失智整合照護之理念、架構與實務

The Concept, Model and Best Practice of Integrated Care for Dementia

臺灣於2018年開始了新的失智症照護政策，除了通過與世界衛生組織（World Health Organization, WHO）同步的「臺灣失智症防治照護政策綱領暨行動方案2.0」，也於十年長期照顧計畫2.0加入了失智症照護的項目。這兩個舉動代表一個從政策層面出發，另一個從服務執行層面出發。另，失智症的照護不僅是有關個案本身，照顧者的支持、左右鄰舍與社區如何組成一個讓失智症患者得以擁有基本人權又兼顧照護相輔相成的失智友善社會。本文主要的目的在探討臺灣針對失智症的防治與照護歷程，歷經政府與民間組織合作，從政策、建置體系到整合模式，如何以整合的思維建構一個全人、全家、全隊的照護模式。文中以中部地區某醫學中心―中山醫學大學附設醫院失智共同照護中心（以下簡稱失智共照中心）及衛生福利部臺中醫院失智共照中心為例，提出整合架構、品管以及專業技術的論述。期待此文章能針對臺灣建構未來失智友善及整合服務有所研究性與政策性的貢獻。 In 2018, Taiwan has been starting the Dementia Care Policy 2.0 by passing the 2018-2025 Taiwan Dementia Plan and adding Dementia Care as one of the 17 service categories to the Ten- Year Long-term Care Plan 2.0. From policy perspectives to service delivery, dementia care is not only about care for the clients but also for supporting the caregivers, neighbors and community to form a friendly society where people with Dementia can have basic human rights and care. The purpose of this paper was to discuss how Taiwan planned for Dementia Care at policy and service delivery levels as well as how government collaborated with the hospitals and nonprofit organizations to come up with integrated care models that were based on holistic care, family-friendly and inter-disciplinary teamwork. We used the Dementia Integrated Care Centers in Taichung City including Chung Shan Medical University Hospital and Taichung Hospital of Ministry of Health and Welfare as demo-sites in 2017 to demonstrate how we developed the service framework, quality management and professional personnel. This study aims to bring dementia research and policy making references by constructing integrated centers and community-based care sites for developing future dementia friendly services in Taiwan.