A Study on Long-term Care Problems and Solutions in Indigenous Tribes: Case of Renai, Nantou County

[[abstract]]摘要 本研究旨在瞭解原住民部長期照顧問題與因應。主要研究目的包括：瞭解原住民部落對長期照顧資源分佈與使用狀況，分析長期照顧供需對原住民部落的影響，探究原住民部落長期照顧發展的困境與因應之道，提出未來推動原住民部落長期照顧的有效策略與方法 研究者採取立意取樣的方式，共邀請了九位與原住民部落長期照顧服務有關的受訪者，並使用質性研究之半結構化的深度訪談來蒐集資料，研究結論如下： 一、 原鄉部落長久以來長期照顧資源缺乏，施政的結果往往無法落實在部落，原鄉需要在地化因地制宜服務模式，更需要各村設置單一窗口長照中心，符合各部落原住民的需求。 二、 長期照顧服務供需的影響，在政府供給層面因人力、醫療資源分布不均、法令限制、缺乏在地培訓場所、輸送困難影響個案量、人力流失及就業機會低。在部落需求層面因地理位置偏遠、申請長照服務過程不順暢或無法提供服務影響繳費意願及放棄接受服務。 三、 為解決部落長期照顧服務的困境，因應之道包括培訓在地人及保障工作權、放寬法令限制、整合長期照護資源平台。 四、 未來原鄉長期照顧需要文化照護融入原住民生活，依個別需求選擇在地推動長期照顧服務，以在地人服務在地人，才是最佳的策略與方法。 關鍵字：原住民；原住民部落；長期照顧；文化照護[[abstract]]Abstract The aim of my thesis is to understand the long-term care of the aborigine and its response, including the resource distribution and use condition of the aborigine long-term care, analysis its impact on tribes, and exploration of the predicament and coping of its development of so as to propose the effective strategies and methods of future long-term tribal care. The researcher adopts the method of purposive samples, inviting nice interviewees who are concerned with the service of the aborigine long-term care and using in-depth interview of semi-structured qualitative research to collect data. The conclusion of my thesis is as followed: (1) The hometown tribe has lacked long-term care for a long time. The outcome of policy could not always focus on the tribe. The tribe need the mode of service that should be localized. And it requires more one-step window service center in each village, which matches the need of each aborigine. (2) The supply and demand impact on the hometown tribe in the aspect of the government includes the uneven distribution of medical resource, the restriction of laws, the lack of local training places, the difficulty of delivery which influences each case, the loss of manpower, and the low chance of employment. In terms of tribal needs, it includes the remote of geographical location, the inconvenience of the process of the application of long-term service or the inability to provide service so as to affect the will to pay and then give up receiving service. (3) To solve the predicament of long-term care service, the methods include the training of the local and the protection of work rights, the loose restriction of laws, and the integration of the resource platform of long-term care (4) The future long-term care requires the assimilation of both cultural care and the aborigine life, choosing to promote long-term care service based on the local needs. Serving the local by the local is the best strategy and method. Key words: The aborigine；the local tribe；long-term care；cultural care[[note]]碩