因應社會變遷帶來的長期照顧服務之需求，政府積極研擬相關政策與措施。家庭托顧服務乃是我國新型照顧服務，此服務以「在地老化」為目標，就是讓老人留在熟悉的社區中接受照顧服務。老人托顧於住家附近的照顧服務員家中，接受身體照顧、保護性及看視性照顧等，如同將小孩托顧於社區中的媬姆家中一般。由於要求照顧服務員必須具備基本的照顧能力與技術，加上地理距離的接近，不但讓家屬能安心托付，服務的可近性亦高。 除此之外，家庭托顧亦能發揮鄰里互助的功能及特色。不過，從「建構長期照護體系三年先導計畫」的實施狀況來看，推動狀況卻不如預期。「建構長期照顧體系十年計畫」亦將之列重點推動服務項目，但是卻也是進展緩慢。為何立意良好的家庭托顧推動不易呢？為何無法獲得民眾的青睞呢?引自國外的家庭托顧在推動的過程中是否遭遇文化適應的障礙呢?本文藉由整理美日實施的經驗，分析家庭托顧的理念、我國引進的環境背景、相關政策與措施等，並探討推動過程中的困境所在，最後提出改善之建議。

Due to the rapid change of the society, there is a need for long-term care-taking. The government, thus, has made some policies to meet this need, and one of them is “Adult Foster Care.” Its goal is to achieve “aging in place,” so that the elderly could stay in the communities that they are familiar with to receive care services. This new measure has a great number of advantages, such as qualified care-takers and convenient locations. However, the level of utilization are lower than expected in the two projects, including a three-year project—the Pilot Program for the Development of Long-Term Care System and a ten-year project—the Program for the Development of Long-Term Care System. Therefore, this paper aims to investigate some difficulties faced in community-based services and provide some suggestions to improve the current situation.