老人安養機構住民生活適應歷程之研究

我國由農業社會轉為工商業社會、高齡化社會加上少子化趨勢，造成家庭結構的改變，傳統的三代同堂已日益式微，雙薪家庭、小家庭的結構因應而生、家庭對於奉養老人的功能也漸漸受到影響，也直接衝擊老人的安養方式。「養兒防老」在我國傳統觀念下一向主張為人子女者，必須負起照顧年邁父母的責任。當家屬無法負荷照顧工作時，不得不尋求其他照護資源的協助，當家屬無法負荷照顧轉而尋求機構照顧，因此，機構式照顧逐漸取代家庭式照顧。本研究從老人遷居機構的因素、家與機構的差異、影響老人遷居安養機構生活適應因素。本研究採取質性研究（Qualitative research）方式進行，採取立意取樣（Intentional sampling）的方法在機構中選取同質性樣本（Homogeneous sample）為訪談研究對象。選取9位長輩為研究參與者，使用「深度訪談法」（In-depth Interview Method），瞭解入住進機構後，對老人而言會造成什麼樣的衝擊。研究採取心理學家亞伯拉罕·馬斯洛（Abraham Maslow）馬斯洛人類需求的五層模型的需求觀點，從第一層生物和生理需求、第二層安全需要、第三層愛和歸屬的需要、第四層尊中需要和最高層第五層自我實現需要，探討老人遷居機構後，如何滿足五大需求。以混亂期、調適期與穩定期三個時期研究與分析，長輩入住機狗的適應。研究發現，入住前的心理準備、機構的軟硬體設施設備、年齡相仿的同儕關係與可以創造長輩舞台的志願服務，更重要的是宗教活動。宗教活動不僅教人向善，更可撫慰人心，縮短人與人之間的距離，盡速融入機構生活。據研究發現，對於機構、即將入住機構的老人與家屬，提出建議改善日後老人在機構生活適應之參考。

關鍵字

老人；安養機構；適應歷程

並列摘要

In the face of the transformation from an agricultural society to an industrial one, along with the population aging plus a declining birthrate, the traditional three-generation families are increasingly rare nowadays in our society and, as a result, the double-income, small families have come to the scene, while taking care of the elderly by family members is also gradually affected, which brings about direct impact on the way of nursing the elderly. “Storing up grains for raining days” is a traditional mindset in our society, raising children so that they could take care of the parents when they grow old. When the family members feel too much burden to take care of their elderly family members and have to seek alternate caretaking sources, institutional caretaking comes into being. This research has looked into the factors leading the elderly to institutional resettlement, as well as the differences between family and institutional caretaking, which are relevant to the adaption of the elderly moving to a new living environment. With the qualitative approach, intentional sampling has been taken by screening homogeneous specimens from the caretaking institutions as the objects for questionnaire interviews. Nine elderly people are chosen for in-depth interviews, which give insight into the impact on the elderly after having moved to the institutional resettlement. This research has adopted the five-tier (stage) hierarchy of needs proposed by Abraham Maslow, a psychologist, proceeding from the first tier of biological and physiological needs, to the second tier of security needs, the third tier of love and belonging, the fourth tier of respect, and the highest fifth tier of self fulfillment, and discussed in the course is how the five needs can be achieved for the elderly moving to the institutional caretaking facilities. The three stages of chaos, adaptation and stability are studied and analyzed to observe the course of adaption of the elderly after moving into the institutional settlement. This research has concluded some essential elements for a successful resettlement, including prior psychological preparation, the institution’s software and hardware facilities, inmates of similar ages, participation in volunteer services, and more importantly religious activities. Religious activities help people stay kind-hearted, soothing the heart and shortening the gaps between people, so that the elderly can adapt themselves to the resettlement as soon and as smoothly as possible. According to these findings, the research has proposed some suggestions for the caretaking institutions and the elderly about to move to the resettlement and their families, as references to the adaptation in the resettlement.