the way to improve the long-term care system and maintain long-term care quality is an urgent task. This qualitative study probes the perspective of the long-term demand situation brought about by the change of population structure aging. Sorts out the correlation between the elderly care population and institutional needs, compares the old and new law of long-term care with each other, and organize and discuss the literature of what the long-term care service content should an institution include and the most suitable establishment type after the implementation of the new law. Last, the comprehensive care services for integrated home care services combined with food delivery services, day care services for community care services and wheezing services, together with institutional accommodation care services that emphasize bath care and spiritual attention, are the core framework for the research. Analyzed the four factors of an institution’s location, climate, population structure, and medical resources and summarized into a one-stop comprehensive all-around long-term institution. Moreover the goal is to build a brand-new long-term care institution at Miaoli Houlong after the implementation of the new law. Combining the health promotion program in the cross-professional field, forward-looking industry-university cooperation, advanced care experience courses and intergenerational learning as institution’s characteristics and core competitiveness of the continued operation. So that it could provide a viable solution for aging. Future research can further explore the central and local authorities on the reform of the long-term institutions after the implementation of the new law, and the improvement of the area with insufficient resources of the long-term institution. As a reference for Taiwan in response to the advent of the super-aged society and the booming period of the long-term care industry.