Elderly Care in the Cultural Context of Paiwan People - a Preliminary Study of Care Practices Among a Paiwan Community in Taitung

• Main Authors: Yu-Chi Huang, 黃喻祺
• Other Authors: Song-Lih Huang
• Format: Others
• Language: zh-TW
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/su9392

碩士 === 國立陽明大學 === 公共衛生研究所 === 104 === Background In addition to the universal health insurance and the “integrated healthcare delivery system” for remote communities, Taiwan government provided several community-based modules of long term care for indigenous populations in Taiwan. These modules often are underutilized. Methods The primary investigator utilized several methods in ethnography, including participatory observation, interviews, and field notes taken on daily interactions and special occasions in the community. The authors then identified significant practices and their cultural background, and tried to relate them to the use of long term care services. Results The traditional sharing and mutual aid among Paiwan people, orchestrated by the community Chief (Tou-Mu), is the primary route of obtaining assistance when a household has short- or long-term care needs. The highly collective ways of production and sharing used to compensate for needs arisen with diseases or disabilities, but the tribal structure has been weakened in recent decades by economic and political factors. In addition, several concepts related to the societal context of health: (1) The elderlies concentrate on the social aspects of health, and regard anyone who can participate in community gatherings as healthy. (2) They tend to disregard symptomless chronic diseases. (3) The elderlies enjoy social prestige and do not see themselves as those in need of assistance. The worries for today's Paiwan tribal chief(Tou-Mu)system: (1)The chiefs (Tou-Mu) are still using private resources to take care of the people amount the tribe and to maintenance the traditional systems ,this are tightening the chief(Tou-Mu) family economic. (2) resulting in the decline of small-scale peasant tribes industrial economy changes that failed to keep the tribal youth so that the traditional cultural values are unsustainable and hard to find young people stay in the tribe to participate the long term care policy. The loss of traditional values also continued to increase the pressure of the chief to maintain the pattern of traditional system.(3)Third, analysis of factors such as the weakening the traditional chief(Tou-Mu) system: the way of partition resource like today's local administrative system; church beliefs conflict with traditional values. Discussion and Conclusions Community-based design of long-term care delivery system relies on a strong community engagement.The Tou-Mu system has to be revived, partly by rejuvenating the agriculture-based economy and partly by recognizing the legal status of a tribe and involve tribe leaders in resources allocation, including those from the government.This project demonstrates that cross-cultural care should aim at the societal and structural factors and not limited to health care delivery Keywords: Cultural health center,Ethnography,Elderly care, Paiwan,Tribes