老人長期照護機構及社工專業的現況與展望

The Institutional Care for Older Persons and the Related Social Services in Taiwan

本文探討台閩地區老人長期照護機構及社會工作專業發展的現況、困境與展望。台灣老人長期照護機構供過於求，平均占床率僅七成，但仍持續有新的機構設立。政府的補助政策，實為重要原因之一，應儘速予以檢討改進。另與護理之家以及身心障礙安置機構之間的區隔與合作，應進一步加強，以建議連續性的機構照顧系統。社工人員在公立、公設民營以及財團法人機構就職者較多，小型機構則甚少雇用社工人員，影響老人權益之維護與個別化服務之提供。長照機構由於工作內容繁雜、機構負責人對社工瞭解不夠、專業督導缺乏以及必然面臨的死亡等議題，使得長期照護機構領域無法獲得社工人員的青睞，投入之專業社工很少。但長照機構社工有其獨特的專業角色，特別在於案主充權、個別化照顧以及社區連結方面，有助於住民生活品質的提升。未來政府應檢討機構安置補助對象，建立評估機制。同時部門整合發展專業人力培育計畫，專業組織也應致力於整合型實務模式與服務方案的開發整理。

This article reviews the current status and future prospect of social work practice in long term care institutions. Even though the current occupancy rate is only 71.7% in the long term care market, more and more new institutions continue to be established. Two major factors affecting the imbalance in long term care market are: government policies regarding the subsidies to the establishment of foundation-owned institutions and to individual institution placements and the departmentalization of elderly care homes and homes for the disabled. There are very few social workers working at long term care institutions, the majority of which in public or larger private ones. The rights of residents in small institutions are often insufficiently protected due to the missing of social workers. This article presented that social workers could help to promote the quality of life of elderly residents by empowering individual residents to express themselves, designing individualized care plans and making connections with nearby community resources. Recommendations were made to modify government policies regarding institution subsidies and to create an integrated plan for social worker manpower development.