失智老人日間照顧與非營利組織面臨之挑戰─以台北市及新北市日照中心為例

Challenges for the Dementia Elderly Daycare and the Non-profit Organizations: The Case of Daycare Centers in Taipei and New Taipei City

蕭玉資(Yu-Tzu Hsiao)

指導教授 ： 施世駿

國立臺灣大學/社會科學院/國家發展研究所/碩士(2017年)

https://doi.org/10.6342/NTU201703417

摘要

為瞭解現今台灣長期照顧政策下的日間照顧，NPO（Non-profit Organizations，以下簡稱NPO）與公部門公私協力運作挑戰。從合作互動面，公私協力互動關係出發，再到執行運作面，深入公私協力運作下的財務及評鑑監督的角色互動，進而分析失智老人於日間照顧的照顧人力問題。主要針對人力與服務輸送困境，最後，自長照十年至今邁向長照2.0的社區照顧，針對NPO與公部門共同福利服務輸送，所面臨的執行困境與建議改善方向。
本研究深入分析NPO於長期照顧政策與公部門長期合作，NPO作為社區服務的組織行動者，依循政策的脈絡下提供失智老人日間照顧服務，首先分析NPO與公部門的互動關係為何，其次透過與公部門「財務」與「監督」兩個層面，從兩個面向分析協力過程NPO與公部門的角色如何定位，透過公部門給予場地設施及經費補助，對NPO進行評鑑監督管制，這樣合作夥伴關係是否影響服務推行，進而了解給予財務及評鑑的監督方式是否合理並且有效率促進政策施行，兩項指標影響服務輸送並試著了解失智老人於日間照顧中心NPO所遇到的問題與挑戰，這些難題能否透過NPO內部解決，抑或需要重新調整公私協力角色分配進而提高效率，NPO作為組織行動者，能做好在地服務者的角色，然而更多不同層面上(如失智教育宣導)的協助，更有賴政府推行強化支持服務再造的可能，政策推動不僅止於公私協力合作，必須全民監督共同推動，有效減輕照顧負擔，為家庭照顧者推行盡善完整便民的服務。

關鍵字

日間照顧 ； 失智老人 ； 長期照顧 ； NPO ； 公私協力

並列摘要

This thesis aims to understand how the daycare of long-term care policy, Non-profit Organizations (NPO) and public departments can efficiently work together to promote welfare services in Taiwan. We adopt the perspective of public-private partnerships to understand the implementation of the public and private partnerships in terms of the financial responsibility and accountability of care provision. The analysis deals with the day care for dementia elderly, with a special focus on the dilemma and difficulties of implementation for the NPOs and public sector in service delivery amid the transition of the long-term care policy over the decades. Based on this analysis, the thesis offers some suggestions for improving the overall situations.
Against this background, the present study provides an in-depth analysis of the NPOs’ role in the long-term care policy and their relationships with the public sector, in the sense that NPOs serve as an organization provider of community services, offering daycare services to the elderly in need. This is then followed by a further analysis of the interactions between the NPOs and the public sector. From the angles of "financial responsibility" and "accountability" – two important aspects in care provision – it is important to understand whether the partnerships affect the implementation of the service provision; and if so, whether the financial responsibilities and evaluation procedures are reasonable and effective in promoting policy implementation. The analysis also touches upon the problems encountered by the elderly in the daycare centers as well as the challenges confronting theNPOs. To fulfill the role of a local service provider (such as dementia education advocacy), NPOs actually depend on the government to support and promote services with financial subsidies and institutional infrastructures. With joint co-operation and supervision between public sector and NPOs, this will effectively reduce the caring burden for the policy implementation and offer convenient and good services conducive to the family caregivers.

並列關鍵字

Daycare ； dementia elderly ； long-term care ； NPO ； public-private partnership

參考文獻

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