我國人口結構之演變，自民國82年9月底65歲以上的老年人口有148萬5,200人，佔總人口之7.09﹪，已達聯合國世界衛生組織所訂的高齡化社會指標，隨著戰後嬰兒潮的人口逐漸老化，近年來我國65歲以上老年人口之比例逐年提高。近年在我國的老人安養也正朝向多元方向發展，為因應2015年後，戰後嬰兒潮世代老化，導致老年人口遽增，未來需再逐步增加機構式資源。目前臺北市公費老人安養機構已僅存臺北市立浩然敬老院一個。公費安養機構的裁併和縮減，影響臺北市老人公費安養之未來，在逐漸M型化、高齡化的社會中，應如何有效分配社會資源，兼顧公平正義與弱勢老人族群之照護，提升公立安養機構的營運效能，是值得探討的議題。本研究嘗試從多種角度切入，在老人機構評鑑的架構思維外，希望能描繪出浩然敬老院存在的價值和效能，先蒐集現有機構文件資料，並分別以質性研究方式，向機構相關人員進行訪談，另引用機構對院民索做滿意度調查結果反映院民對機構的滿意度和期待，據以綜合分析個案營運之成本效能並做目前之政策定位。本研究調查發現，浩院在下列各績效指標方面均表現良好，無論從院民滿意度、訪談內容或是評鑑結果來看，浩院的績效均受到肯定： 1.長者是否獲得適切服務 2.長者生活品質高低 3.是否做到維護長者尊嚴與自主 4.工作效率及服務形象的高低 5.社會資源結合之多寡與其運用 6.員工知能是否合乎標準、人力資源的培育訓練程度。 在研究過程中發現，浩院的角色和功能，將隨著長者需求的改變、院舍的老舊以及工作人力的不足和老化而有所變遷，主管機關在規劃整體老人福利政策時，也會因應老人福利需求作最適當的配置，因此浩院未來的整體績效仍要視未來其扮演的角色功能再作評估。

在高齡化社會中，老人居住安養的議題愈形重要。長久以來，「與子女同住」一直是國人心目中最理想的老年居住安排方式，但隨著老年人生活自主性與教育程度的提升，傾向不與子女同住的比例亦逐年上升，而選擇「自費安養」型態的老年人口也逐漸增加。本研究希望藉由入住自費安養機構老人本身的觀點，深入瞭解他們與此一居住環境的互動經驗及情感依附，並思考如何使居住環境有「像家」的感受。據此，本論文之研究目的在於：一、探討老人遷住自費安養機構的決策過程。二、分析入住自費安養機構老人與居住環境的互動關係。三、探索入住自費安養機構老人對居住環境的依附情形。四、依據研究結果，提供建議作為推動老人住宅政策與實務工作之參考。 本研究使用質性取向的研究方法，以台北市某家自費安養機構作為研究場域，採用半結構式的深度訪談法進行資料蒐集，共計訪談十三位老人，年齡介於七十一至九十二歲之間。主要的研究結果如下： 一、老人入住自費安養機構是一連串的過程，包括需求的引發、資訊的取得、貨比三家與考量要件、以及最終的決定，而其中遷居過程的參與程度和做決定的自主程度愈高之老人，對於新居的看法愈為正面。 二、在實質環境方面，安養機構最大的特色在於具有多元化的空間設施，老年住民可在個人寢室空間從事獨立活動，在公共空間有較多人際接觸的活動，至於機構外部的活動則受限於老人的行動能力、害怕外部環境潛藏的危險性或是擔心跌倒意外。此外，安養機構經常安排各種休閒活動和社會活動，是入住老人相當有利之處，並為老人帶來許多正面的功能與感受。在社會環境方面，「功能距離的鄰近性」與「社會人口背景的同質性」是老年住民互動關係之主要影響因素；而工作人員是協助老年住民維持獨立生活的支持者；原先的社會支持網絡則是提供老年住民情感支持的主要來源。 三、老年住民對於居住環境多數感到喜歡和滿意，但是否將居住環境視同為「家」，則受到「老人對家的定義或觀念」以及「是否仍擁有原本的住家」兩個因素所影響。綜合而論，老年住民的依附類型主要可歸納為三類：（1）我找到一個理想的地方，將在這裡終老餘生；（2）這裡是一個適合居住的地方，可以協助我維持獨立生活；（3）缺乏情感，希望將來有機會重新安排居住環境。 / On an aging society, it has become an important issue that how people live in their old age. For a long time, “living with children,” to Taiwanese people, has been the best way of living arrangement in later life. However, with the enhancement of autonomy and the upgrading of educational level, more and more elderly tend not to live with their children, and some of them choose to live in congregate housing. From the viewpoint of the elderly living in congregate housing, this study aims to understand their interaction with the living environment, their emotional attachment to it, and how to make the environment feel like a home. Accordingly, the purposes of this study are as following: first, examine the decision-making processes of older adults relocating from home to congregate housing; second, analyze the interactive relationship between the elderly residents and their living environment; third, explore the emotional attachment of the elderly residents to their living environment; forth, based on research findings, provide suggestions for the elderly housing policy and the practitioners. This study employs qualitative research approach, and data collection is gotten from a congregate housing in Taipei, including semi-structured in-depth interviews with thirteen elderly residents aging from 71 to 92. The study findings are listed below: First, relocation is a series of process, including the demand for initiation, information acquisition, comparison, consideration, and the