Hou Chien-Chou, Kuo Tsuann
a Department of Medical Sociology and Social Work , Chung Shan Medical University , Taichung , Taiwan.
J Gerontol Soc Work. 2019 Apr;62(3):306-323. doi: 10.1080/01634372.2019.1575307. Epub 2019 Feb 11.
Taiwan faces the world's top aging rate over the next 8 years, making long-term care a priority for all populations, including the 16 indigenous groups who live primarily in the mountains and have different cultural practices than mainstream Taiwanese people. To examine how home care services are coordinated, managed, and delivered to the indigenous populations, we interviewed 10 public care managers and analyzed the interview content to assess their work experiences with home care workers and indigenous users in 2016. The research revealed four findings: (1) Home care utilization patterns and attitudes were different between the rural indigenous and non-indigenous populations; (2) home care utilization was limited by cultural, economic, and language challenges; (3) home care workers faced cultural and socio-structural challenges; and (4) policy and service provisions were rigid, without the socio-structural flexibility needed to accommodate the indigenous culture. A more efficient model will require the collaboration of public care managers, home care workers, and indigenous families to create a fair-coordinated plan. As Taiwan launches the Ten-year Long-Term Care Plan 2.0, a one-stop service delivery center to integrate care options and provide services for people of indigenous backgrounds is a must.
未来8年,台湾将面临全球最高的老龄化率,这使得长期照护成为所有人群的优先事项,其中包括主要居住在山区、文化习俗与台湾主流人群不同的16个原住民群体。为了研究居家照护服务如何协调、管理并提供给原住民群体,我们于2016年采访了10位公共照护管理人员,并分析了访谈内容,以评估他们与居家照护工作者及原住民使用者的工作经历。研究发现了四点:(1)农村原住民和非原住民人群在居家照护利用模式和态度上存在差异;(2)文化、经济和语言方面的挑战限制了居家照护的利用;(3)居家照护工作者面临文化和社会结构方面的挑战;(4)政策和服务提供僵化,缺乏适应原住民文化所需的社会结构灵活性。一个更有效的模式将需要公共照护管理人员、居家照护工作者和原住民家庭共同协作,制定一个公平协调的计划。随着台湾推出“长期照护十年计划2.0”,设立一个一站式服务中心以整合照护选项并为原住民背景的人群提供服务是必不可少的。