失智症年長者之家庭照顧者的照顧經驗與心理歷程探討

Abstract

本研究旨在了解失智症年長者之家庭照顧者面對與照顧罹患失智症家人的經驗，探究其內心所經歷的不同歷程與轉變，並進一步提出其需求、期待與建議。為了能夠深入了解失智症老年長者之家庭照顧者的經驗與感受，本研究採用敘事取向的研究法，以半結構式訪談訪談了三名失智症年長者的家庭照顧者，接著使用「整體─內容」與「類別─內容」方法進行文本的分析。 研究結果發現失智症年長者之家庭照顧者的照顧經驗為：（1）摸不著頭緒的失智症狀；（2）永無止盡的照顧工作；（3）因失智症而改變的家庭動力；（4）家庭照顧者健康亮紅燈；（5）關係的失去與修復。而失智症年長者之家庭照顧者的心理歷程包括：（1）發現失智症的驚懼與心疼；（2）全心全意地投入照顧工作；（3）充滿無力與挫敗感的陌生世界；（4）角色衝突與愧疚；（5）過度負荷與耗竭；（6）自我檢視與整合；（7）生命的頓悟與昇華。失智症年長者之家庭照顧者的需求與期待則有：（1）資訊層面；（2）經濟層面；（3）照護層面；（4）心理層面；（5）制度層面。 失智症年長者家庭照顧者的照護經驗、心理歷程以及需求與期待與過去國內外研究有相符應之處，然而，隨著臺灣長照法的推進以及在地文化，仍有部分發現值得再深入去思考與探究，為這些失智症年長者家庭照顧者提供一個更加友善與支持的環境。

The purpose of this study is to explore the experiences, the psychological processes, and the needs of the family caregivers of the elders with dementia. To understand the experiences and the feelings of the family caregivers of the elders with dementia, narrative analyze was applied to collect the life stories of the three participants. After conducting semi-structure interviews with them, their life stories were analyzed from holistic-content and categorical-content perspective. Finding that the experiences of the family caregivers of the elders with dementia are: (1) the unpredictable symptoms of dementia, (2) the endless caregiving, (3) the changing dynamic in the family, (4) the threats to the health of the caregiver, (5) the loss and repairmen of relationships; the psychological processes of the caregivers of the elders with dementia are: (1) a worrying and horrifying truth, (2) a devotion with all heart, (3) a world full of helpless and frustration, (4) the role conflicts and guilt, (5) high burden and burn out, (6) introspection and integrity, (7) the insight and transcendence to life; the needs of the caregivers of the elders with dementia are: (1) information, (2) economy, (3) caring, (4) psychology, (5) system. The care experience, psychological process, needs and expectations of the family caregivers of the elders with dementia are in line with previous studies in Taiwan and abroad. However, with the development of Taiwan's long-term care services act and the local culture, there are still some findings worthy of re-evaluation and inquiry to provide a friendlier and more supportive environment for these family caregivers of the elders with dementia.