final decision. In this process, the more participation and the more autonomy the elderly have, the more positive their comments for the new residence will be. Second, in physical environment, a wide range of space is the most prominent feature of congregate housing. The elderly residents could engage in independent activities in the individual dwelling units. They would have more interpersonal contacts in the public space. As for outdoor activities, the elderly might be restricted by their mobility, for fear of the potential dangers of the external environment, or falling accidents. Besides, the elderly get many benefits from the leisure and social activities in congregate housing. In the social environment, the interactive relationship between the elderly is influenced by the vicinity of the functional distance and the homogeneity of residents. Staff members of congregate housing help the elderly maintain independence, and original social support networks provide main emotional support to them. Third, most elderly residents are fond of and satisfied with their living environment. Nevertheless, not all of them consider this environment as their home. Viewing it as a home depends on how they define the meaning of home and whether they have self-owned housing. Overall, the attachment type of these elderly residents can be divided into three categories: (1) I found an ideal place to stay throughout my lifetime; (2) this is a suitable place for me to live, and it can help me maintain independence; (3) I have no affection for this place. If given the opportunity, I will try to rearrange my dwelling place.

本創新找出三種現有的電子遊樂機來滿足高齡使用者對於復健運動產品的需求。這三種產品可針對高齡使用者的平衡度、手部及腳部進行運動復健，讓高齡使用者在復健運動的同時仍能享受到電子遊戲的娛樂性。因此，本創新為現有的電子遊戲機找到不一樣的行銷市場。現有電子遊戲機的主要市場是青少年，但本創新是以高齡使用者為主，以老人安養機構為主要採購者，讓既有的產品重新定位、找到新市場。 本創新從機台、廠商、老人安養機構以及高齡使用者四方面提出不一樣的服務模式，以供廠商以及老人安養機構參考。本創新特別針對老人安養機構的特性及財務狀況提出三種不一樣的經營獲利模式，透過不一樣的營利模式面對不一樣的狀況，讓電子遊戲廠商以及老人安養機構能夠有所交集，創造出一個前所未見的新市場。 / This innovation business model discovers three electronic entertainment kiosks in the market which meet the demands of senior. These products can be used for the rehabilitation of senior, including balance, hand movement, and foot exercise, allowing users be entertained when they engage in their rehabilitation. This innovation business model explores a different market for electronic entertainment kiosks. The main market for electronic entertainment kiosks is usually junior, but this model discovers a market for senior user, which the nursing agencies are major buyers. In this case, the product function and purpose is redefined, allowing it to target a new market with a different position. This research proposes a service business model for manufacturers and nursing agencies from four dimensions: electronic entertainment kiosks, manufacturers, nursing agencies and senior users. Also, it points out three profitable methods that will fit the situation of nursing agency characteristics and financial situation. Each method is designed for a different situation, allowing video game makers intersect with nursing agencies, which will create a brand new market.

