這裡是最終的選擇與千挑萬選的好住所：主要照顧者安排失智症長者入住專門機構前狀況與入住過程之考量

This Was a Good Residence that Was the Ultimate Choice and Picked and Chose Carefully: The Situations before the Caregivers Arranged the Elderly with Dementia to Live in Specialized Care Institutions and the Considerations of a Placement Process

施麗紅(Li-Hung Shih)

《高雄應用科技大學人文與社會科學學刊》 2卷1期 (2016/06) Pp. 79-105

https://doi.org/10.6554/JKTUHS.2016.0201.06

摘要

本研究以扎根理論的質性研究方法，訪談主要來自南北直轄市服務老人失智症者的24 小時專門照顧機構，其所推薦的17位主要照顧者，欲瞭解主要照顧者安排失智症長者入住機構之前的狀況以及入住過程的考量。研究結果發現在失智症長者入住機構前的階段，所發現重要的核心概念是：將長者送入機構是「主要照顧者在嘗試各種照顧努力的最終選擇」，包含：失智症之特殊性引發的照顧需要；照顧者自己照顧或尋求各種可能的方式照顧長者；長者被送入失智症照顧機構的關鍵—照顧負荷過高、環境不符需求。在入住過程的核心概念為：入住現在的機構「這裡是為失智長者千挑萬選的好機構」，包含由誰決定長者入住機構事宜；照顧者選擇機構的處境—有限名單中的最佳選擇；照顧者選擇機構的指標—環境、專業、名氣；照顧者選擇對長者入住機構告知的方式。研究者根據此架構提出機構（專業人員）、政府在協助失智症者之主要照顧者的建議，如：提供主要照顧者失智症諮詢與教育；提供機會讓主要照顧者參與減壓服務方案、家庭支持方案；提供諮詢協助主要照顧者及其家庭進行入住決定；以失智長者的理解能力進行入住告知，以利入住後生活適應；解決失智症照顧一床難求的困境等。

關鍵字

失智症長者 ； 主要照顧者 ； 入住機構前狀況 ； 入住過程之考量

並列摘要

The qualitative research approach of Grounded Theory was adopted in this study. The 24-hour specialized care institutions which served senile dementia sufferers in Taiwan had been reached. There were 17 major caregivers recommended by institutions of most municipalities in the north and south of Taiwan. This study would like to know the situations that senile dementia sufferers' pre-located at institutions and the considerations of located process.The study found the core concept that elderly people with dementia before the stage senile dementia sufferers' located at institutions was: to locate the elderly in institutions, ＂it was the last choice after the caregivers trying to all kinds of care services.＂ It contained that: the particularity of dementia caused the care need; Caregivers provided their own care or sought every possible way to take care of the elderly; the key sent the elderly with dementia in care institutions- care load was too high and the environment did not match demand. The core concept in located process was: to live in institutions now, ＂this was a good residence that they picked and chose carefully for the elderly.＂ It contained that: who decided the elderly to place in institutions; the situations that the caregivers selected institutions- the best choice of limited lists; the indicators that the caregivers chose the care institutions- environment, profession and fame; the caregivers selected informed ways to tell the elderly placement institutions. Lastly, according to the framework, possibilities of fostering establishment regarding services of the caregivers by the institutions (professional workers) and government, relevant suggestions are given in this study. It contained that: to provide counseling and education of dementia for the caregivers; to provide opportunities for the caregivers to participate in reducing stress service programs and family support programs; to provide counseling to help the caregivers and their families making placement decisions; to tell placement inform to the elderly with dementia that their abilities can understand, to facilitate adaptation of life after they place in institutions ; to solve the plight of hard to find a bed for the care of dementia etc.

並列關鍵字

the elderly with dementia ； the caregivers ； the situations that pre-located at institutions ； the considerations of located process

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