| IVOD_ID |
169707 |
| IVOD_URL |
https://ivod.ly.gov.tw/Play/Clip/1M/169707 |
| 日期 |
2026-05-28 |
| 會議資料.會議代碼 |
委員會-11-5-26-12 |
| 會議資料.會議代碼:str |
第11屆第5會期社會福利及衛生環境委員會第12次全體委員會議 |
| 會議資料.屆 |
11 |
| 會議資料.會期 |
5 |
| 會議資料.會次 |
12 |
| 會議資料.種類 |
委員會 |
| 會議資料.委員會代碼[0] |
26 |
| 會議資料.委員會代碼:str[0] |
社會福利及衛生環境委員會 |
| 會議資料.標題 |
第11屆第5會期社會福利及衛生環境委員會第12次全體委員會議 |
| 影片種類 |
Clip |
| 開始時間 |
2026-05-28T11:57:46+08:00 |
| 結束時間 |
2026-05-28T12:17:59+08:00 |
| 影片長度 |
00:20:13 |
| 支援功能[0] |
ai-transcript |
| video_url |
https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/89665fc2cee9c367da0794c4f24881797a79f49b44e074560e352d399ec8cc5a56c4274c4566c6a95ea18f28b6918d91.mp4/playlist.m3u8 |
| 委員名稱 |
林淑芬 |
| 委員發言時間 |
11:57:46 - 12:17:59 |
| 會議時間 |
2026-05-28T09:00:00+08:00 |
| 會議名稱 |
立法院第11屆第5會期社會福利及衛生環境委員會第12次全體委員會議（事由：審查
一、國民黨黨團擬具「失智症基本法草案」案。
二、台灣民眾黨黨團擬具「失智症基本法草案」案。
三、委員林月琴等19人擬具「失智症基本法草案」案。
【僅詢答】【第三案如經復議則不予審查】） |
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好 謝謝主席 是不是請呂次長呂次長 你們的2024年的失智症流行病學調查大家已經講很多次了 盛行率大概將近7%這個2.99對啦 將近8% 我講錯了在2011年委託調查的8.04 很接近 |
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30.001 |
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43.446 |
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那這種狀況裡面女性失智症的盛行率9.36大過於男性的6.35而且是遠遠的大過於這個男性那當然年紀越大退化的會越嚴重這種狀況裡面我們是要告訴大家說 |
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49.65 |
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60.833 |
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我抱歉這樣說但是事實也是就是政府要重視這個疾病的原因是大家都會老對你來跟85歲醫生是盛行率23.23%對所以是四個就有一個大家都賭得到你來吃超過85歲賭得到的機會很大每個喔沒錯所以在這種狀況裡面我們希望政府要重視這個件事情重視這個疾病是 |
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77.458 |
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95.228 |
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那更要看見照顧家庭的壓力在這種狀況裡面施政人口的增加不是一個抽象的趨勢而是社會要具體你要政府要具體轉化成看到家庭照顧的壓力長照服務的需求 |
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96.569 |
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107.4 |
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醫療利用的增加以及社區照顧和支持服務你能不能跟得上需求成長的這個問題那大家也一直在講說市政的這個伴隨就是BPSD啦那BPSD裡面 |
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116.289 |
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143.757 |
| transcript.whisperx[5].text |
前五名出現的症狀是憂鬱及負性症狀33.37日夜顛倒作息混亂恐懼或焦慮重複行為以及妄想所以這是一個非常嚴重的情緒還有行為症狀在這種狀況裡面它不是讓失智者患者自己本人痛苦而是照顧者也很痛苦 |
| transcript.whisperx[6].start |
144.777 |
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171.924 |
