我國在民國八十七年開始推展獨居長者的正式服務，其中一項方案為關懷訪視服務，透過志工進行居家訪視增加獨居長者的社會接觸。回顧過往關於關懷訪視服務的文獻，大多是立基於服務提供者的觀點，忽略了獨居長者的聲音，故本研究從獨居長者的角度出發，探究長者接受關懷訪視服務的經驗為何。據此，研究問題如下：(1)長者實際經驗之關懷訪視服務內容為何；(2)長者自覺關懷訪視服務的獲益為何；(3)長者與志工的互動關係為何；(4)長者與志工的互動關係會隨著時間發生哪些變化；(5)長者和志工關係發展的相關因素為何？(6)長者接受訪視服務經驗對其自我概念的影響為何？ 本研究採用質性研究法，以半結構式訪談蒐集資料。訪談樣本來自台北市某老人服務中心列冊之獨居長者，共有9名受訪長者，七位為女性和二位男性，年齡約在70-80多歲，有兩位與親人同住，其餘皆一人獨居。 研究結果如下： 一、長者實際經驗之服務內容：志工的探視、陪伴、叮嚀和聊天，讓長者感到被關懷的情感性支持；此外，長者亦獲得訊息和工具性支持，訊息性支持為告知：(1)活動訊息；(2)社福資訊；及(3)老人中心的聯絡資訊，工具性支持則是：(1)物資贈予；(2)陪同就醫；及(3)住院照顧；最後，志工關懷的同時，其實也在收集長者的資訊，包括：(1)個人資訊；(2)平日狀況；及(3)突發狀況，並在必要時將資訊回報，讓老人中心可以掌握獨居長者的狀況，也就是說老人中心透過志工的關懷訪視，既「關懷」又同時「掌握」著長者的生活狀況。 二、長者實際感受之獲益：志工的訪視增進長者與外界的連結，並建立與志工的連帶；此外，長者與志工接觸的過程中，志工的探問、陪伴、關心等行為，以及聊天互動等都能帶給長者好心情，讓長者不會感到無聊、孤單，以及有被社會排除的負向感受。 三、長者與志工生命交會的故事：長者和志工的相識過程，除了官方安排外，也可能：(1)志工本來就是長者的鄰居；(2)熟人引介；及(3)事先在老人中心的活動場合認識。次之，交談是長者和志工的主要互動，他們的話題偏向大眾性話題，避免談及隱私性話題，這意謂著長者和志工之間大多是在「公我」領域的往來。隨著時間的推移，長者對志工感到更加熟悉、認識、親密、信任和自在，以及有義務產生。進一步將長者與志工之間的互動關係歸類出四種型態：(1)完全任務取向的互動；(2)涉及社交性的往來；(3)涉入情感與生活；(4)兼具鄰居關係。最後，長者和志工之間的互動關係的相關的因素為：(1)個人脈絡；(2)雙方契合度；(3)志工人際吸引特質；和(4)環境因素。 四、長者接受訪視服務經驗中的自我認同：首先，在善意的服務下長者進入了服務接受者的位置，這也決定了長者的應有行為；(1)感謝的必要性；(2)須回報的欠債感；(3)配合的態度，長者的主體被客體化為順從的受助者，但另一方面，長者企圖以其他方式來展現自己的主體：(1)正向詮釋志工的關懷，讓長者自我認定為被關心的朋友和尊敬的長輩；(2)打破互惠關係的不平衡，使得長者不再只是個被施捨的受助者。最後，從其中一位受訪者案例，看到獨老身分決定過程中的角力，兒女對於獨老身分的抗議，但老人中心才真正擁有獨老身分的決定權，在這情況下長者：(1)運用老人中心的正當理由，抵消兒女的反對聲浪，但(2)對於獨老身分仍存有一絲疑惑；因此(3)透過內心取消獨老身分，反抗這個身分的框架，更透過擔任志工以服務者的角色來展現他的主體性。 / Taiwan has launched The Formal Services for the Living Alone Elders since 1998. Among the services, friendly visiting is one of them, which improves social contacts of living-alone elders through in-home visits by volunteers. On account of studies in the past focused mostly on the perspective of services providers and ignored the elders’ viewpoints, this study is based on the elders’ point of view, aiming to build a detailed description of the experiences of living-alone elders receiving friendly visiting services. With the focus on the above point of views, the research questions that guided the inquiry into the experiences of the living-alone elders are as follows: (1) What are the detail services of friendly visiting programs that the elders actually received? (2) What benefits the elders think they have gained from friendly visiting? (3) What are the patterns of interaction between the elders and volunteers? (4) How would the patterns of interaction between the elders and volunteers vary by time? (5) What are the factors that affect relationship development between the elders and volunteers? and (6) How friendly visiting affects self-perception of the elders? This study adopts a qualitative design and interprets data collects through semi-structured interviews with samples of 9 study interviewees, 7 females and 2 males, draw from living-alone elders listed by a certain Seniors Service Center in Taipei City. These interviewees age from 70 to 80, two of which are living with relatives, and the others are living alone. Present significant results from the data are gathered as follows: A. The contents of services that the elders actually received: The elders gain emotional support from the process of chatting, visiting, accompanying, and caring provided by volunteers. In addition, informational support and instrumental support are also provided. The former includes (1) information about programs and activities, (2) news about social welfare, and (3)contact information from Seniors Service Centers; and the latter includes (1) provision of goods, (2) services of accompanying to the doctor, and (3) inpatient care. Furthermore, the time volunteers provide services also means the time they do the research and report back to the Seniors Service Center