功能評估在估計台灣社區老人長期照護需要之應用

Application of Functional Assessment in Estimating Long-Term Care Need among Non-Institutionalized Elderly Adults in Taiwan

吳淑瓊(Shwu-Chong Wu) ； 徐慧娟(Hui-Chuan Hsu) ； 莊媖智(Ying-Chin Chuang) ； 張明正(Ming-Chen Chang)

《中華公共衛生雜誌》 15卷6期 (1996/12) Pp. 533-545

https://doi.org/10.6288/CJPH1996-15-06-05

摘要

本研究設計五種功能評估標準估算台灣社區老人的長期照護需要。五種評估標準依篩選範圍從小到大依序為：(1)三項或以上ADLs障礙、(2)二項或以上ADLs障礙、(3)至少一項ADLs障礙、(4)至少一項ADLs或IADLs障礙、(5)至少一項ADLs或IADLs或認知功能障礙。對2,892位台灣65歲以上社區居家老人人口的代表性樣本進行功能評估發現，在最小篩選範圍的標準下，台灣社區老人中具三項或以上ADLs障礙且需人幫忙的重度功能障礙人數約在四萬人左右；若將功能障礙指標放到最大篩選範圍，即凡具ADLs、IADLs、或認知功能障礙且不一定需人幫忙者，則長期照護需要人數大增到27萬左右，此需要人口將於四十年後漲為目前的四倍。由此可知，台灣勢將面對老人長期照護需要暴漲的壓力。本研究因為不包含目前已經利用機構式長期療養的老人，故以上估算數字應只代表老人對居家式或社區式的長期照護的需要。

關鍵字

日常生活活動 ； 工具性日常生活活動 ； 認知功能 ； 長期照護 ； 估計

並列摘要

Five various functional assessment criteria were applied in this study to estimate the size of non-institutionalized elderly population eligible for long-term care services in Taiwan. The five criteria from the most restrictive to the least restrictive were: (1) three or more ADLs disability, (2) two or more ADLs disability, (3) any ADLs disability, (4) any ADLs or IADLs disability, (5) any ADLs or IADLs or moderate cognitive impairment. Functional evaluation of an islandwide representative sample with 2,892 noninstitutional respondents aged 65 and over showed that the size of the eligible elderly population ranged from about 40,000 persons under the most restrictive disability criterion (human assistance required with three or more ADLs) to 270,000 persons if the least restrictive criterion (instrument or human assistance required with any ADLs, IADLs or moderately cognitive impairment) was applied. The estimate is going to increase 4 times 40 years later. Because the analysis was based on a sample of community elderly, the estimate derived from this study was not including the elderly who have already resided in an institution. The estimate represented the elderly population who were in need of home- or community-based long-term care.

並列關鍵字

activities of daily living ； ins trumental activities of daily living ； cognitive functioning ； long-term care ； estimation