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這個不是一般失能的照顧者那一種痛苦他這個壓力是大到非常的大所以每一個失智者的背後我們都看到正在承受長期壓力的照顧了這個家庭所以我們現在要問的就是說現行的失智的政策是不是真的把照顧家庭的壓力作為政策設計資源配置的優先考量可是我們看到呢 |
| transcript.whisperx[7].start |
172.944 |
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191.518 |
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你們就是停留在服務部件啦我的服務據點怎麼樣啦這一種成果和數據上但是我要再跟你分享的就是說這個2025年社區發展季刊啦有一篇從悲親屬不堪失智照顧的負荷探討照顧暴力和老人保護的困境 |
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195.561 |
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224.6 |
| transcript.whisperx[8].text |
其實是狀況真的不好失智家庭面對不是不只是照顧技巧不好的不足的問題而是每天都要去處理這一個變動衝突不確定性而且在這個我剛剛講這一篇這個文章裡面他講你知道主要是誰在照顧失智病患嗎照顧失智病患的特質是什麼特點是什麼你知道嗎 |
| transcript.whisperx[9].start |
225.601 |
| transcript.whisperx[9].end |
252.83 |
| transcript.whisperx[9].text |
照顧者包委您現在是說照顧者嘛對照顧者我的理解對照顧者的而言當然就是很多嘛就日夜顛倒啦沒有啦不是我來講照顧者我告訴你我直接告訴你答案啦台灣失智症的主要家庭照顧者以成年子女為主其次是配偶因為年紀大了配偶大概沒辦法負荷了 |
| transcript.whisperx[10].start |
253.59 |
| transcript.whisperx[10].end |
262.959 |
| transcript.whisperx[10].text |
成年子女為主然後成年子女以上因為市政是年紀大以後才好發嘛所以55歲以上的照顧者超過幾%你知道嗎 |
| transcript.whisperx[11].start |
268.894 |
| transcript.whisperx[11].end |
283.007 |
| transcript.whisperx[11].text |
55歲以上55%55歲以上的照顧照顧者超過65%三成以上55歲以上的這個六成五的主要的這個照顧者三成以上同時還要工作 |
| transcript.whisperx[12].start |
284.068 |
| transcript.whisperx[12].end |
309.735 |
| transcript.whisperx[12].text |
還要工作還要兼顧照顧責任所以他是身兼多職年齡越高每日平均照顧時間越長健康狀況自己都變不好而被照顧者的病程拖越久日常生活的功能越差行為情緒問題越嚴重照顧者的負荷也很重所以你要看到這個照顧者的主要群體是什麼特質年紀大的 |
| transcript.whisperx[13].start |
311.836 |
| transcript.whisperx[13].end |
335.198 |
| transcript.whisperx[13].text |
年紀大了都還要再工作的然後他還要再照顧他這個失智的這個父母的所以在這個狀況裡面他那個失智症的病程變化因人而異啦從初期輕到中重度有時候病程是要10年到20年大多數但也有急性的馬上退化的 |
| transcript.whisperx[14].start |
335.999 |
| transcript.whisperx[14].end |
361.677 |
| transcript.whisperx[14].text |
但是對家庭照顧者而言非預期的照顧的困擾行為比如說半夜無故醒來然後就要出去了然後大小便失禁了然後重複的問題重複的動作然後半夜醒來自己外出以後迷路了然後找不到人了大家全家就要起來找人了所以這些 |
| transcript.whisperx[15].start |
362.518 |
| transcript.whisperx[15].end |
378.868 |
| transcript.whisperx[15].text |
困擾的是這種逐步退化認知功能都沒了那照顧者是在一個無妄感的狀況裡面他一直要去要去處理這些不斷有的不斷發生的這一些壓力 |
| transcript.whisperx[16].start |
379.948 |
| transcript.whisperx[16].end |
398.682 |
| transcript.whisperx[16].text |
這個事情所以讓家庭照顧者他隱然就是另一種被忽略的隱形的病人而且不要忘了他們都是年齡都已經55歲以上居多所以我要告訴你那你政府的政策要配合 |
| transcript.whisperx[17].start |
399.703 |
| transcript.whisperx[17].end |
413.299 |
| transcript.whisperx[17].text |
政府的政策你要不能停留在告訴大家說來失智者的衛教怎麼做啦宣導這個怎麼處理啦資源網站是什麼啦諮詢電話是什麼啦或是我的據點是什麼 |
