台灣失智老人照護設施之個案比較研究

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Title:	台灣失智老人照護設施之個案比較研究
Other Titles:	A Comparative Study of Three Care Facilities for the Dementia Elderly in Taiwan
Authors:	林彥良 Lin, Yen-Liang
Contributors:	關華山 Kwan, Hwa-San 東海大學建築學系
Keywords:	老人;失智;失智症;照護設施;個案比較;台灣 Elder;Demented;Dementia;Care Facility;Case Comparison;Taiwan
Date:	2003
Issue Date:	2011-05-19T08:42:31Z (UTC)
Abstract:	台灣失智老人照護設施之個案比較研究 ──寧園安養院、喜樂養護中心與台中醫院失智專業照護護理之家指導教授關華山博士研究生林彥良　東海大學建築學系建築碩士學位論文中華民國九十二年七月論文摘要台灣地區人口結構逐漸老化，成為「高齡化社會」後，老人照護的需求急遽膨脹。老人照護問題之中，最複雜、又困難的問題之一，就是失智老人的機構照護問題，如何找到相關適當的失智者照護方式，已經成為當前老人福利政策的緊急課題。此類失智老人照護機構目前方興未艾，不敷社會需求之急遽增加。因此，本研究嘗試以近年成立之機構個案為研究對象，探討台灣地區失智老人醫療照護、照護機構、學術研究、政策推動之歷程與其經驗。本研究的主要研究方法為「文獻回顧」以及「個案研究」。本研究選定三個失智老人照護設施個案，分別是：「台灣省寧園安養院」、「財團法人彰化縣私立基督教喜樂養護中心」、「行政院衛生署台中醫院失智專業照護護理之家」。本研究企圖達到下列四項目的：一、蒐集台灣地區具代表性的失智老人照護設施個案之發展背景以及建立建築設施現況的「基本資料」。二、歸納分析整理此類照護設施個案之「使用」與「建築空間形式」之構成。三、以實地調查與訪談的方法，了解現況使用方式，針對照護設施空間及建築形式進行分析，以便掌握此類設施環境；從而探討失智老人「行為模式」、「照護需求」與照護機構「建築環境設計」之間的關聯。四、藉由比較三個不同的個案，檢討照護環境設施的優缺點、探討建築現況空間規劃所反映的問題。試圖提出建議，期能作為日後興建此類失智老人照護環境設施建築計畫及設計之參考。本研究論述的主題為：台灣地區失智老人照護設施的「個案比較研究」。先從台灣地區失智老人「醫療照護」談起，概述其發展及變遷。接著探討失智老人的「行為特徵」與特殊的「空間需求」。再藉由研究了解「照護設施」的形式生成與空間組成，歸納分析其建築空間的相關「設計考量」。期能掌握整體環境設施，作為進行個案研究的評估架構。最後，執行「個案比較」的工作。本研究個案所比較的項目：一、照護設施個案的經營型態、規模、特質。二、照護設施個案建築空間形式之構成與使用。三、照護設施硬體、建築空間與失智老人行為的對應關係。四、照護設施個案一些建築細部空間及其他方面的探討。研究發現：交通便利、環境優雅、多元化專業的醫療服務、「如家」照護單位、社區性照護系統等，為良好失智老人照護環境設施之重要要素。此外，在設計失智老人照護設施空間時，遊走迴路、安全的庭園、大廳多功能活動空間、居住房間、護理站等，也必須加以重視並慎重考量其特殊性。如此，才能創造出真正符於失智老人需求之照護設施。關鍵字：老人、失智、失智症、照護設施、個案比較、台灣 A Comparative Study of Three Care Facilities for the Dementia Elderly in Taiwan ── "St. Joseph Home ","Changhwa Erhlin Christian Happy Home" and "Professional Dementia Nursing Home attached to Taichung Hospital" by Lin, Yen-Liang Thesis Adviser: Kwan, Hwa-San, PhD Department of Architecture, Tung-Hai University, Taiwan, R.O.C. July 2003, in partial fulfillment of requirement for the degree of Master of Architecture Thesis Abstract The construction of population in Taiwan has been oldening. After becoming "aged society", the demands of the elders'' care-giving increase tremendously. The elderly dementia''s facility care is one of the most complex and difficult ones among the elders'' care-giving problems. How to find the relevant proper ways to take care of dementia has already become an urgent lesson referring to the elderly welfare policy nowaday. These kinds of dementia care-giving facilities are fewer than the society increasing necessity. Therefore, this research tries to study the facilities established in recent years and discuss the process and experience of dementia medical care-giving, care facilities, academic papers and the policy-making in Taiwan. There are two main methods adapted in this research, the "literature review" and the "case study". I select these three care facilities for the dementia elderly below to compare with. They are "St. Joseph Home ","Changhwa Erhlin Christian Happy Home" and "Professional Dementia Nursing Home attached to Tai-chung Hospital ". This research aims to achieve four purposes below: 1. To collect the developing background of Taiwan representative care facilities for the elderly dementia and build up basic data of present architectural equipment situations. 2. To induct and analyze these dementia care-giving facilities'' usages and architectural space form-producing. 3. By means of investigating and interviewing to understand the present using methods, proceed analysis of these facilities space and build forms to take control of these kinds of environments. And then discuss the relationships among the demented elders, the behavior-modes, care-demands and facilities'' architectural designed environments. 4. By means of comparing these three different cases, it examines the advantages and disadvantages of them, discusses problems reflected on architectural spaces planning now. Moreover, this research wishes to provide suggestions and references concerning about architectural planning and design to establish new demented elders'' care facilities in the near future. The theme of this research is a comparative study of three care facilities for the dementia elderly in Taiwan. First, this research talks about the changing and development of the demented elders'' medical care-giving. Second, it discusses behaviors'' characteristics and special space needs of demented elders. Third, this research inducts and analyzes the relevant design considerations of care facilities'' architectural space by studying and realizing the form-producing and space-composing of them in order to control the whole environmental equipments and set up an evaluation framework while studying these cases. Finally, this research is executed with comparing these cases. What the research compares with are the items mentioned below: 1. The type, size and properties of the facilities. 2. The usage and constitution of the facilities'' architectural space form. 3. The reciprocal relationships among the facilities'' hard-wares, architectural space and the elderly dementia''s behavior. 4. The architectural space details and relevant aspects. In this research, we find the convenient traffic condition, delicate environment, multiplicity of professional medical service, home-like care unit and community care system are five important elements for a good care facility for the dementia elderly. Furthermore, we should paid more attention to the wondering loop, security courtyards, lobby multi-purpose activities area, resident''s rooms and nurses'' station while designing, and take the demented elders'' special characteristics into consideration in order to build the care facility that really meet the demented elders'' need. Key Words: Elder, Demented, Dementia, Care Facility, Case Comparison, Taiwan
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