| 摘要: | 由於現代社會少子化及人口結構快速老化，又加上科技進步，醫藥發達，根據內政部今年 9 月最新統計通報，國人平均壽命男生為 76.8歲，女生為83.4歲，且內政部今年3月另一項數據已顯示，我國老年人口數首次超過幼年人口數，而預計在明年，臺灣65歲以上人口將突破百分之十四，成為高齡社會，甚至在114年超過百分之二十進入超高齡化社會，因此，長期照護的議題是越來越重要，且跟我們人人都息息相關。
本文共分五章，第一章介紹研究動機與目的、研究方法及各章架構；第二章先介紹上位概念健康權，再說明健康權與長期照護之關連性，然後依序介紹長照雙法及商業型長照照險；第三章介紹長照服務法的服務類型、照護評估與不服評估時之爭議處理；第四章是先回顧長照1.0後，再說明今年剛上路的長照2.0，之後再與安寧緩和醫療作一連結整合，第五章結論即用長照與安寧療護之結合帶出善終之總結。
從生命權及人格權的角度出發，長期照護制度必須以人為中心，在提供長照服務時，對其人性尊嚴的尊重也是不可退守的防線，安寧緩和醫療條例也是從臨終病人生命權絕對保障，漸走向尊重病人的人性尊嚴與自決權，因此，長期照護和安寧緩和在看似衝突下，其實是相互競合的。最理想的照護就是以人性化的照護為出發點，回應病人身、心、靈的需要，提升病人的生活品質，維護病人的人性尊嚴，而這也是長期照護與安寧緩和的共同終極目標。
With modern society’s declining birth rate, the rapidly aging population structure and the advancement of science and technology and medicine, according to the latest statistics this September from the Ministry of the Interior (MOI), the average life expectancy is 76.8 years old for men and 83.4 years old for women. Other statistics from the MOI this March show that the elderly population in our country has, for the first time, exceeded the number of young children. It is estimated that Taiwan’s population of over 65 years old will exceed 14% by next year to become an aging society and will exceed 20% by 2025 to become an ultra-aging society. Therefore, the issue of long-term care has become increasingly important and relevant to all of us.
This paper is divided into five chapters. The first chapter introduces the research motivation and purpose, research methods, and the chapter structure. The second chapter introduces the concept of the right to health, an explanation of the relevance between the right to health and long term care, as well as the Long-term Care Dual Acts and commercial long-term care insurance. Chapter 3 introduces the service types covered in the Long-term Care Act, care assessment, and handling of disputes arising from assessment dissatisfaction. Chapter 4 reviews Long-term Care 1.0 and explains Long-term Care 2.0 that has just been implemented this year, which are linked and integrated with hospice & palliative care. Chapter 5 covers the conclusion, that summarizes the combination of long-term care and palliative & hospice care.
From the perspective of right to life and personality, the long-term care system should be people-oriented. When providing long-term care services, respect for human dignity is also an uncompromising line of defense. Hospice & palliative regulations have gradually shifted from “absolute guarantee to the right to life” to “respect for patients’ human dignity and right to self-determination”. Hence, long-term care and hospice & palliative care may seem to be in conflict, but they actually complement each other. The ideal care is based on humanized care that responds to the physical, psychological and spiritual needs of patients, enhances their quality of life and maintains their human dignity, all of which are the ultimate goals of long-term care and hospice & palliative care. |
