- 學位論文
只想帶你回家─失智者失蹤家庭的經驗歷程
I Just Want to Bring You Home: The Experience of the Families of People with Dementia Who Go Missing
摘要
失智者失蹤是許多家庭在照顧工作上極大的壓力來源，然而臺灣本土文獻中尚未有人直面家庭面對失蹤事件的主觀歷程，故本研究期望探討失智家庭遭遇親人走失事件的歷程，了解家庭如何面對失智親人走失造成的危機及其衍生的情緒行為反應，及家庭面對親人走失的協尋經驗為何，而當失智失蹤親人被尋回後，家庭如何因應失蹤事件造成的影響，藉此傳達失智者失蹤家庭的心路歷程及經驗感受，而得以對現有政策及服務體系產生回應。 本研究採用質性研究方法進行半結構式深度訪談，主要以立意抽樣、輔以滾雪球抽樣選取五位研究參與者，參與者皆自覺曾經驗過失智親人失蹤事件，且失智失蹤親人已返家，在家庭中的角色包含主要照顧者、次要照顧者或同住者，並採主題分析法進行文本分析。 本研究發現失智家庭經驗失智者走失之歷程包含展開搜索行動、尋求正式與非正式資源協助，以及失智者返家後之照顧安排調整與家庭互動的因應等階段；當家人面對失智者失蹤事件，其情緒行為反應會受個人性格、與失智者關係、照顧角色、對情境的判斷等影響，產生不同的協尋行為及多樣複雜的情緒感受。其中，家庭所採用的協尋資源以警察及社區鄰里為主，警政資源是危難中友善但有限的援手，鄰里社區則扮演家庭長期的支持網絡，展現社區既有的互助能量。在協尋裝置的選擇上，失智者意願是家庭主要的考量，家庭亦具自行發展防走失策略的智慧。而本研究顯示失智者失蹤事件是家庭尋求正式資源挹注的契機，失蹤事件使家庭意識到現有照顧的不足，促使家庭主動連結相關資源，以規劃更安全的照顧安排，而照顧規劃的變動會牽動家人關係，造成家庭動力的改變。 根據上述研究結果，本研究提出針對失智者失蹤相關政策與實務之建議，期望長照服務中增添失智者失蹤相關資源與應變流程之具體規劃，建立警政、社政等協尋資源整合的機制，並重思失智友善社區、輔具資源補助等政策設計；研究方面則期許增添失智者失蹤相關之研究論述，從不同服務體系之視角擴展對此議題之視野，增進實務上交流與服務資源的整合。
並列摘要
The missing incident of people with dementia is great pressure for family caregivers, yet few studies in Taiwan have investigated the issue. The purpose of the study was to explore the subjective experience of the family living with dementia facing missing incidents. The research aimed to examine how the family coped with the crisis caused by the missing incident, including the resulting emotional and behavioral reaction, the searching experience, and the impact on the family after the occurrence. The study used a qualitative approach based on semi-structured interviews of five research participants selected by purposive sampling and snowball sampling. All of them, including primary caregivers, secondary caregivers, or relatives living under the same roof, have experienced the missing incident of the family with dementia, who have returned home. In addition, the thematic analysis method was conducted for data analysis. Overall, the results of the study showed that the course of the family with dementia facing missing incidents included unfolding a search to locate the individual, seeking formal and informal resources for assistance, the adjustment of care arrangements, as well as the adaption of the family after the relative returned home. The emotional and behavioral reaction of the family was affected by their personality, caring role, relationship with the missing individual, and risk assessment of the situation. As for the assistance resources, police and community were usually the main options for the family. It revealed that police were friendly but offered limited aid in times of crisis, and the neighborhood acted as the social support system demonstrating the existing energy of the community. In the choice of searching devices, the safety of the individual with dementia is the primary consideration of the family, also showing the wisdom of the family to develop anti-lost strategies on its own. Moreover, the research revealed that the missing incident, making the family aware of the deficiency of the current care arrangement, was an opportunity for the family to actively seek assistive and alternative care services for a safer care plan. Changes in the care arrangement influenced a family relationship and caused a shift in family dynamics. Based on the research results, this research proposed some recommendations for the missing incident of people with dementia on policies, practices, and academic fields. It is suggested that long-term care services should put more emphasis on planning a contingency process for missing incidents and establish a cross-functional mechanism combining police and social work to integrate the search resources. The government should rethink the policy design of dementia friendly communities and subsidies of assistive devices. Furthermore, more research should investigate the missing incident of people with dementia to expand the horizons of this topic from different service systems and enhance practical communication as well as service resources integration.