日本長照領域推動自立支援照顧模式經驗之初探

A preliminary study on promoting the self-reliance support model in long-term elder care in Japan

面臨身心功能逐漸衰退的老年長照需求者，照顧工作者應如何推動「自立支援」照顧模式，如何協助老年長照需求者提升其生活自理能力，是本文欲闡明之關心所在。有鑑於我國長照界推動的自立支援照顧模式是取經自日本長照界，本文收集日本1988年至2000年之老年長照政策官方文獻以及日本近三年出版之介護福祉士教科書及照顧工作者培訓教科書，篩選納入章節含有「尊嚴」、「自立」、「自立支援」、「照顧的基礎」計8冊，以概念性文獻回顧日本政府與日本社福學者是如何詮釋老年長照領域之「自立支援」理念以及透過推動「自立支援」照顧模式，如何將照顧工作內涵朝「廣義」概念發展。本文歸納出日本長照領域推動「自立支援」照顧模式之特色與意義各有五點；於長照實務場域中的推動步驟含有七項流程；日本培育照顧工作者具備之專業能力包含六個面向，可供我國未來探討「廣義」照顧工作內涵以及規劃照顧工作者提升其專業能力內涵之參考。

This aim of this study was to address how care workers can promote the self-reliance support model and assist elderly people to enhance their self-reliance capabilities when facing the physical and mental deterioration associated with old age. We searched for the terms ''dignity,'' ''self-reliance,'' ''self-reliance support,'' and ''foundations of care work'' in eight certified care worker training textbooks for the past 3 years. A conceptual literature review approach was adopted for examining how Japanese social affairs researchers interpret the concept of self-reliance in long-term elder care. Subsequently, we expanded the caregiving content to a more general concept through promotion of the self-reliance caregiving model. Finally, the study identified five characteristics of the self-reliance caregiving model in use in the long-term care sector in Japan. We discuss seven steps for promoting appropriate practices in the long-term care field and argue that the core professional competence of Japanese care workers is to put ''upholding dignity'' and ''self-reliance'' into practice. Additionally, six aspects of professional capability training were identified in this study. The insights gleaned can be a reference on general caregiving for Taiwanese care workers that may be used to enhance their professional capabilities.