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失能老人入住養護機構之過程─以生命歷程之敘說分析出發

台灣面臨高齡化所帶來的問題日趨嚴重,就失能老人而言,家庭依然是老人最能接受的照顧方式,然而仍然有漸多的老人接受機構式照護。他們早年的生命經驗,如何影響晚年居住安排,最後又是何種因素使他們作出入住機構的決定;他們的感受為何亦是研究所關心的。

以此,本研究以質化研究的敘說分析進行,訪談了八位目前入住機構的失能老人,希望透過老人敘說自己過去的生命經驗,能深入探討他們早年累積的重要資源與晚年居住安排之關聯,並瞭解晚年居住的安排過程、最後入住機構的原因及入住後的適應狀況等。茲將結果摘述如下:

一、 早年生命歷程對晚年居住安排的影響
健康資源:這些老人早年是在物資缺乏的環境中成長,身體照顧極為忽視、受教育的機會亦不多,在先天條件不佳的情況下,他們沒有太多的機會為老年的生活提早進行規劃。
經濟資源:人力資本不足薪資所得偏低,使財富累積困難;而女性從事的無酬家務勞動、照顧者角色,更使女性居於經濟的弱勢地位。
家庭資源:養兒防老的觀念隨著時代改變、久病臥床等因素,越來越窒礙難行,子女數多不代表擁有的家庭資源多,親情依附、子女願意承擔照顧責任,才是老人真正擁有的資源。

二、 晚年居住安排的過程
老人晚年選擇居住安排的過程,符合「層級補償模式」,首先是配偶及子女、最後才是由正式的照顧服務提供,呈現一個有順序的過程。最末接受機構照護的原因因人而異,但就整體而論,老人的健康狀況與自我照顧程度,才是入住機構的主因。

三、 入住機構後的適應狀況
主動入住機構的失能老人,對機構的環境適應較佳,此與入住機構的意願、親情支持等,正向感受較多有關。被動入住的老人雖然心中不願,在缺乏掌控力的情況下,他們通常都認命地接受家人安排,但入住後較難以適應機構的生活。 / Past researches mostly focus on living arrangement of the healthy elders. Therefore, the study attends to emphasize on the relationship between housing and living arrangements of disabled elders and their life course. The samples include 8 elderly people (over 60 years old) living in the institution, and had difficulties performing in the ADL and IADL activities because of health or physical problems.

As a result of the research, the purpose of this qualitative research include: (1) to research the connection between disabled elders living in the institution and the process of their early life; (2) to understand the proceeding of living arrangement for the disabled elders; (3) to discuss their point of view and subject explanations on the institutional care; (4) on according to research finding, the effective suggestions will be proposed, and some of them may as well be put on practice.

The analysis in the content revealed the theme that emerged from narratives -- the health, family resources, especially economic factors in the early life will affect the later life in the way that diminishes choices and opportunities in arranging the elder’s living; the main reasons for the elders to be accepted into institutional care are their healthy status and their degrees of self-care; the elder who voluntarily move into the institution usually have better ability in adapting the passive ones.

Although several meaningful findings are recognized, some limitations are also identified. Practice suggests and future research orientations are discussed.

Identiferoai:union.ndltd.org:CHENGCHI/G0912540022
Creators陳人瑜
Publisher國立政治大學
Source SetsNational Chengchi University Libraries
Language中文
Detected LanguageEnglish
Typetext
RightsCopyright © nccu library on behalf of the copyright holders

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