| transcript.whisperx[18].start |
414.42 |
| transcript.whisperx[18].end |
438.412 |
| transcript.whisperx[18].text |
不行啊政府的政策要進一步的要看到這個家庭的真實的照顧的情境是什麼你才會了解家屬的需求是什麼然後你的照顧的政策才能夠做調整然後如果你沒有的話壓力就是還是停留在個人啊所以我現在問你就是說 |
| transcript.whisperx[19].start |
439.392 |
| transcript.whisperx[19].end |
460.226 |
| transcript.whisperx[19].text |
不是有服務就代表你接住了這個失智者的家庭那失智照顧的資源跟實際的需求仍然有很大的落差你知道嗎這一些失智者的家庭這些照顧者他們現在根據調查他們需求比較多的是什麼你知道嗎 |
| transcript.whisperx[20].start |
464.858 |
| transcript.whisperx[20].end |
479.309 |
| transcript.whisperx[20].text |
阿兵阿兵阿是你們的市長喔市長你來講沒關係我知道這對市長來講有點細節但是如果你不了解一個私人家庭的需求你怎麼會端出一個好的政策呢 |
| transcript.whisperx[21].start |
480.693 |
| transcript.whisperx[21].end |
500.486 |
| transcript.whisperx[21].text |
以照顧者而言剛剛委員關心到了就是也比較高齡了然後甚至還要負擔家裡的經濟那還要兼顧照顧我講過了就不用我們講具體一點是所以他一定要要有替手他要有當他希望喘息的時候能夠有替手能夠進來協助還有沒有別的那當然更具體的 |
| transcript.whisperx[22].start |
505.529 |
| transcript.whisperx[22].end |
530.299 |
| transcript.whisperx[22].text |
更具體的當然就是家庭還需要什麼服務系統什麼服務進來因為剛剛有講到日夜顛倒所以晚上有可能這個照顧者如果都必須由他來在旁照顧的話他也沒有辦法好好睡個好覺所以也希望有一個喘息夜間的喘息服務能夠及時導入喘息但是跟一般失能的喘息不一樣是夜間的喘息講得不錯沒錯我現在就告訴你 |
| transcript.whisperx[23].start |
534.34 |
| transcript.whisperx[23].end |
554.566 |
| transcript.whisperx[23].text |
2026年曾經有台大的這個學術論文探討失智社區服務據點使用者的未滿足需求所以次長你要看這種論文去看人實務面是都去調查出來數據人是需要什麼你如果不知道你都在這裡都不想你只能想到一行而已我告訴你他們這裡面這個是已經在使用失智社區服務據點的這一些人他們 |
| transcript.whisperx[24].start |
563.388 |
| transcript.whisperx[24].end |
585.803 |
| transcript.whisperx[24].text |
主任知道的未滿足的需求前五項第一個身體健康第二交通接送第三心理健康第四外出活動第五家務處理而沒有被滿足的程度來看前五名的第一名是交通接送身體健康外出活動家庭處理以及心理健康家庭 |
| transcript.whisperx[25].start |
590.046 |
| transcript.whisperx[25].end |
613.682 |
| transcript.whisperx[25].text |
這個到底在指涉的是什麼交通接送交通接送為什麼需要交通接送是第一名為什麼一般來說通常他們大概就是那個外出嘛然後可能最主要是可能要購物等等這些相關的一些需求現在就是說這個整個逝世者的需求他照顧需要的不是只是單純的服務據點夠不夠 |
| transcript.whisperx[26].start |
615.263 |
| transcript.whisperx[26].end |
643.184 |
| transcript.whisperx[26].text |
而是说像以交通接送来讲他不是当成交通问题对失智者来说他其实可能还需要让他维持正常的社会互动社会互动社交可是你不能出门他怎么去社交呢那能不能出门往往决定他可不可以到据点也会那能不能就医能不能社会参与社会互动社交活动 |
| transcript.whisperx[27].start |
644.165 |
| transcript.whisperx[27].end |
671.327 |
| transcript.whisperx[27].text |
所以也決定了照顧者可不可以獲得短暫的喘息所以你看他需要的跟一般失能的就是不一樣啊所以這個研究他們去調查然後發現交通接送跟外出活動同時位居未滿足需求程度的前面最前面反映的不是你說服務這個據點而已其實就是說他的需求你沒有看到 |
| transcript.whisperx[28].start |
672.068 |
| transcript.whisperx[28].end |
688.882 |
| transcript.whisperx[28].text |
所以在這種狀況失智者在參與社會參與跟照顧支持銜接上在結構性仍然有這種缺口那家務處理跟外出活動的需求也是反映很多所以他已經漸漸的認知上的退化 |
