臺灣外籍家庭看護工之現象與省思兼檢視長期照顧政策

Abstract

「長期照顧」係指對具有長期身體功能失常或有重大疾病者，提供一段持續性的協助。臺灣社會的整體人口結構已逐漸朝向高齡化，根據推估，臺灣目前65歲以上的老年人口約208萬人，約占總人口的9.2%，但是因為戰後嬰兒潮即將邁入老年，因此只要再過25年，我國老年人口所占的比率將超過20%。再以身心障礙者為例，2005年底領有身心障礙手冊者達93萬8千人，其中屬於重度與極重度障礙者占29萬人。相對於老人對長期照顧需求的逐漸增加，目前更有大量的身心障礙者需要長期照顧服務的介入協助。臺灣社會對於長期照顧服務的迫切需求不言可喻，因此國家若忽視這類的需求，所造成的不單是個人或個別家庭的困境，更將是整體的社會問題，因此國家身負無可回避的責任。\n\n 臺灣社會的長期照顧服務一直高度依賴外籍家庭看護工，為減緩此一情況，國家試圖以投入大量資源扶持機構式照顧服務，與逐步充實社區式與居家式照顧服務等方式改善，但是外籍家庭看護工在台人數卻是不減反增，顯見國家長期照顧政策並未獲得失能者家庭的認同。臺灣外籍家庭看護工現象，其實是一種相當複雜的社會建構過程，是「父權」的家庭文化、「私化」的國家政策與「家庭負擔能力」的鉗制，三者交互影響而建構出失能者由家庭照顧為主的處境。如此過程是值得深入去了解的。\n\n 本文以文獻回顧與整合研究法，作為主要的研究方法。本文研究後認為，臺灣現存的整體照顧資源，會與現有文化觀念交互影響，進而強化家庭對「家人照顧」與「照顧行為女性化」的偏好。當女性照顧者面臨愈來愈強的照顧負荷與危害時，終將在國家政策、經濟能力、傳統文化與父權主義的交互影響下選擇具替代性的照顧服務，即便對失能者及其家庭而言並非最佳選擇。很明顯的，臺灣選擇以「外籍家庭看護工」做為傳統長期照顧方式的主要替代照顧方案，即便國家大幅改革長期照顧政策（照顧服務福利及產業發展方案），情況依舊未獲得改善。因此，臺灣如要建構一套完整的長期照顧政策，就必須先理解失能者家庭在選擇照顧服務時，是同時面對「經濟能力」和「文化輿論」等照顧困境。因此，一般的女性照顧者應從「無償照顧者」的社會弱勢角色，轉變為長期照顧政策的思維中心與主導者之一；而外籍家庭看護工的角色與價值更應該被重新定位與肯定，更應尋求將其融入臺灣整體照顧政策的可能性。

Long-term care service in Taiwan depends on foreign nursing labor for a long time. In order to improve this situation, The government has provided more resources for institutional care services, and community care services and home care services. but foreign nursing labor in Taiwan still increased slowly. It means disabled person’s family can’t relate to The Long-term care service in Taiwan. In fact, foreign nursing labor in Taiwan is a social construction, and was affected by Patriarchy, private policy and home capacity. Finally, disabled person still in their home. This situation need to research.\n This research is based on document analysis. According to the result of this research, the resource of caring and the traditional culture concept have influenced to each other and emphasized. When female caregivers face heavy pressure of family care, they would choose other caring Long-term care service in Taiwan has been dependant on foreign nursing labor for a long time. In order to improve this situation, The government has provided more resources for institutional care services, community care services and home care services as well. but foreign nursing labor in Taiwan still increased slowly. It means the disabled person’s family can’t relate to The Long-term care service in Taiwan. In fact, foreign nursing labor in Taiwan is a social construction, and is affected by patriarchy, private policy and home capacity. Finally, disabled person is still in their home. This situation need to \nresearch.\n\n This research is based on document analysis. According to the result of this research, the resource of caring and traditional culture concept have influenced each other. When female caregivers face heavy pressure of family care, they would choose other caring service, and even it’s not the best one. Obviously, Taiwan chose foreign nursing labor as an alternative route, although the Government have launched a new program of long-term caring (Caring Service welfare & Industry development program). If Taiwan plans to establish a sound caring policy, it must understand the patriarchy, private policy and home capacity. The female caretaker should change from the one who used to be unpaid family caretaker to become the center of the long-term care policy. In addition, we should improve the role and value of foreign nursing labor, and Long-term care service in Taiwan should take foreign nursing labor as its \nregular as well as essential component.\n\nKey Words：long-term care, Foreign Nursing Labor