(unit care)

70 hidemi@scu.edu.tw

2007 () -1-

1970 21 (unit care)

: -2-

(2003)(2003; 2003)(1999;2004;2004;2004) ( 2001) ( 1998; 1999;(2000; 2003)(2000c;2003;2004; 2004;2004;2005)( 2006;2006) -- 1973 (2004;2004d) 20% 2025 270 2 ( ,2004) 1980 (1997;1998;2000;2002; 2005;2005) () 1989 :(1) (2)(3) (4)(5)-3-

(group home) - (unit care)1 21 2 ( ) 2000 ( 2003:12) 2002 (2002) 2001 2002 (2004a;2004b) 3

(, 2004a: ,2004b)

1

2

3

(2007) (2004b)unit care care--- 65 -4-

2006 5 --- group homeunit care (2006) 96 1 1 4 : ;; ;

4

2000 2007 (yoriai) (ootemon) (Senndann no Mori) (Matsushita Denko Age Free Hoshi ga Oka) Seirei Jigyoudan (Egota no Mori) (Ikebukuro Keishinen) (Anjuen ,Minami Ikebukuro)(Rest Villa Kamakura Tokiwa, Watami) -5-

() 1980 1980 (2000) 1989 ( ) 1980 1987 1989 1990 1991 1990 (1991 ) (1993 ) ()(1997 ) (1998 ) ()(2007 ) -6-

(1998)

() (2004) 65 4.48 24.54 61.17 65.70 95 10 65 227 2,239 10 1,796 13 3,700 20 5,800 20 (2006) ( 2006)

-7-

(1);(2) ;(3)

() (1995) -8-

(2000

() (1998; 20005: (1) : (1998) (2) : (3) : (4) : ( ) 5

-9-

( 1998)

(1)(2) (3)

(1963 ) (2002)(2005 ) 12 - 10 -

(A B care house) ( 2005:86-97) (A B ) (day care center) (care house) (2002) (2000 ) () (2000; 2003:11) 4 - 11 -

( 2003:12) 4 (2001;2002)

1950 6~12 (2002) ( 2003:12) 1995

- 12 -

6 (2002;2003:65-66) () (2002; 2003:65-66) 50 4 () (2003:65-66) 1999 2 1999 10 7 750

6

7

(2000c) - 13 -

() ( hotel cost) (2003:12) 21 2000 (2003:12) 2002 (2002) 2001 2002 (2002; 2003:70)

- 14 -

2002 2003 :(2002) :

8 ( 13.2m2) 10 60 6 ( 10 ) 4 ( 15 ) ( 2003:28-29)(2003) 5~9 6~15 ( 2003:204) ( 2003:67)- 15 -

(2002)

: (2003) P.69.

4 ( )() (2003:67-69)- 16 -

( 2003:95) (1) (2) (3)() (4) (5) (6)

(2003:95) 1:3(2002) --- - 17 -

(2002; 2003:136-137) ( 2003:41-46)

= : (2003) P.43.

( 2002a; - 18 -

2003:68)

( 2002) ( 2003:71) 4 (2002) : (2003:187-188)

(2005:131) - 19 -

(2006) (2002a; 2002b)

:() ()()(2002) (2002) : 2004 10 5,716 1,116 700 416 7.1 3.0 2004 10 3,391 204

- 20 -

57 147 8.1 3.0 (2005)

2004 10 (%) (%)

(%) 416 11,885 3.0 9.6 7.3 3.0

() ()

1,116 59,278 5.6 9.6

19.5 14.8

700 47,393 7.1 9.6

12.2 11.9

(%) () () 204 9,191 4.5 10.1 6.0 3.0 (%) 57 4,726 8.1 10.2 1.7 1.5 (%) 147 4,465 3.0 10.0 4.3 1.4

(5,716 )(399,352 ) 3,391 (309,346 ) :(2005) 18 (2004)

() 75 ( 3 ) 373 137 209 161 164 () 13,988 61,133 - 21 -

5.5% 40.8% 4 ( 2005) 5,000 ( 20052007)

(2003:70)

() ( 2001; 2002;2002; 2002;2003;2004; 2005;2006) (2001) 6 ADL (2003:65-71) (2003) (2003)- 22 -

(2006)

() (2003:65-71)(2003:21) 39.2% 16.5% 9.2% 3.1% 9.4% 31.7% ( 2003:65-71)

- 23 -

/ 10.3%( 2003:30) (2003)19 11 14 (2005) : ( ) 1.5 3 5 17 35 1.7 3.5 Rest Villa Kamakura Tokiwa, Watami- 24 -

8

830 188,000 (+)

() 830 ( 250 ) 25 ( 7.5 ) (leaseback) 1 ( 300 ) 7.5

8

90 6 - 25 -

?? ?