about the elders’ condition so that the lives of the elders can get tracked, which include (1) private information, (2) everyday life situation, and (3) emergency conditions. That is to say, the Seniors Service Center can “concern about” the elders and “handle” their conditions at the same time. B. Benefits the elderly think they have gained: The friendly visiting reinforces the links of the elders to the world as well as the ties between the elders and volunteers. Furthermore, in the process of the contact of the elders and volunteers, emotional effects are reflected positively on the elders due to chatting, visiting, accompanying, and caring provided by volunteers, which also prevent them from negative feelings, such as being lonely, getting bored, or feeling a sense of social exclusion. C. The stories between the elders and volunteers: Besides official arrangements, there may be other approaches for the elderly and volunteers to meet each other, including: (1) they are neighbors originally, (2) they were introduced to each other by an acquaintance, and (3) they knew each other before in programs provided by Seniors Service Center. Additionally, the elders and volunteers interact mainly through conversations, which are mostly related to public topics instead of private ones. This means, the interaction mostly remains in a public territory. However, as time goes by, the elderly grow more close and familiar to volunteers. Under this situation, interaction patterns between the elderly and volunteers can be inducted into four categories: (1) task-centered based interaction, (2) ordinary social interaction, (3) interaction involved in private daily lives, and (4) neighborhood interaction. Finally, related factors which affect the interaction relationship between the elderly and volunteers include (1) personal background, (2) compatibility of the elder and volunteers, (3) personal characteristics of volunteers, and (4) environmental factors. D. Self-identity of the elders through process of friendly visiting: On one hand, the elder’s reactions toward the visiting services are decided by services out of volunteers’ goodwill, which also puts the elders into a position of service receivers. These reactions include: (1) the necessity of appreciation, (2) a sense of indebtedness which is compensated by repaying, and (3) an attitude of obeying, which means the elders are shifted into a place of passive objects instead of subjects as a service receiver. On the other hand, the elders attempt to realize their position as a “subject,” that is, the leading role, mainly in two ways: (1) The elders interpret care from volunteers positively, trying to take themselves as friends of volunteers or respectful seniors instead of the needed ones. (2) The elders prevent themselves from being merely help takers by paying back or even becoming volunteers themselves, providing services for others actively. Finally, the study focuses on a special case, in which the identity of living-alone elder is in debate. Offspring of the elder, who think their father need not help, are arguing with the Center whether the elder can be identified as a living-alone elder or not; however, the power to make decision is in the hands of Seniors Service Center. Under this situation, the elder makes a series of responses:(1) At first, he appeases his children by restating justified and legitimate reasons from the Center. (2) But in fact, he still has doubts on his identity. (3)In the end, he seems to accept the truth on the surface but rejects it at heart, insisting to realize himself by being an active volunteer to provide services through programs of Seniors Service Center.

