智能障礙雙重老化家庭使用住宿型機構之決策歷程

智能障礙者較一般人提早10到20歲左右便開始老化，且國內智障者多居住在家中，因此同時涵蓋了照顧者(通常是父母)老化的處境，這個情境也被稱做為「雙重老化家庭」。由於目前雙重老化的相關文獻尚未足夠，且國內、外的文獻均指出雙重老化家庭使用住宿型機構多是出自於不得已的選擇，因此本研究是以質性研究的方式探討雙重老化家庭使用住宿型機構的決策歷程，了解該家庭使用與不使用住宿型機構的考量，以及是否將障礙者送入住宿式機構的原因。當前國內的住宿型機構多是服務中度以上之智能障礙者，所以本研究對象是以障礙程度為中度以上，且年齡在45歲以上的智能障礙者，其照顧者年齡也須在65歲以上之家庭為主。研究結果發現，照顧者的考量共分為十個主題，但無論是哪一個主題，當中都充滿了照顧者對智障者的情感，包含對智障者得不捨、愧疚與罪惡感，而且這樣的情感不只是父母對孩子，就算是智障者的手足們也有同樣的感受。此外，本研究結果也將不同階段雙老家庭所考量的原因與決策情境具體的展現出來，其中值得一提的是，「情感」考量依然是影響照顧者做出決定的重大原因之一，可見雙重老化家庭中都有著這樣深深的依附關係與情感上的糾葛。最後再依據研究的結果，提出一些具體的建議，給政府、服務提供相關單位，以及雙重老化家庭作為參考。

關鍵字

身心障礙者；雙重老化家庭；安養；年老照顧者

並列摘要

People with intellectual disabilities begin aging about 10 to 20 years earlier than normal people do. The people with intellectual disabilities in Taiwan are mostly living in their home now. So, in the progress of aging of them, their caregivers (usually parents) become older simultaneously. This situation is also called “two-generation-elderly families”. Because the number of documents about “two-generation-elderly families” is still deficient,and existing documents all indicate that two-generation-elderly families were forced to use the lodging institution, the purpose of this research is to investigate the decision-making process about the use of lodging institution of two-generation-elderly families, to understand the reason of using or not using lodging institution and to know the cause of sending or not sending the people with disabilities into lodging institution with the method of Qualitative Research. The lodging institutions in Taiwan are mostly for the people with middle-stage disabilities, thus, the objectives of this research are all with middle or more serious stage intellectual disability and older than 45 years old. Also, the caregivers must be older than 65 years old. The result shows the the consideration of caregivers can be classified into ten subjects. Every subject includes caregivers' affection for their children with disabilities. Including attachment, guilt and regret. These emotion is not only parents to children. Even the siblings have the same feeling. In addition, the result also specifically shows the consideration and decision-making situation of two-generation-elderly families at different stages. It is worth mentioning that “affection” is one of the most important reasons which affects caregivers' decision-making. Apparently there are deep attachment relationship and some emotional entanglement in all wo-generation-elderly families. At last, based on the results, this article gives some specific suggestion to the government, relevant service agencies and institutions and two-generation-elderly families for reference.