從偏鄉社區照顧開展至整合照顧模式（BC）──以宜蘭縣大同鄉為例

The Example of Datong Village, I-Lan County--From Care of the Remote Area Extending to Intergrated Care Model

長照十年計畫2.0（以下簡稱長照2.0）強調以社區整合照顧模式來佈建社區中的長照資源，以建構優質、平價和普及的長照服務體系，讓民眾獲得最便利的長照服務。但社區整體性照顧模式之運作，其先決條件是社區中必須有一定的長照資源，才有辦法進一步談”整合”，否則整合照顧將成為空談。對於國內偏鄉地區，既有的問題就是長照資源不足，更遑論以整合照顧模式提供服務。因此，在整合照顧模式之前，勢必須先推動社區照顧計畫，強調社區組織與居民的共同參與，提升社區照顧意識與照顧能量，方能使社區（部落）逐步建構社區資源，讓社區（部落）也成為重要照顧提供者，進而使社區中的失能者安心留在社區中接受照顧。本文以一粒麥子社福基金會自2014至2017年於宜蘭縣大同鄉推動社區照顧試辦計畫，以及2017年7月起順利銜接長照2.0社區整合照顧計畫（BC）之實踐歷程為例，以作為國內執行相關偏鄉照顧方案之參考。 The Ten-Year-Long-Term Care 2.0 is to emphasize on the service of the Community Intergrated Care model to set up a long-term service system of excellence, fairness and popularization. Therefore, it can make people to get the most convenient long-term care service. However, a prerequisite for the operation of Community Intergrated Care Model is to have the necessary long-term care resources, and then there are ways to talk about the ''Intergration''. Otherwise, the intergraton care will be buncombe. The existing problem is insufficient long-term resources for the remote areas. It is not to mention to offer service for the ''Intergration Care Model''. Therefore, we have to promote the ''Community Care Plan'' as well as to emphasize on the community organization and citizens' participation. In order to enhance the care consciousness and care energy before we intergrate the care mode. Then, we can gradually establish resources of the communities (tribes), to make them become the providers. So that the disabilities of the community can stay in the community to accept care peacefully. We act as a ''A Karnel of Wheat Foundation'' have promoted the community care trial plan from the year of 2014 to 2017 in Datong Village, I-Lan County, and at the same time taken the example of linking up the practice of Ten-Year-Long-Term 2.0 Community Intergrated Care Model successfully for the domestic execution reference of the related care for the remote areas.

The Ten-Year-Long-Term Care 2.0 is to emphasize on the service of the Community Intergrated Care model to set up a long-term service system of excellence, fairness and popularization. Therefore, it can make people to get the most convenient long-term care service. However, a prerequisite for the operation of Community Intergrated Care Model is to have the necessary long-term care resources, and then there are ways to talk about the ''Intergration''. Otherwise, the intergraton care will be buncombe. The existing problem is insufficient long-term resources for the remote areas. It is not to mention to offer service for the ''Intergration Care Model''. Therefore, we have to promote the ''Community Care Plan'' as well as to emphasize on the community organization and citizens' participation. In order to enhance the care consciousness and care energy before we intergrate the care mode. Then, we can gradually establish resources of the communities (tribes), to make them become the providers. So that the disabilities of the community can stay in the community to accept care peacefully. We act as a ''A Karnel of Wheat Foundation'' have promoted the community care trial plan from the year of 2014 to 2017 in Datong Village, I-Lan County, and at the same time taken the example of linking up the practice of Ten-Year-Long-Term 2.0 Community Intergrated Care Model successfully for the domestic execution reference of the related care for the remote areas.