我國在民國八十七年開始推展獨居長者的正式服務，其中一項方案為關懷訪視服務，透過志工進行居家訪視增加獨居長者的社會接觸。回顧過往關於關懷訪視服務的文獻，大多是立基於服務提供者的觀點，忽略了獨居長者的聲音，故本研究從獨居長者的角度出發，探究長者接受關懷訪視服務的經驗為何。據此，研究問題如下：(1)長者實際經驗之關懷訪視服務內容為何；(2)長者自覺關懷訪視服務的獲益為何；(3)長者與志工的互動關係為何；(4)長者與志工的互動關係會隨著時間發生哪些變化；(5)長者和志工關係發展的相關因素為何？(6)長者接受訪視服務經驗對其自我概念的影響為何？
本研究採用質性研究法，以半結構式訪談蒐集資料。訪談樣本來自台北市某老人服務中心列冊之獨居長者，共有9名受訪長者，七位為女性和二位男性，年齡約在70-80多歲，有兩位與親人同住，其餘皆一人獨居。
研究結果如下：
一、長者實際經驗之服務內容：志工的探視、陪伴、叮嚀和聊天，讓長者感到被關懷的情感性支持；此外，長者亦獲得訊息和工具性支持，訊息性支持為告知：(1)活動訊息；(2)社福資訊；及(3)老人中心的聯絡資訊，工具性支持則是：(1)物資贈予；(2)陪同就醫；及(3)住院照顧；最後，志工關懷的同時，其實也在收集長者的資訊，包括：(1)個人資訊；(2)平日狀況；及(3)突發狀況，並在必要時將資訊回報，讓老人中心可以掌握獨居長者的狀況，也就是說老人中心透過志工的關懷訪視，既「關懷」又同時「掌握」著長者的生活狀況。
二、長者實際感受之獲益：志工的訪視增進長者與外界的連結，並建立與志工的連帶；此外，長者與志工接觸的過程中，志工的探問、陪伴、關心等行為，以及聊天互動等都能帶給長者好心情，讓長者不會感到無聊、孤單，以及有被社會排除的負向感受。
三、長者與志工生命交會的故事：長者和志工的相識過程，除了官方安排外，也可能：(1)志工本來就是長者的鄰居；(2)熟人引介；及(3)事先在老人中心的活動場合認識。次之，交談是長者和志工的主要互動，他們的話題偏向大眾性話題，避免談及隱私性話題，這意謂著長者和志工之間大多是在「公我」領域的往來。隨著時間的推移，長者對志工感到更加熟悉、認識、親密、信任和自在，以及有義務產生。進一步將長者與志工之間的互動關係歸類出四種型態：(1)完全任務取向的互動；(2)涉及社交性的往來；(3)涉入情感與生活；(4)兼具鄰居關係。最後，長者和志工之間的互動關係的相關的因素為：(1)個人脈絡；(2)雙方契合度；(3)志工人際吸引特質；和(4)環境因素。
四、長者接受訪視服務經驗中的自我認同：首先，在善意的服務下長者進入了服務接受者的位置，這也決定了長者的應有行為；(1)感謝的必要性；(2)須回報的欠債感；(3)配合的態度，長者的主體被客體化為順從的受助者，但另一方面，長者企圖以其他方式來展現自己的主體：(1)正向詮釋志工的關懷，讓長者自我認定為被關心的朋友和尊敬的長輩；(2)打破互惠關係的不平衡，使得長者不再只是個被施捨的受助者。最後，從其中一位受訪者案例，看到獨老身分決定過程中的角力，兒女對於獨老身分的抗議，但老人中心才真正擁有獨老身分的決定權，在這情況下長者：(1)運用老人中心的正當理由，抵消兒女的反對聲浪，但(2)對於獨老身分仍存有一絲疑惑；因此(3)透過內心取消獨老身分，反抗這個身分的框架，更透過擔任志工以服務者的角色來展現他的主體性。 / Taiwan has launched The Formal Services for the Living Alone Elders since 1998. Among the services, friendly visiting is one of them, which improves social contacts of living-alone elders through in-home visits by volunteers.
On account of studies in the past focused mostly on the perspective of services providers and ignored the elders’ viewpoints, this study is based on the elders’ point of view, aiming to build a detailed description of the experiences of living-alone elders receiving friendly visiting services.
