互為照顧者：老化中的父母與精神障礙子女

Mutual contribution in caregiving: the reciprocity between aging parents and adult daughters or sons with mental illness

張正瑋(Jeng-Wei Chang)

指導教授 ： 余漢儀

國立臺灣大學/社會科學院/社會工作學研究所/碩士(2013年)

https://doi.org/10.6342/NTU.2013.11173

摘要

隨著高齡化社會的來臨，精障者父母照顧者的老化現象浮現，精障者與父母的照顧關係亦開始產生變化，隨著變化發展研究及相應社會服務已是刻不容緩。但實際上，國內對於精神障礙者與父母照顧者的研究，多半仍將焦點停留在疾病對父母帶來的負荷及挑戰，並有意無意的弱化精障者的能力、加深疾病印象，對於隨老化動態改變的關係缺乏關注，也忽略精障者在照顧關係中的貢獻，塑造精障者單方接收照顧之刻板圖像。有鑑於此，本研究希望跳脫負向思考，重新關注精障者的能力，探討在持續老化的時間軸上，精神障礙子女與父母的互惠關係。
本研究共訪問了九個家庭，包含九位精障者與她/他們的十位父母。使用深度訪談法瞭解照顧關係中精障子女的貢獻內涵、貢獻如何形成，照顧關係對親子雙方的正向經驗以及隨著老化，父母與子女的改變對照顧關係照顧的影響。
研究結果發現精神障礙子女對家庭提供的貢獻多樣，除了家務協助、經濟支援等方面的實質貢獻，也以各種方式提供家人情感支持，而隨著父母親年老，也分擔家中照顧責任。在這樣的照顧中，精神障礙子女與父母雙方都能獲得正向經驗，惟父母對精神障礙子女的貢獻較難主動察覺。隨著老化來臨，父母與子女雖然面臨生理與心理的挑戰與擔憂，但貢獻與正向經驗仍可能是老化過程的轉機。研究也發現不只精障者與父母的未來照顧計畫空缺，當前政府服務也未提供適切支持，讓精障者與父母傾向暫時維持現狀。
研究最後依據發現認為當務之急除了學界、政府及相關民間服務應開始關注精障者老化議題外，社會工作者也應該在服務中納入精障者能帶來貢獻及正向經驗的思維，正視精障者的能力也讓它被看見。這樣的思維轉變將有機會扭轉現今對精障者的問題論述，發展以精障者能力為中心的服務，支持家庭的互惠關係，進一步使貢獻與正向經驗成為老化過程的轉機。

關鍵字

父母照顧者 ； 精神障礙者 ； 老化 ； 互惠關係 ； 貢獻 ； 正向經驗

並列摘要

Aging parents as caregivers is a common phenomenon with the coming of aging societies. In this context, the relationships between persons with serious mental illness and their parents start to change. Developing related researches and social services is a matter that admits of no delay, but the researchers in Taiwan still focus on parents’ burden and challenges, emphasizing the disability of persons with mental illness. To start from a positive way, this research try to focus on abilities of persons with serious mental illness and the reciprocity between aging parents and adult daughters or sons with mental illness.
In order to understand: 1. The contributions of adults with mental illness, and how the contributions formed. 2. The positive experiences in caregiving. 3. The changes of
relationship as aging. I select nine adults with mental illness and ten of their aging parents for in-depth interviews.
The research results told that persons with serious mental illness do contribute to family in many sides, such like doing housework, providing economic helps, and giving emotional supports, but parents seldom found their adult children’s contribution by themselves. With the process of parents’ aging, persons with mental illness start to share the care responsibility in family, the contributions and positive experiences in reciprocal relationships also become positive energy when the families confront psychological and physical challenges. Besides, the results show the social services are not ready to provide appropriate supports, so that most families tend to maintain the status as the future care plans are empty.
According to the results, I suggest the researchers, government, and social services workers should start facing the issues of persons with mental illness and their aging parents, giving great attention to their contributions and abilities, and supporting the reciprocity between aging parents and adult daughters or sons with mental illness.

並列關鍵字

Aging parents ； caregiver ； mental illness ； contributions ； positive experiences ； reciprocity

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