長照2.0之下，居家服務督導員角色與功能轉型之研究

Abstract

長照2.0政策是一個因應高齡化與少子化之政策，推動至今我們看見因為派案窗口與服務流程變動造成居服督導行政負荷加重、讓原本照服員與居服督導人力不足的現象更為雪上加霜；在居家式長照機構倍數成長下，其服務品質又是如何？而推動至今已邁入第六年的長照2.0政策，對於身處第一線的居服督導，其角色功能是如何？過去的角色功能是否適用、有無新增的角色功能？本研究採取質性研究方法，以半結構式訪談為資料蒐集方式，立意取樣雙北市六間居家服務單位，包括非營利組織、營利組織與勞動合作社；受訪者有六位居服督導、四位居服主管，共計十位，進行個別深度訪談；並以主題分析方式進行資料分析。本研究發現，有三個主題，第一個主題是政策轉變對於居服督導有微視、中介與巨視面之挑戰，以及相對應的因應之道；第二個主題是居服督導在長照2.0之後有角色功能之轉變，有七個新增的角色功能；第三個主題則是對於中央與地方政府部門與組織之建議。研究者之建議則有四個面向，第一是，個案管理這個角色功能上A個管與居服督導有其需要努力之方向；第二是，居服督導這個專業角色上，從中央、地方至組織與居服督導個人需要努力之面向；第三則是，服務使用者選擇權落實在微視、中介與巨視面的做法，以及第四，發揮以人為本的精神之具體相關建議。The long-term care 2.0 is a policy, aiming to responds to the aging society and declining birthrate, has been implemented for six years. However, the workload of home care supervisors had been increased, and the shortage of manpower for the home care workers and home care supervisors become more and more serious, due to the changes of the process of case assignment and service delivering. This study examined the reactions of home care supervisors under this disadvantage situation and whether they adapted to this new roles and functions. We used qualitative research method, semi-structured interviews as the data collection method, and interviewed ten respondents, six were home care supervisors and four home care managers, who working in six purposely selected home-based Long-Term care institutions in Taipei City and New Taipei City, including non-profit organizations, profit organization, and labor cooperative and data analysis by thematic analysis.We found that the Long-Term Care 2.0 had significant impacts on the supervision of home services in micro, mezzo, macro levels; however, home care supervisors, creating new roles and functions, found their ways to adapt to this new situation. The researcher gave some suggestions to the role of case manager has its own direction to be worked on, as does the supervision of case manager and home care supervisors and home care supervisors to improve their work in micro, mezzo and macro levels, and emphasized the importance of the right to choose of service users, based on the human-centered spirit.