失智老人家屬因應、照顧與福利服務使用狀況之研究

The coping, care, and welfare usage of family members of geriatric dementia

李伊珊(yi-shan Lee)

指導教授 ： 莊秀美

國立臺灣師範大學/教育學院/社會工作學研究所/碩士(2010年)

摘要

失智症不同於其他老人慢性病，有些個案的身體並不會有明顯的改變或傷害，因此對家屬來說沒有立即性的危機。加上一般人對於失智症的認知不足，因此從懷疑到就醫的過程，有時就可能經過好幾年的時間。隨著患者情況越嚴重，家屬才逐漸使用相關福利。對家屬來說，已經承受長期的慢性折磨，並累積多年的壓力、情緒、身體傷害了。本研究的目的是為了解失智症的家屬從懷疑家人罹患失智症、確定家人罹患失智症、到照顧失智症患者的過程中，其心路歷程，包含因應方法及照顧模式，並從中延伸出家屬對政府福利服務使用狀況等。
本研究採質化研究之深度訪談法，了解家屬從察覺到就醫的心路歷程、獲取失智症相關資訊的來源、生活受到的影響、因應方式、相關福利服務需求及福利使用狀況等。樣本選取以「滾雪球抽樣」篩選出受訪對象。本研究共計訪問九位家屬，其中有八位女性，一位男性。九位患者中，有七位女性，兩位男性，而患者以中度失智為主。患者的居住狀況以住在養護中心為主，居住在家中患者大多請外籍監護工協助照顧。
根據研究結果，研究建議應加強失智症及福利資訊宣導，儘早將失智症家屬納入社會工作服務的範圍，提昇家屬心理健康支持，並連結社會工作者、醫療、警政及非正式組織資源建構失智症照顧支持系統。

關鍵字

失智症 ； 失智症患者家屬 ； 照顧者 ； 因應 ； 福利使用

並列摘要

Unlike other geriatric illnesses, some dementia cases do not have obvious physical changes or damage, and therefore is not an immediate crisis to family members. Given that most people lack awareness of dementia, the processing from the beginning of suspect to receiving medical care may be several years. Only with more serious situation, family members gradually use related benefits. For the family members, it has been a chronic long-term suffering, and their pressure, emotional, and physical harm accumulated over years. The aim of this paper is to understand their mentality, coping methods and care model in the processing from the suspicion of family member with dementia, the identification, to the care for the dementia patient, and extends to their usage of government welfare services.
Qualitative research with in-depth interview was used in this paper to understand the family's mentality fromawareness to medical treatment, the sources to access for information about dementia, the impact on life, the coping, the demand of related welfare services and the usage of welfare. Samples were selected by "Snowball Sampling". The total of nine family members were visited in this paper, including eight women and one man. Nine patients, including seven women and two men, were mainly in moderate dementia. Living situations of patients were mainly in the conservation center. Foreign care workers were hired to take care most patients living at home.
Based on the results, it is suggested that the information about dementia and welfare should be promoted, social work services should be early provided to families of dementia patient in order to enhance their mental health support, and support system for dementia care should be constructed by connecting social workers, medical institutions, polices and resources of informal organizations.

並列關鍵字

Dementia ； Family members of dementia ； Caregiver ； Coping ； Welfare usage

參考文獻

張可臻、陳昭源、林忠順（2008）。失智症合併精神行為症狀的診斷及治療照護。基層醫學，23(6)，頁153-157。

陳萩憶(2001)。癌症病童父母之壓力反應與調適過程。安寧療護雜誌，7(2)，頁

黃正平（2006）。失智症之行為精神症狀。台灣精神醫學，20(1)，頁3-18。

莊秀美（2005）。『團體家屋』模式運用於失智症老人照顧服務推動之探討，東吳社會工作學報，12，頁75-113。

林冠宏（2006）。阿茲海默氏症。慈濟醫學，18(5)，頁39-48。