高齡者預防照護之政策與實務

The Policy and Practice of Preventive Care for the Elderly

臺灣在2018年將成為高齡社會，為解決人口老化所帶來的社會衝擊，政府除須建構完善的長期照顧體系外，更重要且迫切的是「預防勝於照顧」。本文主要介紹2017年衛生福利部於全國創新推動之預防照護政策與實務成果，提供讀者認識預防照護之理念與形成要素；透過醫事及相關專業團體研發預防照護方案及培訓社區師資人才，並由地方政府結合在地資源佈建社區特約服務點，提供經專業審查之預防照護介入方案。2017年全臺共佈建850特約服務點，共有17,117位參與者，於預防照護方案介入前後利用日本介護（照顧）預防篩檢表（Kihon checklist, KCL）進行檢測，初步研究結果顯示參與者不論在獨立生活、運動、營養、口腔、社交、失智、憂鬱及綜合性潛在介護風險等各面向分數皆較參與活動前顯著改善，特別在情緒方面的幸福感指標大幅提升。

Taiwan is projected to become an aged society in 2018. In addition to establishing a comprehensive, long-term care system that is able to deal with the expected impacts of population aging, it is imperative that the government focus on improving the prevention of aging-related conditions. This article introduces the innovative preventive care policy promoted by Taiwan's Ministry of Health and Welfare and its preliminary results. Furthermore, the foundational ideas behind this policy and how it is being executed are explained. Medical and related professional groups participated in the research and development of the associated care plan and in the training of community-based trainers. Local governments integrate local resources in order to establish contracted community service bases and to provide professionally reviewed preventive care plans. A network of 850 contracted communities was established in 2017, and 17,117 participants have received services through this network to date. The Kihon checklist (KCL, the basic assessment tool for frailty used by the Japanese Ministry of Health, Labor and Welfare) was used before and after the intervention. Participants showed noticeably improved scores on the instrumental activities of daily living (IADL) and in the motor function, nutrition, oral function, socialization, dementia, depression, and lifestyle domains, with scores on the emotional happiness index showing especially strong improvement.