| transcript.whisperx[29].start |
689.482 |
| transcript.whisperx[29].end |
714.682 |
| transcript.whisperx[29].text |
然後旺東旺西搭錯車忘記繳帳單重複領錢搞錯藥物沒有辦法穩定的處理買菜煮飯家務那你們呢在這種狀況裡面你們的政府的服務還偏重在類似失能失能者需求的那一種服務所以你們到底是不是說你的政策上需不需要調整 |
| transcript.whisperx[30].start |
715.362 |
| transcript.whisperx[30].end |
734.758 |
| transcript.whisperx[30].text |
包委員我覺得非常感謝委員提供這樣的一個非常豐富的研究那麼確實啦那個失智跟失能有一個很本質上的不一樣在於那個失智他其實他的身體活動還非常正常嘛他是腦袋不正常身體四肢都很活動而且特別就是委員剛剛說的就是夜間跟這些還有他的整個這一個 |
| transcript.whisperx[31].start |
738.53 |
| transcript.whisperx[31].end |
756.247 |
| transcript.whisperx[31].text |
外出而且當然需要維持社交社會互動而且確實他才能讓他不繼續惡化得太嚴重這個我們也是非常鼓勵所以你們提供了相對應的政策和服務是什麼沒錯確實非常感謝委員這邊的指正我想我們接下來整個對於事實的部分 |
| transcript.whisperx[32].start |
757.068 |
| transcript.whisperx[32].end |
763.093 |
| transcript.whisperx[32].text |
交通接送部分我們會來強化這部分的不只是這個你們現在還在講說是據點設了多少啦共照中心有多少家啦諮詢電話接了多少通啦這些都是重要可是你們就只是停留在這裡這是不夠的 |
| transcript.whisperx[33].start |
774.441 |
| transcript.whisperx[33].end |
800.788 |
| transcript.whisperx[33].text |
交通陪伴家庭協助心理支持夜間喘息服務個案轉閒時真的要進入到家庭接觸這些照顧的壓力所以你在3.0裡面我們希望你把早期失智的生活支持交通的接送家庭的協助照顧者的喘息夜間喘息心理劣心理支持要列為核心的服務而不是在我們剛剛講的那些那我現在就是 |
| transcript.whisperx[34].start |
801.708 |
| transcript.whisperx[34].end |
818.503 |
| transcript.whisperx[34].text |
那他還需要什麼總不能說一篇論文或學者研究不是我現在要問你說到底從官方資料庫來看你看得出來你們的統計資料看得出來需要者的需求是什麼嗎你們有統計過嗎 |
| transcript.whisperx[35].start |
822.503 |
| transcript.whisperx[35].end |
847.722 |
| transcript.whisperx[35].text |
你們的官方資料我們真的看不你們現在是推動CDR資料上傳鼓勵計畫嘛對不對但是呢我們現在就目前公開的失智程度的統計仍然是用流行病學去推估的我就覺得很納悶啊這種東西是不是失智家屬都會帶到醫院去看病啊然後會檢定啊然後會給藥啊 |
| transcript.whisperx[36].start |
850.36 |
| transcript.whisperx[36].end |
877.319 |
| transcript.whisperx[36].text |
這個怎麼還是用推估的呢到底實際的罹病率是多高統計的出來啊可是你們都沒有定期公告實際確診失智者的失智程度到底確診多少人失智的程度各級別是什麼你們長照統計專區裡面針對長照服務使用的人口學的特性分析也沒有納入是否為失智者失智程度等關鍵指標都沒有 |
| transcript.whisperx[37].start |
878.019 |
| transcript.whisperx[37].end |
903.239 |
| transcript.whisperx[37].text |
所以在外界包括立法院要監督包括你們的政策你怎麼去看得出來說不同失智程度的人到底有沒有進入長照體系不同程度的人得到什麼樣的對應的照顧那這個他的需求有沒有對應的政策給他們接住你連這個統計都看不出來我們怎麼會知道你有沒有做得好呢你的需求統計得出來嗎 |
| transcript.whisperx[38].start |
906.696 |
| transcript.whisperx[38].end |
932.909 |
| transcript.whisperx[38].text |
統計連是不是為失智者CDR的失智程度CMS的失能等級各類長照服務的使用情形交叉比對我們就可以看到供給端你不見了多少服務可是我們都看不到這一些數據更談不上交叉分析更看不到實際上使用了哪些服務哪些服務使用不足哪些家庭仍然在正式服務之外通通都不知道 |
| transcript.whisperx[39].start |
934.25 |
| transcript.whisperx[39].end |
945.234 |
| transcript.whisperx[39].text |
所以說你到底有多重視啊你連這個統計資料都看不見你告訴我說你要重視所以你要重視可不可以請你就從統計資料 |
| transcript.whisperx[40].start |
