論長照2.0給付排除長照機構對家屬之影響

NHUIR > College of Humanities > Department of Life-and-Death Studies > Disserations and Theses(M. A. Program in Life-and-Death Studies) > Item 987654321/28953

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Title:	論長照2.0給付排除長照機構對家屬之影響
Other Titles:	On the Long-term Care 2.0 Payment Eliminates the Impact of Long-term Care Institutions on Family Members
Authors:	蔡群烜 TSAI, CHUN-HSUAN
Contributors:	生死學系碩博士班張國偉 CHANG, KUO-WEI
Keywords:	長期照顧2.0計畫;照顧壓力;照顧效能 long-term care 2.0 program;care pressure;care efficacy
Date:	2021
Issue Date:	2022-08-23 13:15:07 (UTC+8)
Abstract:	本研究旨在探討有關長期照顧2.0計畫之相關給付項目，排除住宿型長期照顧機構對其家屬之感受與影響。現行長期照顧2.0計畫著重預防勝於治療，積極推動居家照顧服務，以延緩長輩老化為首要目標。然而隨著長輩衰老至一定程度，家屬照顧負荷隨之提高，不得已而必須採用機構式照顧時，往往因政策無相關補助制度，且國家亦未推動相關保險制度，將使得家庭面臨重大經濟壓力，居家照顧服務與機構式照顧無法順利延續，長期照顧計畫的服務斷層便因此顯現。　　為此本研究採用質性研究法分別就兩面向進行訪談：機構照顧之家屬及長照體系工作人員，針對照顧效能、照顧費用以及照顧壓力等議題進行探討。經研究結果可歸納出：　　1.依照顧效能而言：住宿型機構中的照顧設備相較於家中充足，且全天候皆有工作人員看照，長輩健康與安全無虞；另對於完全臥床或失智症照顧，較有量能照顧。　　2.依支出費用而言：居家照顧服務在政府的補助下，明顯低於機構式照顧，但家內照顧人力之就業收入隱藏成本以及其照顧負荷則難以計算多寡。　　3.依照顧壓力而言：使用機構式照顧，家屬壓力源較多為經濟議題之壓力；而使用居家照顧則仍會因長輩病況、家屬共識不同、或臨時突發狀況等，家屬仍因多項照顧壓力而困擾。　　綜上結果顯示經濟程度許可的家庭便會將長輩送往長照機構，而經濟程度較不允許的則可能維持原樣，待在家中等待服務較斷裂的居家照顧服務，事實上也是沒有完整的解決國人的長照問題。　　本研究希冀政府能顧及在照顧服務以及市場機制的運作下，積極推動「長期照顧保險制度」，以保險制之方式規劃民眾納保，藉由擴大基數分散風險等概念來調節財政支出，並監督照護市場之運作情形。唯有大家一同繳納保費、一同分擔分險，未來的長照服務才能永續發展。　　The purpose of this study is to explore the relevant payment items of the Long-Term Care 2.0 Program, excluding the feelings and influences of residential long-term care institutions on their families. The current Long-term Care 2.0 Program focuses on prevention rather than treatment, and actively promotes home care services to Delaying the aging of the elders is the primary goal. 　　However, as the elders age to a certain extent, the family care load increases accordingly. When institutional care must be adopted as a last resort, there is often no relevant subsidy system due to the policy, and the state has not promoted the relevant insurance system. As a result, families are faced with severe economic pressure, and home care services and institutional care cannot be continued smoothly, resulting in a gap in long-term care services. 　　For this reason, this study adopted qualitative research method to conduct interviews on two aspects: family members cared for by the institution; staff of the long-term care system. Discussed issues such as care efficiency, care costs, and care pressure. The research results can be summarized as follows:　　1.In terms of care efficiency: compared with home care facilities, residential institutions have sufficient care facilities, and there are staff looking after them around the clock, so the elders are healthy and safe; in addition, there are more care facilities for complete bedridden or dementia care.　　2.In terms of expenses: home care services cost significantly less than institutional care when government subsidized, but it is difficult to calculate the hidden cost of employment income of family caregiver and their care load.　　3.In terms of caring pressure: when using institutional care, the source of stress for family members is the pressure of economic issues; while using home care, family members are affected by a variety of medical conditions, family members’ has different consensus, or temporary emergencies. The family is still troubled by multiple care pressures.　　To sum up, the results show that households with a higher economic level will send their elders to long-term care institutions, while those with less economic levels may remain as they are, staying at home and waiting for home care services with broken services. In fact, there is no complete solution for long-term care of the people. This study hopes that the government can actively promote the “long-term care insurance system”, taking into account the operation of care services and market mechanisms, planning people's insurance coverage in the form of an insurance system, adjusting fiscal expenditure by expanding the base and diversifying risks and other concepts, and supervising How the care market works. Only when everyone pays the premiums and shares the insurance together can the long-term care services in the future develop sustainably.
Appears in Collections:	[Department of Life-and-Death Studies] Disserations and Theses(M. A. Program in Life-and-Death Studies)

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