悠遊智在—失智社區服務據點運作經驗初探

本研究旨在探討雙北市失智社區服務據點運作經驗，研究目的主要為瞭解失智症社區服務據點的運作過程、遭遇困難與資源連結情形，並根據研究結果提供服務建議。本文採質性研究方法，以深度訪談法進行資料蒐集，共訪談台北市、新北市7處失智社區據點負責人以及2名市政府衛生局承辦人員。研究結果：失智社區服務據點透過個案管理、非藥物治療活動，「維持」失智者認知及身體機能、「促進」失智者社交活動及「安穩」情緒，重拾自信；辦理家屬支持團體，提升家屬照顧知能及照顧品質，減輕家屬負擔，建構互助系統；在社區方面，據點成為失智照顧服務轉運站，提供社區民眾諮詢，並連結社區資源以建構友善失智環境。失智據點經營過程遭遇困難包含計畫規定限縮據點發展及人力資源不足，據點透過改善工作流程，連結各界資源，加強宣傳及資源連結解決，開辦三年過程中已有初步成效。研究建議：一、整合社區資源，建構社區志工人力管理系統，改善資源不足狀況。二、改善失智症個案管理資訊平台，落實失智症個案管理模式。三、進行據點分類制度，提供補助彈性或協調場地，貼近各據點運作需求。四、持續進行失智症公共宣導，針對不同資訊接受者設計宣導內容，有助於失智者家屬接觸長照服務。五、建議醫事類型據點培植社區人才；長照類型據點增加外展活動；社福或相關團體類型據點使用跨專業合作方式，提供失智者所需課程。

關鍵字

失智社區服務據點；失智症社區式照顧；運作經驗

並列摘要

The purpose of this research is to understand how community-based dementia care centers operate, the challenges they face and their usage of resources. The researcher does so by examining the operational experience of Taipei City and New Taipei City’s community-based dementia care centers and uses the research findings to offer advice for serving clients with dementia. The researcher conducted depth interviews on managers from seven community-based dementia care centers in Taipei City and New Taipei City as well as two case officers from the Health Bureau. The research findings are as follows: The care centers use case management and non-pharmacological interventions to “maintain” dementia clients’ cognitive health and body functions, “encourage”clients to engage in socialization and “soothe” their emotions, which helps them regain self-confidence; By supporting family caregivers, the care centers lessen the caregivers’ burden, builds mutual support systems and increases their caretaking knowledge as well as raising the quality of their caretaking; These centers have become a transport hub for dementia care services as they offer consultation to community residents and use resources from the community to create dementia-friendly environments. Challenges the community-based dementia care centers have faced during their three years of operation include project regulations that limit their development and lack of manpower, but by making changes to the workflow, finding different resources and increasing promotion about their services, they are starting to show results. The researcher’s advice: 1.Integrate community resources and create a community volunteer management system to tackle the lack of manpower. 2.Improve the current case management system for dementia clients to truly implement case management for dementia clients. 3.Sort community-based dementia care centers into different types and implement flexible funding systems to better answer the needs of each center. 4.Continue to raise public awareness about dementia services and to reach different demographics through different types of promotions to expose family members of people with dementia to long-term care services. 5.Care centers with a medical focus should groom influential volunteers within the communities; Long-term care centers should increase their outreach activities; Welfare related centers should take a trans-disciplinary approach to offer classes that dementia clients need.