| 摘要: | 「老人外展服務」工作已成為現今台灣老人福利服務相當重視的重點工作。在相關法令與機構服務漸趨成熟的情況下，為因應龐大的老人福利服務業務，「外展服務」的確有其積極推展的重要性。社區外展服務主要的推動項目有：「社區日間托老」、「短期照顧」、「社區講座」、「問安專線」、「福利諮詢」、「文康休閒服務」以及「居家服務」等，本研究透過機構特性與機構推動外展服務之情形進行研究，研究對象為台灣地區54所已立案的老人安養、養護機構，本研究資料來源是以1999年本人參與之台灣省政府社會處之研究資料庫，有效問卷47份，回收率為87％。本研究之目的為了解各機構目前辦理外展服務的情形、辦理外展服務的優點及缺點、遇到的困難及希望獲得的協助。研究結果發現：（一）老人機構外展服務之推動—進入機構參與模式之檢討：1.過去機構以「文康休閒及才藝」為主的外展服務已轉型至以「照護」為主的發展趨勢，機構之「日托」、「臨托」服務在社區中，成為最主要發展要項；2.整合資源平台提供諮詢服務之傳達訊息責任；3.休閒、文康相關活動仍佔「進入機構參與模式」一定比重及功能；4.老人學苑需求日益增加更應普及化、社區化，機構可多辦理，服務地方民眾，扮演進入機構外展的社區性責任及功能，並可擴展社區照顧據點。（二）機構辦理「走出機構外展服務」方面：1.與社區聯結活動走出機構，進入社區是重要的面向，並且有利於機構行銷與發展； 2.陪同社區中老人就醫是重要的社區外展服務，以回應社區中人口老化健康照顧之需求；3.老人「居家服務」之外展工作大幅擴展，成為重要的機構外展功能。（三）推動外展服務之優缺點、及面臨困難：1.推動外展服務之優點為「增加社區關係」、「符合社區民眾需求」、「增加場地設施使用率」「增加機構知名度」，對機構之行銷及業務擴展有相當貢獻；2.推動外展服務之缺點主要為「工作量增加」、「財務負擔增加」、「院民生活被打擾」、「機構場地變得擁擠」及「服務品質下降」等，對機構形成挑戰；3.機構推動外展所面臨困難包括「專業人力」、「財力不足」及「場地設施及空間不足」均讓機構外展推動被限制。本研究建議：1.機構應積極擴大外展居家服務，並且在評鑑制度中成為重要項目；2.提昇外展居家服務照顧品質及照顧管理制度；3.持續培力照顧員專業人力，邁向專業證照制度及規劃升遷管道；4.機構編列預算，爭取財力支持；5.大專院校開設推廣教育學程、產學合作，俾利學用一致化。
Recently, the issue of Elderly Outreach Service had become a very important project on elderly welfare in Taiwan. In order to appropriate a huge business of aging welfare service, positive outreach service promoted absolutely important under a relevant policy and agent service gradually mature circumstance. The main programs of community outreach service are as follows; 1.aged day care in community, 2.shortterm care, 3.community lecture, 4.greetings call, 5.welfare consulting, cultural & leisure service as well as at home service etc. This research proceeded its study through the character of institution and situation of outreach service implementation, the subjects of research were 54 registered aging care, nursing care institutions in Taiwan and the data derived from 47 available questionnaires (returned rate 87%) of Taiwan Social Bureau in 1999. The aim of this research tried to understand the different institutions in managing the situation of outreach service for the present. The consequence of research were found: 1.Promoting an outreach service of aging institution-study on participating in institution model; (1) the cultural, leisure and artificial skill programs were the main service long ago, however the institutional day care, temporary care were the primary developing programs in the community and the "care" were instead of this important trend development (2) a stage of resources integrating to assure the responsibility of consulting information transmission. (3) relevant activities of leisure, cultural programs still occupied certainly the percentage and efficacy on "participating in institution model" (4) the aged institutes demanded extensively, the institutions could offer universalizing, communizing services for the people to act the social responsibility and efficacy for melting into "participating in institution model" then enlarged the care centers in the community. 2.institution managed "out of the institution outreach services": (1)it was a very important profile to walk up to people in the community from institutions with activities, it was a good way of institutions on marketing and development (2)accompany the community elderly to the out patient was an important outreach service, to respond the demand of senile healthcare in the community (3) the outreach program of aged at home service extended extremely, it had become an important outreach efficacy of institution 3. To meet both merit & defect and difficulty on outreach service promotion: 1.the merit of outreach service promotion were increasing community relationship, corresponding with demands of community people, rate of increase to utilize space facilities, to advance the institution exposed opportunity in public, it would absolutely contribute to the institution on marketing and business promoting; (2) the defect of outreach service promotion mainly were working hours increase, heavy financial burden, life of clients would be disturbed, institutional space had gone crowd and down grade service quality happening... etc would challenge the image of institution; 3. The difficulty on promoting outreach service included; practitioners power, a shortage of finance, a shortage of spaces and facilities were limited development on outreach service. This research suggested; 1 institution had to extend positively outreach service and made this program becoming an important item on the evaluation system; 2 to raise outreach at home care quality and care management system; 3 to empower perpetually caregivers towards the professional channel between registered system and promotion; 4 to budget for the institution and to seek the financial support; 5 to create the promoting educational curriculums in the universities, collaboration with industry and academy to carry out consistency on study & usage. |
