長照復能訓練之國際借鏡

Reablement in Long-term Care: Lessons Learned from International Experiences

我國於2018年長照2.0實施復能專業服務，強調以個案為中心，以指導個案生活參與的策略，以個案自選最重要的、最在意的生活項目，做目標導向訓練管理。本文收集整理四個國家之長照專業服務新訊，彙整重點。近三年來日本政府啟動科學長照、以成效為導向的品質管理，建置資訊平台，監測與回饋具有成效、專業度高的服務單位，也減少成效不彰者給付。挪威復能團隊成員同處辦公，專業人員與照顧服務人員密切合作，共同以個案想要的復能目標達成為重；發展社會教育媒材，持續向社會大眾教育和宣導復能概念，建立復能識能。英國在多元場域提供中期照護，最初六週為免費提供，避免因經濟考量錯失時機。復能專業人力投入到以生活照顧為主的團隊（social care）中，緊密合作。澳洲一開始便篩選有潛力個案進行復能，有潛力者與無潛力者後續的服務路徑區隔，每人每年僅能申請兩個期程的復能給付。建立以復能為優先的長照制度，是必須選擇的道路，許多國家的歷程與案例，可供我國借鏡。

Reablement services of Long-term Care 2.0 has been implemented in 2018. It emphasizes a client-centered strategy that guides a client to choose and participate in important life tasks and use their performance of these tasks as an outcome indicator. This article describes and summarizes the latest information of long-term care professional services from four countries, Japan, Norway, England, and Australia.In the past three years, the Japanese government has launched science-based long-term care and performance-based quality management, built an information platform, monitored and given feedback to the professional service units who delivered efficacious care, and reduced payments for those service units with poor outcomes. The Norwegian reablement team staff work together in the same community office, thus providing an environment to facilitate frequent and effective inter-professional collaboration. The professionals work closely with the caregivers to achieve the reablement goals set by the client. Education platforms by social media were created to promote the reablement literacy of the public. The United Kingdom National Health Service provides intermediate care in multiple settings with six-weeks free service to promote easy access to reablement and eliminate financial burden to the recipient. The reablement professionals join the social care team to works closely with the caregivers. Australia My Aged Care separates those with reablement potential and those without potential via screening at the time of application. Those with potential are eligible to receive two periods of reablement per year.The establishment of a long-term care system that prioritizes reablement is a necessary mission to ensure aging in place. Lessons learned from other countries' experiences can be a good reference for our country.