實現「在地老化」之終生住宅發展形式探討

Feasibility of Aging in Place and Foundation of Life-time Housing Development

黃耀榮(Yao-Rong Hwang)

《台灣老年醫學雜誌》 1卷3期 (2006/02) Pp. 138-150

摘要

由老人居住安排的變遷歷程，可以發現實現「在地老化」係許多國家共同追求的目標。如何建構可以終生居住而不需變遷或改造的居住環境，將是落實「在地老化」的最終理想。本文經由「在地老化」過程各階段生活能力之屬性特徵分析，呈現居住者在「在地老化」的過程將歷經可獨立生活、需要輔助式照護、需要完全照護，以至於臨終安寧等不同的生活階段。各生活型態中因為肢體、感官與心智能力的障礙所需要的無障礙環境條件，以及在各生活型態中因應不同的照護需求所需要的服務設施設備系統，將是未來提供「在地老化」居住環境的主要發展重點。
經由美國、澳洲、瑞典、芬蘭等福利國家終生住宅之發展概況與形式分析而界定終生住宅的理論概念，其意涵著居住者不遷移而隨著不同階段的生活能力與照護需求而陸續增加家事服務、行動輔具、無障礙設施、護理服務、復健支持、臨終照護等環境機能與服務設施。針對我國終生住宅之發展現況與困境分析，以及實現「在地老化」之機制與對策，本文提出在原居住宅之起居、用餐空間、照護服務空間、衛生、儲藏空間應能具備整合性、彈性、替代性之空間計畫特性以滿足各階段之生活機能，有利於建構單一終生住宅模式；而在機構照護的集居環境或老人住宅之開發應具有多層級照護功能，分區提供各層級照護區，以利建構生活園區的終生住宅模式。最後，建議確實落實建築技術規則以建構全面性無障礙環境條件，並因應社會結構之變遷，利用都市計畫每5年定期通盤檢討，就各現有社區留設「社會福利設施用地」等公共設施保留地之可行性進行評估。

關鍵字

在地老化 ； 終生住宅 ； 形式 ； 實現

並列摘要

In response to the changing process of living arrangement for the elderly, many countries have made ”aging in place” a common goal for pursuing the wellbeing of their senior citizens. The development of a ”lifetime living environment in which senior citizens do not have to move to secure supports and services meeting their changing needs will be the ultimate realization of the ideal of ”aging in place”. This article analyzes the characteristics of living ability capacity in different stages during the transition of ”aging in place”, illustrating how older residents can experience the increasing services from independent living, assisted living, and skill nursing to hospice. Enhanced accessibility for senior citizens with physical, sensory and mental disability and comprehensive provision of caregiving services and facilities would be the major issues in the future development of a lifetime living environment for aging in place.
We define the concept of life-time housing after analyzing the development and patterns of lifetime housing in the United States, Australia, Sweden and Finland. Lifetime housing aims at developing homes that can be adapted easily to suit the residents' changing requirements throughout their lifetime. Senior residents do not have to move into new settings as a lifetime home and its hosting community are designed to be adaptable enough and provide necessary housekeeping, nursing care, facility for mobility, rehabilitation, hospice and other supporting and caregiving services needed during the different stages of aging and decay. After examining the existing difficulties in developing lifetime housing in Taiwan and studying feasible strategies for facilitating ”aging in place”, we suggest that the spaces for living, dining, caregiving, sanitation and storage in a regular house should be re-designed based on the principles of integratability, flexibility, and adaptability so as to meet the residents' different needs in different stages of their lives and to construct a model of lifetime home. Institutionalized community housing or nursing home, on the other hand, should be developed to incorporate multi-tier caring services in order to meet a model for lifetime community.
Finally, we suggest that rules concerning disability accessibility in Technical Regulations for Building Construction and other relevant laws should be rigorously enforced in order to build up an overall barrier-free environment. Moreover, the possibility of land use for social welfare facilities in the community should be periodically evaluated along with the five-year comprehensive review of urban plans to meet the changing needs of the society.

並列關鍵字

aging in place ； life-time housing