身障機構服務對象老化服務提供模式之研究

A Study of Services Provided by Institutions for the Disabled Versus the Current Model of Facilitation of Aging Services

台灣地區身心障礙福利機構多數皆面臨服務對象老化需求轉變的問題，但對於機構中老化的身障者服務內涵，卻少有研究。本研究目的在於了解身心障礙機構提供老化服務之現況。研究方法：採橫斷性研究，以郵寄問卷方式進行資料蒐集，研究對象為台灣地區以智能障礙為主的身障機構122家，共計回收118份問卷其中116份問卷為有效問卷，回收率為97%。研究結果：各機構平均老化的比例為35%；就轉銜安置方面：當需求轉變後，機構以採取轉介至護理之家為最多占（58%），轉介過程遇到最大的問題是收費問題（82%）；就在機構設立專區方面有80%認同身障者在機構終老，而已設立老化專區者僅占14%。就照顧內涵而言，本研究完成環境設施方面、教育訓練、醫療保健、體適能、評估工具、教學活動、班群運作、作息安排、家庭支持等調查並分析其執行現況。最主要的困難則是在於照顧人力、緊急醫療的壓力及健康照護的技術方面。結論：國內身障機構普遍均面臨了老化智障者照顧的問題，同時也面臨轉介的困難，機構雖高度認同讓服務對象在機構在地老化，卻僅有少數機構實施老化專區的行動，除了顯示最大的困難在於照顧人力不足之外，在政府提倡長期照顧政策的同時，規劃人力支持、醫療技術、老化知能培訓實有其必要性，對智障者老化之具體配套措施值得省思。

In Taiwan, the majority of services provided by welfare institutions for the disabled aremet with challenges due to changes in aging needs; however, research is scarce when itcomes to the services provided for the disabled who experience aging inside aninstitution. The purpose of this research is to understand the current situation ofaging services provided by institutions for the disabled. Research method: using across-sectional study, questionnaires were sent through the post to collect data. Thestudy focused on 122 institutions that mainly house the intellectually disabled. A totalof 118 questionnaires were completed, with 116 being effective, resulting in a responserate of 97%. Research results: the average aging ratio among the surveyed institutionswas 35%. Regarding transfer and placement, when there is a change in resident needs,the majority of the institutions refer residents to nursing homes (58%); the biggestproblem during the referral process is fees (82%). Concerning setting up a specializedaging area inside institutions, 80% agree that the disabled should spend their old agewithin the same institution, but only 14% of the institutions already had a specializedarea. As far as what is included in their care, this study surveyed and studied manyaspects of the current situation, such as the environment and facilities, educationaltraining, medical care, physical fitness, assessment equipment, educational activities,class operation, routine and schedule, and family support. The most challengingaspects are caretaker resources, the stress of urgent medical treatment, and the know-how for health caretaking. Conclusion: taking care of the aging mentallydisabled is a common problem that local institutions for the disabled experience.Likewise, referrals are also a challenge. Although institutions largely agree thatresidents should age within the same institution, few are mobilizing to implement aspecialized area for the aging residents. In addition to showing that there is a scarcityof caretaker resources, this study showed that the government’s promotion oflong-term caretaking policy and specific support measures for the aging of theintellectually disabled, such as human resource support planning, medical technology,and the necessity for old age training which are worthy of consideration.