強化居家醫療及安寧療護善終－－澎湖經驗

Strengthen Home-based Medical Care and Palliative Care to Make Good Death Possible, Experiences in Penghu

高齡、失能或多重慢病對醫療是挑戰，尤其在離島，當長輩無法出門，如何把醫療服務搬到家裡彌平健康不平等，若藥石罔效或想落葉歸根，怎麼讓鄉親完成心願？筆者為澎湖第一位具安寧緩和專科的地方公費生，積極推廣安寧療護及居家醫療，將來想怎樣被照顧，現在就要提供相應的醫療服務。本文分享目前幾個重點業務，如安寧療護、居家醫療、機構安寧、病人自主權利法等，建構有機的照顧網絡，讓鄉親能在地善生善終。經數年努力安寧涵蓋率有略微提升至四成，非癌佔比提高已破五成，部分個案也能在居家或機構善終。

Advanced age, disability, and multiple chronic diseases pose challenges to medical care. How can we bring medical services to homes to bridge health care inequalities when our elders cannot go out for doctor visits? If medicine fails to work or if we the elderly want to return to their roots, how can we help these folks fulfill their wishes? The author is the first local government-funded student on Penghu who specializes in palliative care. He also actively promotes home-based medical care. How he wants to be taken care of in the future must be coincide with corresponding medical services now. This article shares several current key businesses, such as palliative care, home-based medical care, hospice care in institution, Patient Right to Autonomy Act promotion, etc., to build an organic care network so that folks can live a good life and die locally. Nowadays, the hospice coverage rate has increased, as well as the proportion of non-cancer cases, and some such cases can also die at home or institutions.