國立政治大學社會學系八十七學年度第一學期碩士論文摘要 研究生：黃秀玲 撰 指導教授：林佳瑩博士 論文名稱：銀髮小家庭居型態之比較研究 基於研究主題，本研究把不與子女同住的「獨居」或「夫妻同住」之老人的家庭歸納為「銀髮小家庭」，乃以高雄縣內60歲以上銀髮小家庭老人164人（居住家中不與子女同住83人、居住高縣老人公寓81人為樣本）為樣本，探討銀髮小家庭老人對居住需求的考量、比較不同居住型態（居住在自己家中、居住在老人公寓）對銀髮小家庭老人生活滿意度是否有差異存在。 整體而言，銀髮小家庭老人的共同特點是：多數老人主觀認為晚年的生活該由「自己」來負責任，且這群銀髮小家庭老人的教育程度跟一般非銀髮小家庭老人相比明顯很高，而退休前的職業也多是以軍公教人員為多，故老人們退休後也有穩定的經濟來源---退休金終身俸，或是由兒子供養為主。而比較不同的是我們可以由分析中發現：在「婚姻狀況」方面有明顯分佈上的差異，公寓中的老人婚姻狀態最多為喪偶，佔了半數以上；而居住在社區中的老人卻半數以上多為已婚與配偶同住。 銀髮小家庭老人居住需求前十名依序為：「尊嚴自主的生活」、「無障礙生活空間」、「附近有公園」、「專門的空間設計」、「交通方便」、「24小時緊急送醫」、「親情圍繞」、「訪視巡邏」、「親友聯絡」、「專人三餐服務」、「拓展人際關係」。可見對銀髮小家庭老人而言，有一個舒適、安全的生活空間對他們而言是很重要的考量項目，且居住的地點最好還是能兼顧與子女親友的聯繫，讓老人的情感支持不至於因獨居或夫妻同住而減少；加上若有專人幫忙老人準備三餐，對銀髮小家庭老人來說是一項很貼心的福利服務。經過整個研究的結果，我們可以發現居住在老人公寓的老人其整體生活滿意度、實際居住滿意度均不會比社區不與子女同住老人的結果來的遜色，甚至還比社區不與子女同住老人的反應還要好。這一方面是因為居住在老人公寓的老人一般而言教育程度較高、職業以公務員、軍警人員、教職人員為多，這些公務員體系的老人一直都有穩定的退休制度可以保障他們的晚年生活，再加上他們提早規畫老年生涯、且對子女的觀念能夠隨著社會的變遷做適度的調整，使得他們在面對老年這項事實時能以較開朗的態度來生活，並積極參與社會活動，主動運用社會資源、多方面吸收新知、發展興趣，依舊過的坦然自在。 目 錄 第一章 緒論 第一節 研究緣起……………………………………………………1 第二節 問題陳述……………………………………………………2 第三節 研究目的……………………………………………………4 第二章 文獻探討 第一節 台灣老人居住安排的變遷…………………….……………6 第二節 老人居住型態………………………………………..…..11 第三節 老人公寓………..………………….………………..….15 第四節 老人生活需求面面觀……………………………………..19 第三章 研究設計 第一節 研究架構…………….…………………………………..25 第二節 研究假設………………………………………………….26 第三節 操作性定義…………………………………………….…27 第四節 研究樣本………………………………………………….28 第五節 問卷設計………………………………………………….30 第六節 資料蒐集與分析方法……………………………………..32 第四章 受訪老人資料基本變項分析 ………………………..33 第五章 影響老人居住需求之相關因素分析 第一節 銀髮小家庭老人對居住需求考量的優先順序………………….41 第二節 銀髮小家庭老人個人基本特性對居住需求之分析…………….44 第三節 居住需求對居住型態之相關分析………………………………46 第六章 居住型態之分析 第一節 居住型態對個人基本特性之交叉分析……………………….48 第二節 銀髮小家庭居住滿意情形變項分析………………………….53 第三節 居住型態與居住需求各項滿意之相關分析………………….57 第四節 居住型態對整體生活滿意、經濟情況滿意、居住需求滿意之比較分析……………………………………..…………………60 第七章 結論與建議 第一節 結論………………………………………………………….63 第二節 建議………………………………………………………….70 附表 表1-6 ………………………………………………………………….76 附錄一 參考書目 中文書目…………………..…………………………………………….84 英文書目………………………………..……………………………….90 附錄二 問卷……………………………….…………………..93 表 目 錄 表1 台灣地區及美國65歲以上兩性人口之居住型態……………………………14 表2 受訪老人居住需求依平均分數排行……………………….……………….42 表3 銀髮小家庭老人個人基本特性對居住需求之單因子變異數分析………….45 表4 居住需求與居住型態之相關分析…………………………………………..47 表5 老人個人基本特性對居住型態、居住安排方式的卡方分析……………….51 表6 老人公寓老人與社區老人實際居住需求滿意程度的平均分數比較……….54 表7 老人公寓老人、社區不與子女同住老人之居住需求滿意度前十名比較…..56 表8 居住型態與居住滿意需求各項之相關分析…………………………………59 表9 居住型態對整體生活滿意度、經濟情況、子女、親友來往頻率之單因子 變異數分析…….………………………………………………………….61 表10 居住型態對心理社會適應、社會參與、專業諮詢與服務、設備環境需求 滿意之單因子變異數分析…………………………………………………61 表11 居住型態對居住需求、居住需求滿意之單因子變異數分析……………….61 圖 目 錄 圖1 受訪老人之居住安排方式比較長條圖…………………………………….34 圖2 受訪老人之性別比較長條圖………………………………………………34 圖3 受訪老人之籍貫比較長條圖………………………………………………34 圖4 受訪老人之教育程度比較長條圖………………………………………….34 圖5 受訪老人之宗教信仰比較長條圖………………………………………….34 圖6 受訪老人之婚姻狀況比較長條圖…………………………………..…….35 圖7 受訪老人之子女來往頻率比較長條圖…………………………………….35 圖8 受訪老人之親友來往頻率比較長條圖…………………………………….35 圖9 受訪老人之主要經濟來源比較長條圖…………………………………….36 圖10 受訪老人之一個月生活花費比較長條圖………………………………….36 圖11 受訪老人之生活費夠不夠用比較長條圖………………………………….37 圖12 受訪老人之經濟狀況比較長條圖………………………………………….37 圖13 受訪老人之健康狀況比較長條圖……..………………………………….38 圖14 受訪老人之主觀認為晚年該由誰負責比較長條圖…….………………..38 圖15 受訪老人之理想居住安排方式比較長條圖……………………………….38 圖16 受訪老人之整體生活滿意度比較長條圖………………………………….38 圖17 老人公寓老人得知老人公寓這項訊息之管道長條圖…………………….39 附 表 附表1 老人公寓老人個人基本特性資料次數分配表………………………………76 附表2 社區老人個人基本特性資料次數分配表…..………………………………78 附表3 老人公寓老人在選擇居住型態時的需求次數分配表…….…………………80 附表4 社區老人在選擇居住型態時的需求次數分配表……………………………81 附表5 老人公寓老人實際居住需求滿意次數分配表………………………………82 附表6 社區老人實際居住需求滿意次數分配表…………………………..