948.479 |
| transcript.whisperx[40].end |
971.888 |
| transcript.whisperx[40].text |
告訴我們呢 會有困難嗎 部長 次長包委員 我這邊我想這個確實 任何的就像剛剛部長在早上答詢的時候他也說你要精準 政策上要精準去面對這個基本上就是你的樣態 還有整個統計上一定要先要先充分掌握 這個我們回去會趕快你們現在通通都沒有 通通都沒有 |
| transcript.whisperx[41].start |
972.708 |
| transcript.whisperx[41].end |
993.578 |
| transcript.whisperx[41].text |
所以我再講一次實際確診失智者的人數失智程度的分佈CDR失智的程度CMS長照服務等級的交叉分析失智者使用各類長照服務的情形還有各縣市服務的使用差異以及照顧者支持服務使用的情形然後我們還要這個回應在檢視這種資源的配置妥不妥當和不合理 |
| transcript.whisperx[42].start |
1002.539 |
| transcript.whisperx[42].end |
1029.051 |
| transcript.whisperx[42].text |
跟委員說明剛剛委員關注到幾點確實我們的想像只要有就醫應該資料就會上傳可是因為有關失智的這個診斷相關的評估工具在健保那邊的給付他們有限定說一定是用哪一類的工具是尊重醫師的專業那因為我們這邊在有一些相關的獎助福利我們在認定上要統一工具的標準所以我們認定是CDR所以才會有一個 |
| transcript.whisperx[43].start |
1029.851 |
| transcript.whisperx[43].end |
1033.192 |
| transcript.whisperx[43].text |
鼓勵就診醫院這邊幫忙協助上傳CDR的一個一個費用由長照基金在支持很多人都不知道有補助獎勵那我們這次來我們會強化來宣導那所以剛剛健保署代表也有特別提到目前就醫的失智症有15萬多人那可是我們這種流病調查這樣的一個 |
| transcript.whisperx[44].start |
1052.759 |
| transcript.whisperx[44].end |
1055.882 |
| transcript.whisperx[44].text |
他跟實際的落差很大這個就是潛藏在社區裡面如何透過鼓勵這些長輩能夠社會參與之後能夠及早的把他懷疑的能夠及早透過公召中心這邊來確診 |
| transcript.whisperx[45].start |
1071.88 |
| transcript.whisperx[45].end |
1090.403 |
| transcript.whisperx[45].text |
你們應該在你們統計上方法上跟醫院第一線的這些醫療機構銜接上你們要想辦法去克服你剛剛所說的那個問題是不是嗎我們現在確實在我們的失智的這個管理系統裡面有去勾擊健保這邊的一個專家討論出來的會下那個失智症的診斷碼有勾擊那勾擊了這個清澈之後我們再來比對在 |
| transcript.whisperx[46].start |
1100.405 |
| transcript.whisperx[46].end |
1104.468 |
| transcript.whisperx[46].text |
我們附設供召中心的醫療院所就醫的這樣的一個民眾我們會把這個名冊給這個你們要列為重點因為這個涉及到個資啦所以在這跟個資有什麼我們沒有在講個資沒有沒有那是兩件事情你把公積出來名單交到社區裡面那是個資的問題但我講的是到底有多少離病的人 |
| transcript.whisperx[47].start |
1125.125 |
| transcript.whisperx[47].end |
1133.549 |
| transcript.whisperx[47].text |
離病的人他的他是輕度中度重度這個跟個資沒有關係這種統計是一個大的群體上的統計而已這塊如果已經是我們確診我們掌握的這個都沒問題所以現在沒有問題我統計數據都看不到怎麼會沒有問題然後他們使用各縣市的服務的這個體系量能的差別在哪裡你就是要我剛剛講一個是 |
| transcript.whisperx[48].start |
1152.978 |
| transcript.whisperx[48].end |
1178.712 |
| transcript.whisperx[48].text |
服務據點使用者他提出他的需求我想交通需求嘛一個是政府由上而下你透過你所能擁有的健保的大數據你看到了這個現象而你知道這個現象以後你對應的政策要拿出來所以這是雙向的一個是由下而上反映上來的一個是由上而下透過官方的這個掌握的資料數據然後 |
| transcript.whisperx[49].start |
1180.593 |
| transcript.whisperx[49].end |
1205.242 |
| transcript.whisperx[49].text |
擬定的 這個上下要交流在一起然後擬出一個最適符合照顧者家庭的需求的應該是要這樣子 這才叫做重視兩統計資料就沒有了 算不上重視包括我們剛剛所說的有SDR就是說從極輕度 輕度 中度到重度其實這邊我們都有相關的統計數據這樣你們都沒有公佈 |
| transcript.whisperx[50].start |
1207.443 |
| transcript.whisperx[50].end |
1208.665 |
| transcript.whisperx[50].text |
那你們公佈一下給我們看 |