台北市居家照顧服務需求評估暨服務項目內容及計價研究

Abstract

隨著人口老化和平均餘命的延長，以及去機構化和社區照顧理念倡導和服務措施之推動，生活正常化與服務社區化乃是在1960年代以後對老人去機構的二大策略。居家服務已成為輔助一般老人，可以維持熟悉的居家或社區生活環境，以及協助失能老人，延緩接受機構照護的重要措施。而根據國內多項研究顯示：65歲以上的老人，有高達70％的比例希望與子女同住，且目前老年人與子女同住比例仍甚為普遍，約佔68％。由上述調查可知，大部分老人不論身體狀況如何，都希望居住在家庭和社區中。為使老人在老化過程中能在社區過獨立自主的生活，享有居家生活的保障，使其能在熟悉的環境安享晚年，居家照顧服務是目前已開發國家，設計老人相關福利措施上的共同走向。台北市的居家照顧服務自1983年起推行，由政府雇用專職在宅服務員，在社區社福中心為70歲以上低收入戶老人提供家務性服務。1990年，為突破政府精簡人事的政策限制並擴大服務提供量，開始轉型為委託民間專業機構，辦理居家照顧服務。並逐步將服務項目，增加至身體照顧服務項目。服務對象也擴大至中低收入戶、單身榮民及65歲以下身心障礙者。委託服務單位也由最初的一家擴大至1999年的八家居家服務機構，成為各縣市政府委託民營的觀摩對象。 Abstract: Our nation is aging, and substantially a number of people are struggling under enormously physical, financial and emotional burdens. Disabled elderly people are particularly vulnerable to losing their independence. Many are unable to obtain the needed assistance at home, and the placement in a nursing home is too often the end result. The organization and financing of our long-term care system are fragmented and riddled with gaps. The support and services of home and community care are inadequate and there is little assurance of quality. Thus the burden of procuring and paying for long-term care falls heavily on the disabled people themselves and on their families. These families and other informal caregivers play a vital role in the long-term care network, and their efforts need to be supported. Today’s society perceives long-term care less as a family duty and more as a government problem. Accordingly, the government should contribute to the cost of the program－sharing the burden with the families.