長期照護機構住民之非正式照顧者的人我角色定位探究

Informal Caregiver's Relationships with the Elders in a Long-term Care Institution

陳增穎(Tseng-Ying Cheng) ； 張小雯(Hsiao-Wen Chang)

《長期照護雜誌》 20卷2期 (2016/09) Pp. 167-184

https://doi.org/10.6317/LTC.20.167

摘要

研究目的：將長者送至長照機構是家屬常面臨的兩難挑戰。本研究的目的為：一、探討非正式照顧者讓長者入住機構的決策因素；二、瞭解長者入住機構後非正式照顧者的自我角色定位；三、瞭解非正式照顧者與住民關係的角色定位。研究方法：採用質性研究方法中的田野工作，結合觀察與深度訪談。結果與討論：讓長者入住機構的決策因素有：一、無法提供失能長者所需的照顧服務；二、家庭居住環境設備無法滿足長者需求；三、長者罹患精神疾病。長者入住機構後非正式照顧者的自我角色重新定位為：一、照顧壓力因長者入住機構而稍感紓解；二、主動承擔照顧責任，也為自己成為非正式照顧者賦予意義。非正式照顧者與住民關係的角色重新定位為：一、從相安無事到衝突升高的親子關係；二、關心依戀、親情不變的親子關係；三、盡到義務就好的親子關係；四、堅守婚姻承諾、不離不棄的配偶關係；五、不計前嫌到情如母女的婆媳關係。本研究發現傳統孝道思維模式下，現今照顧專業已被優先考量；家人關係亦需重新定位。建議非正式照顧者可以重新安排平日生活。機構照護專業人員亦應提供關懷住民和家屬的「全家」照護模式，提升非正式照顧者對機構照護的參與動機。

關鍵字

長期照護機構 ； 主要照顧者 ； 照顧歷程

並列摘要

Purpose: Family members faced the dilemma of institutionalizing their elders. The goals of this study were about to: (1) explore those informal caregivers' decision-making factors. (2) understand how they adjusted their roles. (3) understand their relationships with the elders. Method: field work combined observation and interview were conducted. Conclusion: The results showed that family members can't afford the professional care and environment, or the elders had mental illness were the factors that sent their elders to long-term care institution. The family members' stress was ease up more or less, but they still felt the responsibility and found it meaningful to take some care the elders. The relationship can be categorized of five types: tensional parent-child, attached parent-child, obligatory parent-child, accompanied spouse and harmonious mother-in-law and daughter-in-law. The findings indicate that professional care has the priority over piety. The family members should re-consider their relationship with the elders and re-arrange their time. The long-term care institutions also need to provide whole-family services, to promote the motivation of the family's participation.

並列關鍵字

Long-term care institutions ； primary caregivers ； Exploration of the Process

參考文獻

Dellasega, C., & Mastrian, K. G. (1995). The process and consequences of Institutionalizing an elder. Western Journal of Nursing Research, 17(2), 123-136. doi:10.1177/019394599501700202

衛生福利部統計處（2014）。中華民國 102 年老人狀況調查報告。取自 http://www.mohw.gov.tw/cht/DOS/Statistic.aspx?f_list_no=312&fod_list_no=4695

Montgomery, R., & Borgatta, E. (1989). The effects of alternative support strategies on family caregiving. The Gerontologist, 29,457-464.

Wilson, H. S. (1989). Family caregiving for a relative with Alzheimer’s dementia: Coping with negative choices. Nursing Research, 38(2), 94-98.

內政統計通報（2013）。102 年第 11 週（101 年底我國老人長期照顧及安養機構概況）。取自 http://sowf.moi.gov.tw/stat/ week/list.htm