臺灣失智者的照護現況與展望

Dementia Care in Taiwan

依台灣流行病學調查，社區中失智長者之盛行率為2.7%-5%，較歐美國家為低；推估之罹患人數約為3.5萬人至8.7萬人，但實際經鑑定為失智並持有身心障礙者身份者僅約6800人，絕大多數之個案隱藏在社區中。失智症之診斷、治療與照顧未如其它老年慢性疾病之普及，失智長者異常行為之處理不論是在機構中或家中都是照顧者相當大的負擔，現階段個案及照顧者所獲得之醫療、照護等資源都十分有限，不過產、官、學界已正視這項照護議題。未來期望能從失智症之早期診斷與早期治療，在政策上鼓勵家庭照顧、建立臨託服務及訂定失智者照顧機構設置標準等著手；使失智長者享有安全、尊嚴照護之際，照顧者亦享有優質家庭生活。

In Taiwan, the prevalent rates of dementia in community dwelling elderly persons range from 2.7% to 5.0%. These rates are lower than those in the western countries. While it is estimated that there are 35,000~ 87,000 demented individuals in Taiwan, the actual number of demented person in the registry office is less than 6,800. It is believed that the majority of the demented persons comprise a hidden population. Although diagnosis and treatment are available and reimbursed for those with dementia, these services are not as popular as with other chronic illness such as hypertension or DM. In adult day care centers and institutions, the demented persons have gradually come to compose a significant percentage of the caseload; even though most demented persons are being cared for by their own family in the home. In institutions, persons with dementia are cared for right along with the physically disabled. However, there now seems to be a trend to treat the demented persons as a special aggregate and deserving of specific dementia care. The need to support caregivers has also become an issue. With the aim of providing quality care for demented persons, while maintaining the quality of life for the family caregivers, we recommend: concerted efforts to promote the early diagnosis of and intervention for dementia, respite care for family caregivers, restructuring of care facility for demented persons and education preparation for formal caregivers.