長期照顧的社會經濟與網絡治理「厚熊笑狗」行動研究初探

Using the Participatory Action Research Approach to Explore Social Economy and Network Governance for Long-term Care: A Case Study of Elderly Care with Homie Care Model in Puli

面對台灣高齡化的人口照顧課題，本文透過行動研究的方式，分析暨大、埔基與愚人之友基金會於2017年共同組成行動研究團隊，針對鄉村高齡照顧的若干重要課題，以「社會經濟」為核心理念，逐步鏈結在地社群網絡與產業資源，規劃在地化的高齡照顧社會經濟網絡，協力建構一個以大學、長照組織、在地社區組織及地方產業所共同參與的「厚熊笑狗高齡生活照顧體系」治理網絡。透過本項行動研究的歷程分析，發現在地化的長期照顧服務涉及網絡建構、網絡運轉、網絡穩定等不同階段的課題。首先，在網絡建構的階段，需要透過信任與價值理念認同兩項關鍵要素的相互交織，促成在地社群成員共同參與網絡的建構過程，並成為後續網絡治理的行為者；其次，在網絡運轉的階段，則是需要進一步透過行為者間的資源交換，加深行為者間的互動關係，使得網絡得以產生鏈結與運轉；最後，在網絡的穩定階段部分，需要透過網絡制度規範的建立，將行為者的角色與參與在網絡中的行為進行常態化的規範建立，讓網絡能夠永續運轉。而在地化的網絡，也會因為新議題或行為者的出現，網絡會持續地進行重組，透過動態過程形成解決在地需求的服務資源網路。本文透過彙整高齡社會下建構社會經濟體系與網絡治理的重要創新方案，作為國內各大學投入在地社會實踐之行動經驗參考，同時提出政府長照政策在推動上應有的興革建議。

Taiwan's Long-Term Care (LTC) Plan 2.0 introduced in 2016. In order to step into the community and experiment with a set of social design practices, the team of USR of NCNU have worked proactively with civil groups, Puli Christian Hospital and Quixotic Implement Foundation (NPO) to set up the Community Care Network since 2017. This project proposed a working model that recognizes, facilitates and supports informal neighborhood care networks (called Homie Care System) at multiple levels.To explore social economy and network governance of the innovative model for elderly care, we conducted the participatory action research analysis using data from Puli town involving 25 communities, 8 NPO and 13 local enterprises. The results of this study indicate that ''trust'', ''value identification'', ''resource-sharing'' and ''norms'' directly impact implementation to Community Care Network. The novel Homie Care model developed by USR team of NCNU may provide a useful experience for future research on social practices and offer some specific recommendations for practices and policies for long-term care.