老化智能障礙者之休閒參與及阻礙之研究

隨著高齡社會的來臨，社會開始重視中高齡者休閒活動與成功老化的議題，但老化智能障礙者族群卻是被忽視的一群。目前臺灣 50 歲以上智能障礙者人口數約有 2 萬 5 千人(衛生福利部統計處，2020)。隨著醫療進步，提高了智能障礙者的平均餘命，了解其老化後的休閒活動需求及阻礙是當務之急。本研究目的在探究老化對智能障礙者之影響、了解老化智能障礙者休閒參與、休閒阻礙及阻礙協商策略。研究個案為來自桃園心燈教養院共 11 位 45 歲以上之智能障礙者。以質性研究方式進行，採半結構式訪談大綱訪談 2 位機構中主要照護人員，並以結構式問卷訪問其中 5 位具有簡單口語表達能力之個案。研究結果發現，老化對於智能障礙者在生理、心理、認知功能與社交功能上都有影響，智能障礙者普遍缺乏老化意識，且目前有嚴重的雙老問題。在休閒參與上，偏好靜態活動，動態活動需要照顧者一對一的引導。在休閒阻礙上，個人內在的阻礙為此族群主要的困境，包括缺乏動機、情緒不穩、無法了解休閒意義等，其阻礙協商策略多由照顧者代為進行。建議相關單位在老化智能障礙者身上，應加強其老化意識與生死教育，幫助其了解家人的離世與自己的老化現象，也應在年輕時就導入休閒教育概念，以提升智能障礙者族群在老化後的生活品質。

關鍵字

老化；身心障礙者；休閒教育；休閒阻礙

並列摘要

With the coming of an aged-society, people begin to pay attention to the issues regarding leisure activities and successful aging of middle-aged people. However, old individuals with intellectual disabilities (ID) is a population that has been neglected. There are about twenty-five thousands people with intellectual disabilities in Taiwan over the age of 50 (Ministry of Health and Welfare, 2020). With the advancements in medical treatment and healthcare, the average life expectancy of people with ID has been increased. It is necessary to understand the situations of their leisure activities and the barriers they are facing. The purpose of this research was to explore the impact of aging on people with ID, such as their leisure participation, leisure constraints and leisure negotiation strategies as well. This case study included a total of 11 individuals with intellectual disability identification that are over 45 years old, who live in Lighten Opportunity Center. The method of this study applied individual interview with two professional caregivers to receive the proxy content of 11 subjects. Furthermore, a structured questionnaire was used to inquire five subjects who can express their own thoughts to confirm the information. Results of the study showed that the influence of aging on physical, psychological, cognitive and social conditions of people with ID is obvious. However, they are barely aware of the condition of aging. Not only they were confronted by the aging process, but their parents or caregivers are also facing the issue of old age. On the perspective of leisure behavior, they usually prefer static activities, and always need one-by-one guidance from caregivers when participating exercise. The biggest leisure constraint of these people is their interpersonal constraint, including lack of motivation, emotional instability problems, and inability to understand the meaning of leisure. When they confront with any constraint of leisure, they cannot overcome by themselves. The leisure negotiation strategies are mostly carried out by caregivers in the organization. In order to help aging people with ID understand the death of their family members and their own aging issue, caregivers should focus on their awareness of aging and the life and death meaning education. We also suggest that caregivers could introduce the concept of leisure education to the people with ID in their early stages of life, so the quality of their later years may be improved.