With the focus on the above point of views, the research questions that guided the inquiry into the experiences of the living-alone elders are as follows: (1) What are the detail services of friendly visiting programs that the elders actually received? (2) What benefits the elders think they have gained from friendly visiting? (3) What are the patterns of interaction between the elders and volunteers? (4) How would the patterns of interaction between the elders and volunteers vary by time? (5) What are the factors that affect relationship development between the elders and volunteers? and (6) How friendly visiting affects self-perception of the elders?
This study adopts a qualitative design and interprets data collects through semi-structured interviews with samples of 9 study interviewees, 7 females and 2 males, draw from living-alone elders listed by a certain Seniors Service Center in Taipei City. These interviewees age from 70 to 80, two of which are living with relatives, and the others are living alone.
Present significant results from the data are gathered as follows:
A. The contents of services that the elders actually received: The elders gain emotional support from the process of chatting, visiting, accompanying, and caring provided by volunteers. In addition, informational support and instrumental support are also provided. The former includes (1) information about programs and activities, (2) news about social welfare, and (3)contact information from Seniors Service Centers; and the latter includes (1) provision of goods, (2) services of accompanying to the doctor, and (3) inpatient care. Furthermore, the time volunteers provide services also means the time they do the research and report back to the Seniors Service Center about the elders’ condition so that the lives of the elders can get tracked, which include (1) private information, (2) everyday life situation, and (3) emergency conditions. That is to say, the Seniors Service Center can “concern about” the elders and “handle” their conditions at the same time.
B. Benefits the elderly think they have gained: The friendly visiting reinforces the links of the elders to the world as well as the ties between the elders and volunteers. Furthermore, in the process of the contact of the elders and volunteers, emotional effects are reflected positively on the elders due to chatting, visiting, accompanying, and caring provided by volunteers, which also prevent them from negative feelings, such as being lonely, getting bored, or feeling a sense of social exclusion.
C. The stories between the elders and volunteers: Besides official arrangements, there may be other approaches for the elderly and volunteers to meet each other, including: (1) they are neighbors originally, (2) they were introduced to each other by an acquaintance, and (3) they knew each other before in programs provided by Seniors Service Center. Additionally, the elders and volunteers interact mainly through conversations, which are mostly related to public topics instead of private ones. This means, the interaction mostly remains in a public territory. However, as time goes by, the elderly grow more close and familiar to volunteers. Under this situation, interaction patterns between the elderly and volunteers can be inducted into four categories: (1) task-centered based interaction, (2) ordinary social interaction, (3) interaction involved in private daily lives, and (4) neighborhood interaction. Finally, related factors which affect the interaction relationship between the elderly and volunteers include (1) personal background, (2) compatibility of the elder and volunteers, (3) personal characteristics of volunteers, and (4) environmental factors.
D. Self-identity of the elders through process of friendly visiting: On one hand, the elder’s reactions toward the visiting services are decided by services out of volunteers’ goodwill, which also puts the elders into a position of service receivers. These reactions include: (1) the necessity of appreciation, (2) a sense of indebtedness which is compensated by repaying, and (3) an attitude of obeying, which means the elders are shifted into a place of passive objects instead of subjects as a service receiver. On the other hand, the elders attempt to realize their position as a “subject,” that is, the leading role, mainly in two ways: (1) The elders interpret care from volunteers positively, trying to take themselves as friends of volunteers or respectful seniors instead of the needed ones. (2) The elders prevent themselves from being merely help takers by paying back or even becoming volunteers themselves, providing services for others actively.
Finally, the study focuses on a special case, in which the identity of living-alone elder is in debate. Offspring of the elder, who think their father need not help, are arguing with the Center whether the elder can be identified as a living-alone elder or not; however, the power to make decision is in the hands of Seniors Service Center. Under this situation, the elder makes a series of responses:(1) At first, he appeases his children by restating justified and legitimate reasons from the Center. (2) But in fact, he still has doubts on his identity. (3)In the end, he seems to accept the truth on the surface but rejects it at heart, insisting to realize himself by being an active volunteer to provide services through programs of Seniors Service Center.
| Identifer | oai:union.ndltd.org:CHENGCHI/G0097264005 |
| Creators | 洪文滿 |
| Publisher | 國立政治大學 |
| Source Sets | National Chengchi University Libraries |
| Language | 中文 |
| Detected Language | English |
| Type | text |
| Rights | Copyright © nccu library on behalf of the copyright holders |
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