| Summary: | 碩士 === 輔仁大學 === 社會工作學系 === 95 === The population is aging in Taiwan which leads to the degeneration in physical, mental, and social functions. The rate of the elderly affected by chronic disease and disability has increased gradually and has driven up the needs for long-term care. As a consequence, how to satisfy the care needs of the disabled has become one of the urgent issues for long-term care policies. A great number of studies have taken on subject related to those needs in the past and yet few have examined the degree to which the needs are satisfied. The few existing studies on the issue have paid the attention primarily to factors related to the individualistic levels, omitting the area levels which are indispensable for shaping policies. This study examines factors related to unmet needs of disabled elders in an attempt to fill the gap in the literature and to provide innovative recommendation Taiwan in the future.
The purpose of this study are five-fold : 1)to examine the state of the unmet need of disable elders; 2)to identify individual-level factors of the unmet need; 3) to examine area-level determinants of the unmet need; 4) to investigate the effects of interaction between individualistic and area level factors; and 5) to draw from findings some implications for practices and policies.
This research pertained to a cross-sectional design, using data collected at the second-stage survey of “ Long-term Care Need Assessment in Taiwan”. A national representative sample of 6,820 disabled elders with family caregivers were included in the study. Hierarchical linear modeling was used to analyze the data.
The result showed that the highest ratio of unmet ADL needs was climbing stairs(21.0%) and the lowest ratio pertains to eating(5.9%) . The degree of unmet IADL needs had an average of 3.39. It meant that unmet IADL needs were not as serious as expected. The result of hierarchical linear modeling indicated that educational degree of disable elders, living arrange, caregiver’s age, relationship to patient (spouse versus descendant ), caregiver burden, number of illness, number of IADL limitations, number of persons in household, interaction between social welfare expense and using home services, and interaction between social welfare expense and number of IADL limitations were key factors related to the unmet ADL needs of disable elders. As for the unmet IADL needs, disable elders’ age, sex, educational degree, living arrange, economic situation, caregiver sex, caregiver burden, the ADL score, number of IADL limitations, number of persons in household, interaction between social welfare expense and educational degree of disable elders, between members of home services and educational degree of disable elders, interaction between using home services and members of home services, and interaction between using home services and social welfare expense were the significant factors.
The results showed that interaction between individualistic and area level factors were significantly associated with the unmet need of disable elders. It pointed to the importance of strengthening long-term care resources in the area level, providing services tailored for the needs of elders from different areas with various needs, and monitoring service programs to assure that those targeted were served.
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