Home Care Services for Indigenous Population in Taiwan: Cultural and Socio-Structural Implications for Long-Term Care Policy

J Gerontol Soc Work. 2019 Apr;62(3):306-323. doi: 10.1080/01634372.2019.1575307. Epub 2019 Feb 11.

Abstract

Taiwan faces the world's top aging rate over the next 8 years, making long-term care a priority for all populations, including the 16 indigenous groups who live primarily in the mountains and have different cultural practices than mainstream Taiwanese people. To examine how home care services are coordinated, managed, and delivered to the indigenous populations, we interviewed 10 public care managers and analyzed the interview content to assess their work experiences with home care workers and indigenous users in 2016. The research revealed four findings: (1) Home care utilization patterns and attitudes were different between the rural indigenous and non-indigenous populations; (2) home care utilization was limited by cultural, economic, and language challenges; (3) home care workers faced cultural and socio-structural challenges; and (4) policy and service provisions were rigid, without the socio-structural flexibility needed to accommodate the indigenous culture. A more efficient model will require the collaboration of public care managers, home care workers, and indigenous families to create a fair-coordinated plan. As Taiwan launches the Ten-year Long-Term Care Plan 2.0, a one-stop service delivery center to integrate care options and provide services for people of indigenous backgrounds is a must.

Keywords: Long-term care policy; Taiwan; home care services; indigenous population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Case Managers
  • Cultural Competency
  • Delivery of Health Care
  • Health Policy*
  • Health Services, Indigenous*
  • Home Care Services*
  • Humans
  • Long-Term Care*
  • Population Groups
  • Qualitative Research
  • Rural Population
  • Taiwan