失智症友善社區評估：以台北市中正區崁頂次分區為例

Dementia Friendly Community Assessment: An Example of Assessment in Kanding Subzone, Zhongzheng District Taipei City

10.3966/102673012016092703015

徐佩琪(Pei-Chi Hsu)；莊依菲(Yi-Fei Chuang)；鍾美怡(Mei-Yi Chung)；徐亞瑛(Lotus Yea-Ing Shyu)；黃秀梨(Hsiu-Li Huang)；鄭亘妙(Shiuan-Miao Cheng)

失智症 ； 友善社區 ； 社區評估 ； dementia ； friendly community ； community assessment

長庚護理

27卷3期（2016 / 09 / 01）

467 - 475

繁體中文

隨著失智人口激增，失智症的醫療及照護費用逐年上升。營造失智症友善社區被認為具有延後失智者機構安置時間、降低照護成本、增進失智者與照顧者生活品質等效果。本文運用英國阿滋海默症協會提出失智症友善社區指引做為資料收集與分析架構，進行台北市中正區「崁頂次分區」之社區評估，評估方法包括: 擋風玻璃式觀察，訪談失智者、主要照顧者及重要人士，與問卷調查。結果發現社區僅被動地配合現有的政策，接受「由上而下」的方案，缺乏自發性發展「由下而上」的策略，與失智症友善社區的指引仍有些許落差。建議建立失智症友善社區未來應努力方向包括：(1) 強化失智症的宣導，增加對失智症的正確認知，創造改變的氛圍與迫切性；(2) 積極早期發現失智者，鼓勵失智者及照顧者參與政策擬訂；(3) 凝聚各部門及社區重要人士建立失智友善社區的共識，發展在地化的社區失智症照護模式。

As the dementia population grows, medical and care costs associated with dementia increases every year. Building a dementia-friendly community is considered to have the effect that can delay the placement of persons with dementia into long-term care facilities, reducing the cost of care and improving quality of life patients and their caregivers. In this paper, the guidance of dementia-friendly community by UK Alzheimer's Association was used as a framework for data collection and analysis to conduct a community assessment at ＂Kanding Subzone＂ in Zhongzheng District, Taipei City. Assessment methods include: windshield observation, interview the persons with dementia and their primary caregivers as well as community opinion leaders, and survey by a questionnarie. The results indicated that most communities adopted the ＂top-down＂ strategies to follow the existing policy and programs and spontaneously developed bottom-up strategies were lacking. Gaps still exist when compared to the indicators of a dementia-friendly community. It is recommended that the future efforts to achieve a dementia-friendly community should include: (1) strengthening advocacy for dementia, increasing awareness of dementia, and creating a sense of urgency and change atmosphere; (2) actively uncovering persons with early dementia, encouraging those persons with dementia and caregivers involved in policy formulation; (3) obtaining consensus among service departments and community stakeholders to develop a dementia-friendly community and to establish a locally acceptable dementia care model.

1. Alzheimer Scotland(2011).Delivering integrated dementia care: The 8 Pillars model of community support.
2. Alzheimer Scotland. (2011a). 5 pillars model. Retrieved from http://www.alzscot.org./assets/0001/1226/Getting_post_diagnostic_support_right.pdf
3. Alzheimer's Australia. (2013). 'Younger Onset Dementia: A New Horizon? Retrieved from https://fightdementia.org.au/sites/default/files/NATIONAL_CONSUMER_SUMMIT_-_FINAL_March_2013.pdf
4. Alzheimer's Australia NSW. (2014). A guide to becoming a dementia-friendly community. Retrieved from https://fightdementia.org.au/.../NSW_DementiaFriendlyGuide_Sept14.pdf
5. Alzheimer's Disease International. (2015a). World Alzheimer report 2015: The global impact of dementia. An analysis of prevalence, incidence, cost and trend. Retrieved from http://www.alz.co.uk/research/WorldAlzheimerReport2015.Pdf
6. Alzheimer's Disease International. (2015b). Dementia friendly communities (DFCs): New domains and global examples. Retrieved from http://www.alz.co.uk/adi/pdf/dementiafriendly-communities.pdf
7. Alzheimer's Society. (2013). Building dementia friendly communities: A priority for everyone. Retrieved from http://alzheimers.org.uk/dementiafrienlycommunities
8. Crampton, J.,Eley, R.(2013).Dementia-friendly communities: what the project "Creating a dementia-friendly York" can tell us.Working with Older People: Community Care Policy & Practice,17(2),49-57.
9. Innes, A.(2013).In practice: Working towards dementia friendly societies.Perspectives in Public Health,133,141.
10. Lin, S. Y.,Becker, M.,Belza, B.(2014).From dementia fearful to dementia friendly: Be a champion in your community.Journal of Gerontological Nursing,40(12),3-5.
11. Mitchell, L.,Burton, E.(2010).Designing dementia-friendly neighbourhoods: Helping people with dementia to get out and about.Journal of Integrated Care,18(6),11-18.
12. Swaffer, K.(2014).Dementia: Stigma, language, and dementia-friendly.Dementia,13,709-716.
13. World Health Organization(2012).Dementia: A public health priority.
14. 內政部統計處(2015)．104 年第3 週內政統計通報(103 年底人口結構分析)． 取自http://www.moi.gov.tw/stat/news_content.aspx?sn=9148 [Departent of Statistics, Ministry of the Interior. (2015). The 3rd Week Internal Affairs Statistics Bulletin in 2015 (The structural analysis of the population by the end of year 2014). Retrieved from http://www.moi.gov.tw/stat/news_content.aspx?sn=9148]
15. 台北市政府民政局(2015)．臺北市每月各里人口數及戶數．取自http://ca.gov.taipei/ct.asp?xItem=107077006&ctNode=41896&mp=102001[Department of Civil Affairs, Taipei City Government. (2015). The month number of person and household in districts Taipei City. Retrieved from http://ca.gov.taipei/ct.asp?xItem=107077006&ctNode=41896&mp=102001]
16. 台灣失智症協會(2014)．103~150 年臺灣地區失智症人口推計報告． 取自http://www.tada2002.org.tw/tada_know_02.html [Taiwan Alzheimer Disease Association. (2014). The Report of Project Numbers of Person with Dementia in 2014-2016. Retrieved from http://www.tada2002.org.tw/tada_know_02.html]
17. 衛生福利部護理及健康照護司(2014)．失智症防治照護政策綱領暨行動方案．取自http://www.mohw.gov.tw/cht/DONAHC/DM1_P.aspx?f_list_no=716&fod_list_no=0&doc_no=46372 [Department of Nursing and Health, Ministry of Health and Welfare. (2014). Taiwan Dementia Policy: A Framework for Prevention and Care. Retrieved from http://www.mohw.gov.tw/cht/DONAHC/DM1_P.aspx?f_list_no=716&fod_list_no=0&doc_no=46372]

1. 曾煥裕、石泱(2018)。失智老人及其照顧者使用社區式服務影響因素之研究。社會發展研究學刊，21，34-70。
2. (2024)。社區志工的失智症知識、對失智症者態度及提供失智友善行為意願之研究。新臺北護理期刊，26(1)，18-31。