| 摘要: | 目前國內對於獨居失能老人鮮少有相關之研究，本研究以獨居失能老人的人口特質、健康狀況、社會支持、醫療服務使用及居家環境做概略描述，並分別依性別做比較。
研究資料取自行政院衛生署委託國立台灣大學進行之『全國長期照護需要評估』研究計畫，研究對象為772位獨居失能的老人，研究結果顯示：平均年齡為79.7歲、女性佔68.3％、籍貫以閩南籍最多（71.4％）、外省籍（13.1％）次之，約七成之家庭月收入在一萬元以下，平均子女數為3.7人，近七成個案沒有任何照顧者，平均罹患1.5種以上之慢性病。慢性病以高血壓、關節炎或風濕、心臟病居多；五成以上個案的認知功能正常，ADL平均有0.79項失能，IADL平均失能2.89項，個案在八成以上沒有參加任何宗教或社團活動；在過去一個月中，個案約七成看過西醫門診，個案的居住環境普遍不佳，尤其近九成的家中浴室或地板，並未做好防滑及安全扶手設施。
在性別比較結果顯示：女性獨居失能老人在認知功能之中、重度障礙是男性的兩倍。男、女性的獨居失能老人在平日最主要的接觸對象為鄰居，兒女次之。女性獨居失能老人和兄弟姐妹的接觸最少、而男性獨居失能老人最少接觸的則是親戚。與家人的互動關係則以女性獨居失能老人較佳；在醫療服務的使用狀況，除了門診整體看診次數外，男性在住院、急診或由急診轉住院的百分比均比女性要高。
獨居失能老人非常需要正式照顧資源的介入，但並不是每個獨居老人都適用且需要同一式樣的照護及介入服務。盡量協助獨居者在其生活體系中去建立支持系統，發揮個案管理師的功能，利用有限的資源，提供個別性的服務，將照護資源發揮到最大的成效，才是往後政府與民間需要努力的方向。
Studies on disabled elderly who live alone are rare. This research focused on disabled elderly living alone, and attempts to describe their demographic, health, social, medical care utilization, and living environment characteristics. Furthermore, sexual comparisons on these characteristics are carried out.
Data come from the “National Long-term Care Needs Assessment” study. In the study, there were 722 disabled elderly living alone. Results showed that the average age was 79.7 years. The percentage of females, Fukienese, and Mainlanders were 68.3%, 71.4%, and 13.1%, respectively. Over 70% of subjects had a monthly income below NT$10,000. On the average, study subjects had 3.7 children, but about 70% of them did not have a caregiver. Hypertension, arthritis, and cardiovascular disease were the most common chronic conditions. On the average, subjects had disabilities in 0.79 of 6 activities of daily living, and in 2.89 of 8 items of instrumental activities of daily living. More than half of the subjects had normal cognitive functions. More than 80% did not participate in any social or religious activities. In the past month, about 70% have had a physician visit. The living environment in general was poor, and almost 90% of subjects did not have any anti-slipper devices in bathrooms.
Sex comparison showed that the females had more serious cognitive impairments than males, but had fewer physician visits, emergency room services, or hospitalizations. Both sexes had frequent contacts with neighbors and children, but females also had more social contacts than males.
Disabled elderly who live alone are in need of formal intervention. The type of intervention needed do vary across individuals. For the disabled elderly living alone, the aim of future policy should try to establish support mechanisms from their social contacts. With limited resources, the government should consider using a care management scheme to assist these elderly to receive individualized and effective services. |
