失智老人家庭雇用外籍看護工之經驗

The Experiences of Hiring Foreign Caregivers among Families with Demented Elderly Person

本研究目的在探索失智家庭雇用外籍看護工之經驗、考量與感受。本研究為質性研究，利用滾雪球抽樣，共17位失智家屬接受深度訪談。失智家庭的需求包含學習處理失智與失能問題技巧、心理支持、24小時且一對一照顧方式的期待，並且讓個案與家屬之間的家庭關係能夠繼續維持。影響失智家庭選擇長照服務的因素包含資訊的取得、機構形象，以及及時回應性的安全感。國內長照體系以照顧失能為主，失智家庭較難產生認同感，對於失智老人的照顧選擇會偏向雇用外籍看護工。家庭在取得共識過程中，尤其是配偶照顧者會有掙扎情緒。在這雇用外籍看護工的過程中遭遇的一些負面問題不影響家庭繼續雇用外籍看護工的決定。從Maslow「需求層級理論」來看，家庭雇用外籍看護工之期望為滿足較低層級基本之生理與安全需求。基本需求必須先被滿足家庭才能運作，但是照顧者之心理、社會層次的需求仍無法被滿足，此需國內長照資源之協助。

The purpose of the study is to explore the experiences, concerns and feelings of Taiwanese family with dementia older adults in hiring foreign caregivers. This study was a qualitative study, using Snowball Sampling. Seventeen families with dementia older adults were interviewed. The fundamental needs of families with dementia older adults which employed foreign caregivers included skills for managing dementia and physical disability related problems, psychological support, expectations of 24 hour availability and one on one care style, and maintaining the relationship between the families and the demented elders. Factors affecting dementia families to choose Taiwan long term care services included information channels, the images of institutional care, and the availability of instant and quick response to needs. The caregiving of the Taiwan long-term care system was oriented toward caring for physical disabled people, so dementia families had difficulties to agree with the care provided by institutions. Therefore, these families tended to rely care on foreign caregivers. During the hiring process, the spouse caregivers revealed more emotional struggle. Even families had encountered negative experiences during the hiring process, such experience didn't influence the family to keep employing foreign caregivers. According to Maslow's Hierarchy of Needs, our study findings showed that hiring foreign caregivers among families with dementia older adults was only to meet the families' fundamental needs – physiological and safety needs. The fundamental needs must be met in order to keep families' function work. But higher levels of support for psychological health for family caregivers were still unmet and this shall be assisted by Taiwan long- term care services.