在地整合的共生照顧體系：日本佛子園行善寺

Community-Based Integrated and Inclusive Care System: A Study of BUSSI-EN GYOZENJI in Japan

2025年日本老年人口比例將達到30%，日本政府重視社區整體照顧議題，為此，厚生労働省於2016年提出「地域共生社會」政策。佛子園行善寺以「大雜燴」為主要經營理念，強調社會包容與正常化，希望創造共容性的社區。本研究以行善寺為研究對象，主要研究目的為：（1）理解日本在地共生型服務理念；（2）介紹社會福祉法人佛子園行善寺的空間配置、環境設計；（3）以在地共生社會理念分析佛子園行善寺的實務運作。本研究以文件、檔案紀錄、訪談、參與觀察蒐集資料，共訪談4位工作人員，以及14天的參與觀察。研究結果發現：（一）行善寺以空間設計實踐共生型理念：不論男女老少、身障者等各式各樣的參與者都可以自在地在行善寺行動，就如同小型社區。（二）以正常化與社會包容為核心精神，提供以福利服務使用者為中心的服務，創造「不排除任何人」的環境。（三）透過各式各樣的人與人之間互動，打破照顧者與被照顧者界線，產生彼此支持的關係。（四）需注意在地共生社會政策是否造成政府責任退縮，以及中央政府與地方政府責任劃分的問題。

"By 2025, 30% of the population of Japan will be older adults. The Japanese government has gradually attached greater importance to the notion of community care. In 2016, Japan’s Ministry of Health, Labour and Welfare proposed a policy of“region–society symbiosis.”Bussi-En Gyozenji, a regional social welfare organization, takes the concept of“integration (between various members of society)”to be its main operating philosophy. They hope to realize a society where everyone—young and old, able-bodied and non-able-bodied—interact with each other as contributing members of society. This study aimed to (1) explore the concept of region–society symbiosis, (2) introduce the services of Gyozenji and explore how they designed their premises with accessibility in mind, and (3) analyze how Gyozenji implements the concept of region–society symbiosis. Data were collected from documents, archival records, interviews (with four staff members), and an observation of organization activities (for 14 days).Our results indicated the following. (1) Gyozenji uses accessible design to realize the conception of a symbiotic society. Clients can use Gyozenji services regardless of their gender, age, or disability or lack thereof. (2) Gyozenji creates an environment in which“no one is excluded”(their motto) and provides user-centric welfare services with social inclusion and normalization as their core values. (3) Gyozenji lowers the boundaries between care recipients and caregivers through close interpersonal communication and the creation of a supportive relationship. (4) The policy of region–society symbiosis has resulted in the government taking a backseat. We propose for the responsibilities between the central and local governments to be well defined."