失智症在職家庭照顧者之經驗探討

Abstract

隨著生物科技與醫療技術的迅速發展，人類不斷運用科技技術改善生活品質及健康照顧，平均壽命逐年增加，失智症的盛行率亦逐年上升。對老化快速的臺灣來說，老化的人口結構所帶來的失智症的盛行與其照護需求的衝擊成為了一大難題，越來越多的家庭需要安排人力照顧失智症家人。然家庭照顧者不僅扮演「照顧」角色，也需扮演「工作」或其他角色。故本研究以失智症在職家庭照顧者為研究對象，探討其在照顧歷程中的經驗與平衡照顧與工作的策略。 本研究採用質性研究深入訪談法，透過立意取樣與滾雪球取樣的方式，共訪談4位在職家庭照顧者。研究發現失智症照顧是一個動態歷程，在受訪者中，大部分人都有家人共同分擔照顧責任。他們普遍認為處理失智症患者的情緒問題最為困難。而照顧者與失智症患者之間的關係質量對雙方身心健康和生活質量有深遠影響。儘管照顧充滿挑戰，但親友支持和互惠感能帶給照顧者正向經驗。工作帶來的成就感和同事的支持亦能減輕照顧者的負面情緒。另一方面，傳統孝道文化與性別觀念仍會影響人們對家庭照顧的認知和態度。女性通常被認為是主要照顧者，面臨更大的壓力和平衡挑戰。失智症患者也會自我污名化，降低自尊心並減少社交活動，但有效的社會宣導和家庭支持可以減少污名化現象，提升患者自尊心和社交能力。目前有更多是渠道讓照顧者了解失智症相關資源，而不同照顧者會依據家庭狀況與條件選擇不同的服務資源。此外，工作帶來的經濟支持和個人成長有助於照顧者應對照顧壓力，經歷長期職業生涯的照顧者能更好地平衡工作與照顧責任。 故依據研究發現，在政策制度面建議:建立友善照顧者的工作制度與氛圍 ，以更好留住熟練工；持續普及失智症長期照顧的相關知能；評估家庭照顧者服務的實施效果。

With the rapid development of biotechnology and medical technology, humans continuously use technological advancements to improve quality of life and healthcare. As a result, the average life expectancy has been increasing year by year, and the prevalence of dementia has also been rising annually for Taiwan, which has an aging population, the impact of dementia prevalence and the demand for care stemming from the aging demographic structure has become a major issue. More and more families are required to arrange personnel to care for family members with dementia. Family caregivers not only play the role of "caregivers" but often also take on "work" or other roles. Therefore, this study focuses on employed family caregivers of Persons with dementia, exploring their experiences and strategies for balancing caregiving and work. This research adopts qualitative method,using in-depth interviewing, conducting in-depth interviews through purposive sampling and snowball sampling.A total of four employed family caregivers were interviewed. The study found that dementia care is a dynamic process, with most respondents sharing caregiving responsibilities with family members. They generally found managing the emotional issues of dementia patients to be the most challenging aspect. The quality of the relationship between the caregiver and the dementia patient profoundly affects both parties' physical and mental health, as well as their quality of life. Despite the challenges of caregiving, support from friends and family and a sense of reciprocity can provide caregivers with positive experiences. The sense of accomplishment from work and support from colleagues can also alleviate negative emotions among caregivers. On the other hand, traditional cultural notions of filial piety and gender expectations still influence perceptions and attitudes towards family caregiving. Women are often expected to be the primary caregivers and face greater stress and challenges in balancing these roles. Dementia patients may also self-stigmatize, which can lower self-esteem and reduce social interactions. However, effective social advocacy and family support can reduce stigma, enhance self-esteem, and improve social capabilities. There are now more channels for caregivers to learn about resources related to dementia, and different caregivers may choose different services based on their family situations and conditions. Additionally, economic support and personal growth from work can help caregivers cope with the stress of caregiving. Caregivers with long-term careers are better able to balance work and caregiving responsibilities. Based on the study's findings, the following policy recommendations are made: establish a caregiver-friendly work system and atmosphere to better retain skilled workers; continue to promote knowledge related to long-term dementia care; and evaluate the implementation effectiveness of services for family caregivers.