長照機構人性化服務之解析與兩岸比較——以雙連安養中心及杭州市第三社會福利院為例

Abstract

背景 人口的老齡化正在成為一種世界性的趨勢。而相比於歐洲平穩緩慢的老化進程，在中國的老齡化來的迅速且猛烈，預計在2035年進入超高齡社會。雖然在近30年中養老床位數量快速增加，照護品質出現諸多問題，但另一方面積極探索養老品質提升的作為也持續出現。人性化照顧的品質面向是養老機構至為重要的品質層面。而臺灣在該方面比大陸起步早，經驗更豐富，故本研究希望通過比較兩岸養老機構的差異，從而思考以雙連安養中心為例的台灣模式與大陸模式之間的差距，並探討臺灣模式是否能夠幫助大陸養老機構提升其人性化照護的品質。 方法 本研究採用個案研究法，將雙連安養中心與杭州市第三社會福利院作為探討的個案標的，以內容分析法來瞭解兩岸機構經營之現況，以及探討各別的人性化服務之優劣勢，以進而評估大陸長期照顧機構學習採納的可能性。 結果 依據從文獻中歸納出的老人的心理需求、生理需求、社會需求、靈性需求、全人照護與個別化等六個人性化位面來評估兩間機構的人性化服務。研究結果發現，透過在居住環境設施、公共環境設施、醫療設施、精神文化設施、生活服務、照護、組織架構、服務體系、培訓制度、員工薪資及激勵政策、組織文化諸方面進行了人性化要素的檢視與比較，發現雙連安養中心在設施、服務、及制度方面均有值得學習的人性化服務。 結論 通過檢視與比較，雙連安養中心的適老化設施的設置，靈性慰藉，及員工同理心的培養方面是值得杭州市第三社會福利院借鑒與學習。由於大陸機構在滿足老人的個體需求、群聚需求和人生意義追尋方面仍有欠缺，因此應該從老人實際生活中的具體而細微的需求出發，通過設計和設置來滿足老人實際需求的硬體設施，從而達到提升老人使用體驗的滿意度。而在照護人員態度及能力培訓方面，主要停留在技能培訓層面，缺乏對於照護人員的友善態度的正向引導並培養其具有同理心關心老人，尊重和讓老人信任的服務品質。同時對於照服員精神慰藉的服務能力缺乏應有的重視，也沒有投入相應的資源，這方面的工作仍然任重道遠。管理方面則以獎懲制度為主，儘管可以通過指標維持一定程度服務品質，但不利於激發照護者自發的善意和照護的主動性。

Background Population aging is a common trend that the globe will face. Comparatively with Europe’s steady and slow aging process, China is undergoing a rapid and fierce transformation that is expected to transform the country into a super-aged society by 2035. Though the number of pension beds is increasing rapidly and the quality of care is still in doubt during this period, active exploration for improving the endowment continues. The most critical aspect of senior care institutions is the quality of humanized care, and Taiwan has a head start and extensive experience in this area. By comparing the differences between the nursing institutions on both sides of the Taiwan Strait, we hope to observe the process of elderly care development in mainland China, analyze whether there is a gap between the mainland model and the Taiwan model represented by Suang-Lien Elderly Center, and explore whether the Taiwan model can be conducive to improving the quality of humanized care in mainland China. Methodology This study adopts the case study method, taking Suang-Lien Elderly Center and Hangzhou No. 3 Social Welfare Institution as the subject. Through case selection, data analysis, and report, we aim to illustrate the current operation situation of the two institutions and explore the advantages of Suang-Lien’s humanized services, exploring the possibility of its replication in the mainland. Result From the literature, we have summarized four humanization dimensions, including psychological needs of the residents, physiological needs, spiritual needs, social needs, holistic health care, and individualization of residents. The results showed that by examining and comparing humanistic factors in residential environmental facilities, public environmental facilities, medical facilities, spiritual cultural facilities, life services, nursing, organization, service system, training system, employee salary, incentive policies, corporate culture, and many aspects, the organization, Shuang lian, provides worth-learning humanistic services in terms of facilities, services, and institutions. Conclusion Through review and comparison, Suang-Lien’s aging-friendly facilities, spiritual comfort, and the cultivation of empathy among the staff are of great value to us.Several gaps exist in our institutions when it comes to meeting the individual needs, group needs, and the pursuit of life meaning of the elderly. Starting from the specific and subtle needs of the elderly in their actual lives, we may design and set up facilities that can meet the actual needs of the elderly, so as to enhance their satisfaction. As for the training of care personnel’s attitude and ability, we are mainly at the level of skills training, lacking positive guidance for their friendly attitude and cultivation of their empathetic care, respect and service quality. At the same time, there is a lack of attention and resources devoted to the improvement of their spiritual comfort. In terms of management, with the system of rewards and penalties mainly used, although it can maintain a certain degree of service quality through indicators, it is not conducive to stimulating the caregivers’ spontaneous goodwill and caregiving initiative.