隨著高齡化的進展，失智症老人大富增加，其照護模式亦備受關注。日本實施介護保險的同時，機構照護亦趁勢改革，其中大型機構導入「生活單位型照護模式」unit care、社區中分散設立失智老人之家(group home)及類似托老所的小規模多功能照護據點等措施，格外引人注目。此二者共通的特色是：(1) 房間個人化 (2) 生活環境家庭化； (3) 照護服務個別他，尤其適合照護失智症老人；惟亦可能因照護水準及效率難以掌控，反而讓小規模家庭氣氛的優點流為封閉的「小型收容所」缺點。失智老人之家以5-9人小規模家庭氣氛見長，自介護保險實施以來，4年內全國成長率高達10倍以上，現今被譽為失智症老人照護模式的王牌。失智老人之家、托老所等既非家庭亦非職型機構，因此被定位為「第三類型機構」，同時也是「社區照護類型」的具體實踐。本稿以檢討日本的機構照護革命為主軸，分析失智老人之家快速成長的理由，間接反映「社區照護類型「比「機構照護類型」建設成本低而效率高，值得作為臺灣發展社區照護的參考，非但用在失智症老人，一般失能老人亦可嘗試使用。

While Long-Term Care is put into practice, the institutional care in Japan is also revolutionizing. The most important of which includes the introduction of small-scale unit care into large-scale institutes, and the establishment of group homes and takurousyous that are between family and institution. The two solutions have the following features in common: (1) personalized space (2) more home-like living environment (3) individualized care. However, they also present the common shortcomings: (1) difficulties in maintaining quality and efficiency of care (2) closed environments easily become small shelters. In Japan, the number of small-scale group homes that hold 5-9 people has increased over 10 times from 2000 to 2004. Group homes are now considered the answer to the care model of mentally incompetent elders. Being referred to as type-Ⅲcare service, group home are actually the realization of community care. This essay will examine the revolution of institutional care in Japan, analyze the reason for the rapid growth the group homes, and demonstrate the efficiency of institutional care. It can be taken as an example for the community care in Taiwan.