上學「趣」：雲、嘉、南地區失智長者的學習長路

The Joys of Going School The Long Road of Learning among Aging People with Dementia in Yulin, Chia-Yi and Tainan

全球目前有超過4,680萬人罹患「失智症」（Dementia）；而台灣的失智問題有多嚴重？根據官方統計，目前失智總人口數約24.4萬人，幾乎等同於一個彰化市的總人口數。上述這些數字顯示，失智這項疾病已成為台灣必須面臨的重要健康議題。研究失智照護的專家學者指出，失智症的照護不能光靠醫療院所的醫護人員，它必須走入社區，活化社區資源。據此，既可節省醫療資源，也可提升失智照護品質及實踐失智照護在地化。國內中、南部地區的風俗民情、人民的生活方式及聚落的發展，正好吻合社區介入的新取徑，讓失智預防及照護社區化找到可能性本研究由大林慈濟醫院相關失智之醫療團隊及中正大學社科院系所師生一起從社區介入，結合雲、嘉、南等地區的衛生局及非營利社會組織合作，透過AD-8極早期失智篩檢量表及MMSE（mini-mental state examination）檢測等方式，篩檢出罹患失智症的病人。並於社區設置「樂智學堂」，並組成失智病人與家屬社會支持團體，不僅關心病人，也關心家屬。此一學堂的特色是失智長者可以得到完善的照護，家屬也有機會喘息。從一到多據點，主要從懷舊療法介入讓失智病人有機會接觸人群，在互動過程中相互取暖。也因此發現必須要規劃在地性的學習課程因地制宜，才能延緩失智者老化的速度，進而提升其生活品質。

More than 46.8 million people suffer from ＂dementia＂ throughout the world. According to official statistics, the total number of people with dementia in Taiwan is approximately 244,000, equivalent to the population of Changhua city. Figures show that Taiwan has to cope with this important health issue. Expertise suggested that the care for dementia patients cannot be solely reliant on staff from medical institutions; joining the community and utilizing available resources within the community are also important. By doing so, medical resources can be economized, and the quality of care can be enhanced and localized. In central and southern Taiwan, the customs and natural lifestyle are suitable for community involvement. This study was conducted by the Dalin Tzu Chi Hospital dementia medical team, together with teachers and students from the Social Science Institute of Chung Cheng University, as well as the Health Bureau and non-profit social organizations including the Yunlin, Chiayi, and Tainan counties. The patients were given a screening through the AD-8 very early deme ntia screening scale, and the MMSE mini-mental state examination testing. After passing the screening tests, the patients were gathered in a ＂Joyous Dementia Centre＂ that does not only provide care for patients, but also for their families through social support groups comprised of dementia patients and their families. The distinguishing feature of the institution is that elders with dementia can receive proper care, which allows their family members to have a chance to take a break. Community involvement, mainly through nostalgia therapy, improves the elders' contact with people, and allows them to receive positive emotions from the process of interacting with others. The finding of the research is that educational courses must correspond with the community values and lifestyles. Through localization, the rapid growth of the dementia population can be halted, and the quality of the lifestyle of the elderly with dementia can also be improved.