POPULATION AGING AND LONG-TERM CARE POLICY
Resource
國家政策季刊 v.4 n.4 pp.5-24
Journal
國家政策季刊,v.4
Journal Issue
n.4
Pages
5-24
Date Issued
2005
Date
2005
Author(s)
WU, SHWU-CHONG
Abstract
本文主旨在說明長期照護之本質，分析我國老人長期照護需求與供應之變遷趨勢，及其對未來政策改革之啟示。綜合國內外資料，長期照護是對身心功能損傷個案的長期性服務，服務涵蓋範圍甚廣，包含專業診斷與治療、生活照顧、居家無障礙環境修繕、輔具提供、與住宅服務等，和醫療服務相較，其技術層級較低，再加上服務期長，因此如何將照顧和生活融合，增進個案自我選擇與獨立自主，於是成為先進老化國家長期照護改革的主要訴求。由於我國老人所佔比率將於20 年內從10%增為20%，未來照顧需求數量肯定大幅成長，再加上未來老人教育經濟提升與家庭照顧功能式微兩大因素的推波助瀾下，將來對正式服務的需求不只數量將更為增加，對照顧品質的要求，以及對選擇服務的獨立自主性，均會一併提升，是規劃未來制度不可忽略的重要趨勢。順此趨勢，我國長期照護改革應強調：（一）發展各式居家與社區式服務資源以建造多元的社區照顧環境；（二）培訓本籍照顧管理員提升其照顧技術，並引進財源支持本勞的留任，提升對外勞的競爭力；（三）中央協助地方政府實質強化照顧管理中心的組織編制和經費需求，技術支援管理作業流程的建構，以落實其統籌管理社區資源，並執行個案照顧管理業務；（四）建立財務制度，支持上述服務設施與人力資源的發展、服務輸送、與管理制度的執行。為加速有效改革，建議在「建構長期照護體系先導計畫」的實驗基礎下，檢討規劃各層面未來的改革策略，並致力全國的宣導與溝通，凝聚各界發展力量。 The purpose of this article is to explain the nature of long-term care and to analyze the trends of long- term care needs and demands in Taiwan. Furthermore, it aims to provide some implications for long-term care policy reform. A vast number of literatures published internationally and in Taiwan have defined long-term care as services provided over a long period of time to those with disability in either physical or cognitive functions. A broad range of services, such as professionally diagnosis and treatment, care related to daily living activities, living environment modification, assistive equipment or technology, and housing services are included. Comparing to medical care services per Se, it requires less professional training but is needed over a longer period of time. Thus, the integration of care and daily living, and the enhancement of choice and autonomy in selecting services have become a major focus in long-term care reform in many aging countries. The percentage of elderly in Taiwan will increase from 10% to 20% in about 20 years. The need for long-term care will certainly increased significantly in the near future. Moreover, with the improvement in socio- economic status among the elderly and the decrease in the care-giving role of the family, the demand for formal services is likely to increase. In addition, the demand for quality and independence in selecting services will also increase. Policy makers should take these factors into consideration when planning for the long-term care system of the future. Thus, the reform of Taiwan's long-term care system should emphasize the followings: (1) development of various home-based and community-based services to create a community care environment incorporating multiple types of services; (2) improving the quality of care provided by local care workers and care manager through education and training; establishing financing mechanism to support the use of local workers, to reduce the turnover, and to increase their competitiveness against foreign care workers; (3) the central government should assist the local government to carry out resource management by helping them to establish its care management centers with additional funding and personnel allocation, and by providing technical support for developing its own care management scheme; (4) establishment of a sustainable financing scheme to support the development of both services and personnel resources, service delivery, and care management mechanism. To effectively reform the long-term care system in a timely manner, strategies and policy direction should be reviewed in conjunction with the understandings and evidences acquired through the Pilot Program for the Development of Long-Term Care System. More efforts in media campaign will be needed to communicate the goals of the reform to various professional disciplines and service sectors in order to unit players involved to work together towards a better long -term care system.
Subjects
老化(aging)
長期照護(long-term care)
政策(policy)
Type
journal article