長期照顧十年計畫服務使用情形-嘉義縣兩年追蹤研究

The utilization of service of Long-term elderly care program: a two years follow-up study in Chiayi community

郭芳雅(Kuo Fang-Ya)

指導教授 ： 張李淑女

亞洲大學/健康學院/長期照護研究所/碩士(2011年)

摘要

老年人口及失能者遽增已無可避免，因此近年來長期照顧議題受到各界的關注，我國已於2007年開辦長期照顧十年計畫，未來即將開辦長期照顧保險。有鑑於此，本研究目的欲深入瞭解失能者持續使用長期照顧服務的狀況與變化情形。研究樣本為2008年長期照顧十年計劃服務收案之個案，經過長期照顧服務綜合評估後，持續至2010年使用服務者共計330人。使用spss12.0 for windows套裝軟體進行卡方檢定、獨立樣本t檢定、複迴歸分析。
研究結果發現失能者在ADL變化趨勢在第六個月功能有上昇，但自第12個月後逐漸下降。在使用長期照顧服務失能者的人口學特性中，發現以不識字、無偶者、山地原住民身分者、有福利身分別者、無管路、心智功能完好者功能較佳的功能較佳；在使用服務方面，有使用喘息服務、居家護理、居家復健者其ADL分數較低，有使用老人營養餐飲服務者其ADLs分數較高。在使用服務後發現有使用喘息服務、老人營養餐飲服務、交通接送到第6個月的ADL變化有明顯進步。在主要照顧者負荷變化中，可發現使用長期照顧服務後主要照顧者負荷下降，且有使用喘息服務的主要照顧者負荷下降較明顯。影響持續使用社區式長期照顧服務者身體功能變化的因素在人口學特性中發現年齡越高ADL功能呈現顯著下降；在身體健康狀況無顯著發現；在使用服務狀況中發現有使用居家服務者其ADL功能有顯著提昇。
研究建議在政策面上，強化相關資料銜接、增加復健專業人力；在實務面建議加強鄰近縣市合作及規劃多元性的喘息服務。

關鍵字

使用服務 ； 長期照顧 ； 日常生活活動功能

並列摘要

Background: The need for long-term care is increasing because of longer life expectancies and aging populations. Therefore, a long-term elderly care program has been launched in Taiwan program in 2007 to meet the rapidly increasing need for long-term care in Taiwan's aging population. It is funded by the central government and operated by local government which provides subsidies in different amounts to eligible applicants based on the extent of their disability and their families' economic situation. People with a higher level of disability and with lower family income will be granted a higher amount of subsidy.
Aim: The aim of this study was to examine the outcomes of disabled elders who continuely use the long-term elderly care services for two years.
Design: A database from a rural region long-term care center at Taiwan was used. Disabled elders who continued to use the services for two years were selected to be the study subjects. From 2008 to 2010, a total of 330 people were included.
Results: The results of this study showed the ADL function at six month has been trending up, gradually declined at 12 month. However, only until 18 month the score lower than the initial score. Also those who use respite services, homecare services, home rehabilitation service have lower ADL scores, and who use meal delivery service have higher ADLs scores. The result also revealed that the use of long-term care services can ease caregiver’s burden, especially in those who have use the respite services. Nevertheless, the use of respite services was not wildly accepted by Taiwanese people, the number of people use this service was still low.
Conclusion: The result of this study shows positive outcome within those elders who have been using the services from this long-term elderly care program continually for 24 months. The trend of ADLs scores shows the services delayed those elders’ physical function degeneration. It has also eased the family care burden efficiently. However, the findings also revealed some services still not been wildly used in this rural area.

並列關鍵字

services utilization ； Long-term care ； ADLs

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