………83 / Abstract This study explores housing and living arrangements of independent living elders and the differences in life satisfaction among citizens of independent living arrangements. The samples include 83 elderly people (over 60 years old) living in their own house and 81 elderly people (over 60 years old) living in congregate housing in Kaohsiung. The research result shows that independent living elders in congregate housing are higher level of life satisfaction than in their own house. According to overall statistics , the differences between elderly people living in their own house and elderly people living in congregate housing are the status of higher education and steadier income ( because most of them are soldiers or public servants ). Past researches always focus on community care needs of the disabled elderly , and I hope that after my study the authorities concerned can lay emphasis on the housing of all independent living elders in the future.

有鑑於過去人口結構的變化，台灣已成為人口老化速度最快的國家，人口老 齡化已成為一個重大議題。而老年人比例最高的日本，卻出現廣泛的老年貧窮 （下流老人）現象。因此，本研究以日本的情況為依據，對台灣老年貧窮的整體 概況和未來趨勢的發展進行資料整合與分析。主要探討台灣“老年貧窮”問題的 出現，並找出其影響的程度及其未來的發展，後續並深入分析其造成台灣“老年 貧窮”問題之關鍵指標因素，以及政府解決老年貧窮問題的政策與措施。研究發 現，超過五成老年人口落在最低收入、最貧窮層級的家戶中，顯示台灣社會的“老 年貧窮”現象有所增加。而造成台灣老年貧窮的原因為：一、退休養老金不足（低 於基本生活開銷）; 二、就業（低薪的工作環境）; 三、家庭養老功能下降（老 人獨居比率不斷上升）; 四、太早離開勞動力市場（儲蓄不足）。研究結果顯示，弱化的社會保障制度是老年貧窮比率升高的主要原因，而老年貧窮的現象亦廣泛存在於台灣社會，因此建議需提升公眾意識，提早準備充足的退休養老金、並加 強社區老人關懷功能、以及持續關注老年貧窮的問題。本研究結果可提供未來探 討台灣老年貧窮議題之參考，相關研究值得後續做進一步的探討分析。 / In view of the change in demographic structure in the past few years, Taiwan has become the country with the fastest speed of population aging. The aging population has become a major issue. Japan has the highest ratio of aged citizens, and the widely discussed phenomena of elderly poverty (The low-living elderly). Thus, this study based on Japan's case, has systematically reviewed, analyzed, and secondary data, in order to provide the overall and future trends of elderly poverty situation in Taiwan. The study probes into the emergence of the “elderly poverty” problem and try to find out the extent of this problem and its future outlook, to explore the causes of the “elderly poverty” problem in Taiwan and the official measures for alleviating elderly poverty. The research found that more than 50% of the elderly was the poorest households with the lowest income, nearly half of the elderly population falls to the lowest and poorest level, shows “the low-living elderly” phenomenon has increasing in Taiwan’s society. The causes of the elderly poverty in Taiwan: 1. the labor pension is too low (less than the necessary living expenses); 2. unstable employment (low income work); 3. family care function are decline (the elders living alone has keep rising); 4. early to exit from the labor market (lack of deposits). The weakened social security system are the main causes for the rising old-age poverty. The elderly poverty exists widely and need to promote public awareness for prepare adequate deposit in retirement, strengthen care function of community and focus on the elderly poor issues. For overall pictures of elderly poverty in Taiwan is worthy of further investigation and discussion.