社區老年精神病患家屬之照顧負荷

精神疾病患者在步入老年時期，隨年齡增長，除了精神疾病還會合併生理問題與身體失能，健康照顧需求會更多，需要跨科醫療及護理服務，社區老年精神病患的後續長期照顧需求需多元化、全人、全時及全方位服務。家屬則承擔許多照護責任，造成不同的疾病負荷，精神病患照顧者應具備正確的觀念與態度，才能夠照顧好自己，進而幫助病人，筆者提出具體的自我調適之建議，提供照顧者參考：（1）家屬千萬不要自責，這不是任何人的錯；（2）照顧精神疾病的家人是所有家庭成員的共同責任；（3）家屬要對精神疾病說不，而不是對病人說不；（4）家屬必須自我照顧；（5）家屬要協助對抗精神疾病，醫療團隊和病人及家屬一起制定各項治療約定。建議未來需落實加強家屬或鄰里居民對老年精神疾病的認知，提供諮詢及教育，且透過社政單位徹底了解精神病患的家庭困境並協助解決，期能打造一個對老年精神病患之友善社區，並擴及整個社會國家。

關鍵字

老年精神病人；家屬；負荷

並列摘要

As psychiatric patients aging, in addition to psychological illness, they will also encounter physical issues as well as disability. They demand more health care, require interdisciplinary medical and nursing services; therefore, the follow-up and long-term care demand of elderly mental patients in the community require diversified, whole-person, full-time and all-round services. Family members bear a lot of care responsibilities, causing diverse disease burdens. Caregivers should have correct concepts and attitudes to take care of themselves while helping patients. Authors put forward some specific self-adjustment suggestions for caregivers' reference: (1) family members ought not to blame themselves, it is not anyone's fault; (2) taking care of patients with psychosis is the common responsibility shared by all family members; (3) family members should say ＂no＂ to psychosis, not to the patients; (4) family members must take priority of self-caring; (5) family members should assist patients to combat psychosis; and work with the medical team, as well as the patients together to formulate various treatment agreements. It is recommended to strengthen awareness of elderly psychosis for family members or local residents, provide consultation and education. Furthermore, by thoroughly understand the plight of mental patients' families through social and political departments and assist in solving issues; in order to create a friendly community for the elderly psychiatric patients, and hence extend the service to the entire society and the country.

並列關鍵字

elderly psychiatric patients ； caregiver ； burden

參考文獻

戎瑾如、吳佳珊、廖素絨（2018）．老年精神衛生護理師之角色與能力的發展．源遠護理，12(3)，5-13。https://doi.org/10.6530/YYN.201811_12(3).0001

馬先芝（2003）．照顧者負荷之概念分析．護理雜誌，50(2)，82-86。https://doi.org/10.6224/JN.50.2.82

陳姿廷、吳慧菁、鄭懿之（2015）．臺灣精神障礙者手足照顧經驗之初探：以父母照顧經驗做對照．臺大社會工作學刊，31，55-103。https://doi.org/10.6171/ntuswr2015.31.02

徐瑀謙、黃莉萍、徐敏芳（2016）．社區精神病患家屬照顧負荷及其預測因子．健康與建築雜誌，3(2) ，64-71。https://doi.org/10.6299/JHA.2015.3.2.R7.64

張文彬（2021）．精神疾病與長期照顧的距離：論 2018 年龍發堂事件後的精神病人長照制度．社科法政論，9，1-41。https://doi.org/10. 6268/RSSLP.202103_(9).0001

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社區老年精神病患家屬之照顧負荷

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