制度與文化的共同作用：後戰地金門家庭照顧者的圖像與服務反思

<p>金門在冷戰時期已邁入高齡化社會，解嚴後，老人照顧成為議題，政府力拚經濟，家庭引進外籍看護工應急，種下照顧私有化體制。近年隨著金門陸續推展長期照顧服務，家庭照顧者個管體系和服務隨之開展。本研究以社會照顧為分析架構，蒐集在地某協會推展家庭照顧者的檔案和中央、地方家庭照顧相關的規定與措施，探索金門家庭照顧者的特性與處境。主要發現是男性家庭照顧者、留守照顧者、高齡照顧者是在地特性，存在男性有累不輕談、受遙控的留守照顧者、自身難保的高齡照顧者之處境。在中央、地方相關措施聚焦在個人，卻面臨服務難進家庭的挑戰，凸顯文化與制度的衝突。回應之道是發展呼應在地家庭照顧者之創新服務，進行照顧文化的改變。</p> <p> </p><p>Kinmen’s aging society emerged during the Cold War, but long-term care was overlooked post-martial law as economic growth took priority. Families resorted to hiring migrant care workers. Recently, the decelopment of long-term care services have fostered family caregiver case management and services. This study applies a social care framework to analyze Kinmen’s family caregivers using archival data from a local caregiving association and government policies and measures. Findings highlight distinct caregiver profiles: male, left-behind, and older caregivers. Challenges include unspoken exhaustion (male), remote supervision (left-behind), and physical strain (older). Moreover, relevant national and local measures are oriented toward the needs of individuals, service providers encounter barriers in reaching into households in need, highlighting the tensions between cultural norms and institutional structures. The establishment of innovative services tailored to the needs of local family caregivers, thereby fostering transformation in the culture of care.</p> <p> </p>