居家失能老人在照顧服務使用的自我選擇權之相關因素研究

Objectives:To examine the prevalence and correlates of self-determination of homecare service among disabled Taiwanese elders. Methods: Nine hundred forty two (942) subjects among the 2079 disabled elders from the "Pilot Program for the Development of Long Term Care System Study" implemented in Taipei and Chiayi City were recruited. Elders with severe cognitive impairments and those with surrogate responses were excluded. Multinomial logistic regressions were applied for statistical analysis. Results: Forty-six percent of the respondents indicated that they could choose the care services by themselves, 36.3% could choose some services, and 16.8% were unable to choose services. Compared with those who could not make their own decisions, those who could not choose their services totally are more likely to have social welfare status (OR=0.45, 95%CI =0.25-0.79), severe ADL disability (OR=0.29, 95%CI=0.15-0.56), cognitive disability (OR=0.40, 95%CI=0.24-0.68), without personal income (OR=0.43, 95%CI=0.24-0.78), daughter-in-law caregivers (OR=O.36, 95%CI=0.15-0.88). Elderly with greater awareness of long-term care services exhibited higher probability of choosing their services (OR=1.13, 95%CI=1.01-1.27). Conclusions: Economic status, physical and mental functioning, the relationship with caregiver, education and the awareness of services were the important factors associated with self-determination of disabled Taiwanese elders. Our government should consider these factors when promoting relative long-term care policy for disabled elders.