Institute of Public Health, College of Medicine, the National Cheng Kung University, Tainan, Taiwan.
Arch Gerontol Geriatr. 2013 Mar-Apr;56(2):370-6. doi: 10.1016/j.archger.2012.11.005. Epub 2012 Dec 3.
Although family caregiving for elderly people has been the backbone of long-term care in Taiwan, it is not clear whether informal help from family members has diminished in recent years due to changes in social structure and traditions. The objective of this study is to examine the trend and the factors influencing the use of informal and formal caregiving among disabled elders in the community of Taiwan. Data were drawn from three waves of the Taiwan Longitudinal Study on Aging (TLSA) (1999, 2003, and 2007) to examine the receipt of help with activities of daily living (ADLs) in a nationally representative sample of Taiwanese elderly people aged 65 and older. Results showed the trend in having at least 1 of 6 ADL limitations in the community increased mildly in the past decade but a significant rise in the use of paid help compared to informal help between 1999 and 2007. Factors associated with higher likelihood of paid help use included better socio-economic status and more ADLs. However, those living with spouse only were much less likely to use paid help than those living with adult children. Findings suggest that future long-term care (LTC) policy in Taiwan should focus more on providing elders who live alone or with spouse only additional caregiving resource. Given the rapid growth of foreign care workers as primary source of caregiving, the government needs further monitoring to promote care quality and also strategies to develop needs-led home and community based care.
虽然家庭照顾老年人一直是台湾长期护理的支柱，但由于社会结构和传统的变化，近年来家庭成员提供的非正式帮助是否减少尚不清楚。本研究的目的是探讨台湾社区残疾老年人使用非正式和正式护理的趋势和影响因素。本研究的数据来自三次台湾老龄化纵向研究（TLSA）（1999 年、2003 年和 2007 年），以调查在全国代表性的台湾 65 岁及以上老年人样本中，日常生活活动（ADL）得到帮助的情况。结果表明，过去十年中，社区中至少有 6 项 ADL 受限的趋势略有增加，但与 1999 年至 2007 年相比，有偿帮助的使用与非正式帮助相比显著增加。与有偿帮助使用可能性更高相关的因素包括更好的社会经济地位和更多的 ADL。然而，与与成年子女同住的人相比，与配偶同住的人使用有偿帮助的可能性要小得多。研究结果表明，台湾未来的长期护理（LTC）政策应更加关注为独居或仅与配偶同住的老年人提供额外的护理资源。鉴于外国护理人员作为主要护理来源的快速增长，政府需要进一步监测，以提高护理质量，并制定以需求为导向的家庭和社区护理策略。