? ? ?

- 26 -

? ?

() (2003) - 27 -

7(3):251-264 (2006) : 2007 4 18 http://sowf.moi.gov.tw/04/02/ -960308.htm (2003) (MMSE)(CDR) 17(1):23-32 (2006) (2004) 5:119-172 1998 138 2-9 2000 9219-31 (2003) 12(3):155-165 (2001) 82:1-25 (2004) 14(1):13-24 (2000a) 6:73-99 (2000b) 92:233-241 (2000c) 90:292-302 (2004a) 92 2 : (2004b) --- 106:345-357- 28 -

(2004c) group home (2004 9 7 ):- 202 (2004d) --- 2 (2004 10 29 ): (2005) 12:75-113 (2004) (2004 9 7 ):- 202 (1998) (1999) 3(6):721-727 (2004) 2(1):56-67 (2004) 7(4):352-354 (2004) (2004 9 7 ):- 202 (2006) 50(7):52-56 (1998) 4195-238 (1998) --- 8392-114 2000 (2004) 106:237-244- 29 -

(1999) ( ) 16-17 (2003) 12(1):152-159 (2000) -- 92:206-214 (2003) -- 50(5):84-90

() (2000) 22(3):411-424 (2002) () 11-17 (2003) (2002) () 23-27 (2005) :( 2005.12.11) 2008 1 5 from http://www.izai.net/tokuyou.html (1997) : 24(4):225-232 (2002) : ( 1) 42:1-4 (2005) - 30 -

588:23-30 (2004) (2005) 18 (2004 ) 2007 12 25 From

http://www.mhlw.go.jp/toukei/saikin/hw/kaigo/service06/kekka3.html (2003) 2015 --- (2003) (2002) () --- 39-58 (2005) 26(4):401-411 (2002) () --- 1-13 (2003) (2002a) --- () 2-4- 31 -

(2002b) -- 85:5863 (2001) (2003) 2003 (2007) 2007 6 30 from http://www.clc-japan.com/unit_care/serch/list-unit01.htm (2006) 47(1): 79-82 (1998) : 514:79-86 (2005) --- (2005) --- (2002) : (2002 ) 319-320 (2004) A : 1 5:133-140 (2005) :- 32 -

2 6:89-94 (2005) 46(2):100-111 (2006) -- 46(3):7586 (2002) :K 42:9-12

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Discussion on the Environmental Construction and Practical Ideas of Unit Care Service ModelHsiu-Mei Chuang

Abstract For the rising of demand in the aged welfare, the longterm care service model has changed a lot in recent years. The care models for the elderly have been developed gradually since 1970s. . In the beginning of 21 centuries, one of long-term care policy, the new nursing home for elderly based on the unit care ideas has reframed the long-term care service model. New nursing home for elderly is a small scale life unit" type of nursing home, whose characters include "single room", "pay for housing rent, and the small group unit care (Unit Care). The Unit Care is not only popular care service model in Japan; it also attracts attention in Taiwan in the recent year. This article will enrich the debates of Unit Care, which can improve the understanding of Unit Care model in Taiwan. This article will help us to understand the practical experiences of Unit Care in Japan, and thinking the implement of the Unit Care service model for elderly in Taiwan. The following issues were discussed in the article: 1. The analysis on the developmental background of Unit Care service model in Japan, which has impacted group home and the practice of long-term Care Insurance System. 2.

The law system, environmental construction and practical ideas of Unit Care

Associate Professor, Department of Social Work, School of Arts and Social Sciences, Soochow University - 34 -

were discussed. 3. The states of Unit Care service model focused on the development of advancing care service in the nursing homes. 4. The effects of the Unit Care on the practices field in nursing home were introduced. 5. The suggestions in the practice of Unit Care were provided for Taiwan.

Key wordsunit care, environmental construction, practical ideas

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