人口結構逐漸呈現高齡化，是現今世界上許多國家共同的趨勢，而我國的人口結構也漸漸邁入高齡化的趨勢，許多關於老人福利、安養、退休生活等議題益發值得討論，加之目前年輕人平均所撫養長輩人數之「撫養比」有不斷攀升的現象，顯示老人照顧議題更成為其中越來越不可忽視的重要一環。而我國公部門體制下的老人照顧人力資源運用，目前則正面臨著環境與法規變遷的挑戰，因此老人照顧的人力資源如何妥善配置，並針對其相應的工作職能進行強化，是為本研究主要探討的面向。 因此本研究經由組織分析、工作分析、個人分析等三層次訓練需求評估理論，並輔以中外文獻檢視，探討我國北區老人之家頤苑自費安養中心此一之個案。本研究運用質性研究方法，以北區老人之家頤苑自費安養中心老人照顧服務員及中心管理人員為研究對象，進行深度訪談，評估未來發展之訓練需求，最後根據文獻探討與深度訪談之研究發現，提出針對北區老人之家頤苑自費安養中心照顧服務員未來訓練規劃之建議，俾優化照顧人力的運用狀況，以提升老人照顧服務的品質。 本研究主要結論包括：(一) 組織承諾與團隊建立面向：可靠性之導向；（二）工作知能與工作態度面向：反應性與保證性之導向；（三）自我成長與生涯規劃面向：有形性與關懷性之導向。盼此些實務建議可作為我國公辦民營老人安養機構改善照顧人力運用與配置的參考。 / The increasing aging phenomenon of the structure of population is the common issue to many countries around the world in this days, and our country also faces the same situation. There are so many issues of senior citizens' welfare, healthcare, and retired life need to discuss. This survey executed through the 3 theories of training demands: organization analysis, work analysis and individual analysis, to investigate the chosen case: northern region senior citizens' home. This survey adopted qualitative research method, proceeded to interview to the nursing aides of northern region senior citizens' home, to evaluate the training demands of further developing, and then present the conclusions of the survey which was based on both the literature review and research findings of depth interview. The conclusions of this survey include the following: (1) The dimension of organizational commitment and team building: Reliability. (2) The dimension of work skills, and Work attitude: Responsiveness and Assurance (3) The dimension of self growth and career planning: Tangibles and Empathy. Expecting these suggestions could improve the using of care staff and the quality of elderly care.

本文係針對台灣地區各縣市1999至2008年之老人安養機構設立之床位數進行分析，利用雙因子固定效果模型（two-factor fixed effects model）探討台灣地區各縣市老人安養機構設立之重要影響變數，以及這些變數對於老人安養機構設立床位數影響程度之強弱。本文首先將文獻之檢閱做整理介紹，先概述至今國內外討論老人安養機構設立及使用之相關文章重要觀點，了解這些文章作者的研究時間與空間範圍、所使用分析方法、論點及其變數設定，在最後與本研究之結論相互比較，觀察文獻與本研究之間是否具有一致性。 由於本論文重視各地區變數之影響，故本研究使用具地域性之各縣市數據資料作為變數，經由資料蒐集，將合適之變數納入研究考量，參閱文獻資料，加上能夠取得之數據資料為考量。本文將討論下列變數：台灣地區實質薪資、各縣市老年人口數、各縣市人口密度、各縣市教育程度為大專及以上人口之比率、各縣市失業率、各縣市女性勞動參與率、各縣市15歲以上人口婚姻狀況有偶人數比率、各縣市出生率、各縣市外籍與大陸配偶人數、各縣市社福外籍勞工人數以及各縣市每萬老人接受居家服務人次等十一個變數。對於老人安養機構設立數之關係，觀察其影響程度，了解各地區差異，期能對政府提供具體的政策建議，並對未來各縣市公私立老人安養機構之設立提供參考。 / This study analyses the number of the beds established of the long-term care (LTC) facilities of each city and county in Taiwan between 1999 and 2008, using “two-factor fixed effects model” to explore some of the important influential variables of the long-term care facilities of each city and county, and the strength of the relation of these variables of the hospital beds. This article firstly introduces and reviews some articles and studies that are basically related, and overview the important points of view of the establishment of the long-term care facilities, to understand the analytical methods and the arguments of these articles and authors. As the importance of this thesis, the effect of regional variables, the study uses cities and counties level variables. Through data collection, using the variables in the study that are considered appropriate. Refer to the literature, adding with data obtained for the considerations. This article will discuss the following variables: the real wage of Taiwan each year, the number of counties and cities in the elderly population, the population density, the population with tertiary education level, the unemployment rate, the female labor force participation rate, the population over the age 15 that have marital status, the proportion of birth rate, the number of foreign and mainland spouses, the number of the welfare of foreign workers per 10,000 of the elderly receiving home care people, totally 11 variables. To establish the relationship between the number of observed effect level of long-term care facilities of each city and county, to understand the regional differences, to provide the government on specific policy recommendations. In the future, we expect to provide the public and private sectors the reference establishment of nursing agencies of each city and county.