以人為本：日本長照機構照護作為之觀察
以人為本：日本長照機構照護作為之觀察
郭育倫a
摘要
本文是筆者三次赴日本長照機構從事老人照護工作之經驗論述。日本長照機構之照護理念是一種「活出自主與尊嚴的老人照護模式」，諸如：（1）讓長者由口進食，品嚐食物風味；（2）長者即使包尿布，也要協助其坐馬桶如廁；（3）長者沐浴有尊嚴，泡澡放鬆身心。筆者反思台灣經驗提出幾項思維：（1）照顧者不論是照服員或家屬，都要重視長者的生活品質，不只是讓長者活得長壽而已，要讓長者活得有意義、活出自主與尊嚴；（2）長者需要足夠且受過專業訓練的照顧人力，照顧者需具備足夠的專業知識，才能站在提供長者最佳生活品質的角度思考最佳照護策略；（3）長者需要有尊嚴且無憾的辭世，因此推動機構安寧照護讓長輩得以善終乃勢在必行。本文以親身實作經驗及非結構性的自然情境觀察法探索日本照護經驗之深層意義，期能對台灣長照服務的推動及品質提升有所助益。
關鍵字：以人為本、長期照護、日本
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Reflection on the Patient-centered Care Services at Japanese Long-Term Care Institutions
Yu-Lun Kuoa
This article was written on the basis of the author’s observations from three visits to long-term care institutions for elderly people in Japan. The author determined that the model of care services in Japan enables elderly people to “live autonomously with dignity.” For instance, (1) the elderly people in Japan eat through their mouths, tasting the flavor of food. (2) They are encouraged to use the toilet even if they wear adult diapers, and (3) they are encouraged to enjoy bathing with dignity and make they relax. In regards to Taiwanese elderly care practices, the author suggests the following: (1) caregivers or family members should esteem the elderly person’s quality of life; living a meaningful and an autonomous life with dignity is more crucial than just living a long life. (2) Care services for elderly people require adequate and trained caregivers. Caregivers should be required to have sufficient expertise to understand an elderly person’s perspective and provide the best caregiving strategies as well as the best quality of life. (3) Elderly people should be enabled to live the rest of their lives with dignity and without remorse. Action is required to promote hospice care at institutions to let elderly people die at peace with themselves. This article concerns the personal experience of author’s and unstructured-natural observation in Japan, and was written in the hopes of improving the quality of long-term care in Taiwan.
Key words: Patient-centered Care、Long-Term Care、Japan
