失智症友善社區評估：以台北市中正區崁頂次分區為例

Dementia Friendly Community Assessment: An Example of Assessment in Kanding Subzone, Zhongzheng District Taipei City

隨著失智人口激增，失智症的醫療及照護費用逐年上升。營造失智症友善社區被認為具有延後失智者機構安置時間、降低照護成本、增進失智者與照顧者生活品質等效果。本文運用英國阿滋海默症協會提出失智症友善社區指引做為資料收集與分析架構，進行台北市中正區「崁頂次分區」之社區評估，評估方法包括: 擋風玻璃式觀察，訪談失智者、主要照顧者及重要人士，與問卷調查。結果發現社區僅被動地配合現有的政策，接受「由上而下」的方案，缺乏自發性發展「由下而上」的策略，與失智症友善社區的指引仍有些許落差。建議建立失智症友善社區未來應努力方向包括：(1) 強化失智症的宣導，增加對失智症的正確認知，創造改變的氛圍與迫切性；(2) 積極早期發現失智者，鼓勵失智者及照顧者參與政策擬訂；(3) 凝聚各部門及社區重要人士建立失智友善社區的共識，發展在地化的社區失智症照護模式。

As the dementia population grows, medical and care costs associated with dementia increases every year. Building a dementia-friendly community is considered to have the effect that can delay the placement of persons with dementia into long-term care facilities, reducing the cost of care and improving quality of life patients and their caregivers. In this paper, the guidance of dementia-friendly community by UK Alzheimers Association was used as a framework for data collection and analysis to conduct a community assessment at “Kanding Subzone” in Zhongzheng District, Taipei City. Assessment methods include: windshield observation, interview the persons with dementia and their primary caregivers as well as community opinion leaders, and survey by a questionnarie. The results indicated that most communities adopted the ""top-down"" strategies to follow the existing policy and programs and spontaneously developed bottom-up strategies were lacking. Gaps still exist when compared to the indicators of a dementia-friendly community. It is recommended that the future efforts to achieve a dementia-friendly community should include: (1) strengthening advocacy for dementia, increasing awareness of dementia, and creating a sense of urgency and change atmosphere; (2) actively uncovering persons with early dementia, encouraging those persons with dementia and caregivers involved in policy formulation; (3) obtaining consensus among among service departments and community stakeholders to develop a dementia-friendly community and to establish a locally acceptable dementia care model