影響高齡身心障礙者家庭支持之因素探討－－以南投縣草屯鎮居家個案為例

Exploring Factors Influencing Family Support for Elderly People with Disabilities: A Study of Home-Dwelling Cases in the Caotun Township of Nantou County

本研究旨在針對居家高齡的身心障礙者進行家庭支持系統的分析研究，著眼於生活狀況、經濟、情感以及接受社會福利服務的意見與期待。其目的有：（1）瞭解影響居家高齡身心障礙者家庭支持的相關問題，以落實長期照顧計畫規範的在地化服務；（2）找出高齡身心障礙者個別化需求與被忽略的問題，冀望社會各相關體系需要傾聽他們的聲音；（3）期盼能為政府部門提供重要施政策略，讓高齡身心障礙者享有福祉與安適的生活。本研究以效標抽樣法選取八個願意接受訪問家庭的個案，依據訪談大綱施以深度訪談之質性研究，每個月進行一次訪談，期間共三個月，受訪者中男女性各有四位，平均年齡為66歲。研究結果發現：（1）七名個案（87.5%）的家庭內部支持均較為貧乏或不完整，在服務介入之後，對於家庭情感、福利服務、照顧需求與健康新知均有明顯的助益；（2）經濟安全與需要照顧為高齡身心障礙者首要問題；（3）家庭仍為高齡身心障礙者主要的支持力量及重要資源；（4）高齡身心障礙者福利服務認知度普遍不高；（5）家庭支持的向度分析，可分為情緒性支持、資訊性支持與工具性支持，而家庭支持的完整與否，深受此三項支持之影響。其結論為居家高齡身心障礙者需要完善的家庭及社會福利支持，而自我的充實與正向積極的思維，也是讓有限的生命活得更有尊嚴，更能提昇自我價值的關鍵因素。

This study analyzes the family-support system for home-dwelling elderly people with disabilities. We addressed these peoples’ living conditions, economic status, family affections, and opinions and expectations of social welfare services. The purposes of this study include: (1) understanding the problems associated with family support among home-dwelling elderly people with disabilities to facilitate the long-term care associated with providing better localized services; (2) identifying the problems encountered by elderly people with disabilities that have their individual needs and been neglected to assist the associated authorities and organizations in understanding the needs of these elderly people; and (3) providing the government with a reference for policy implementation to assure the welfare and wellbeing of elderly people with disabilities. This qualitative study adopted a criterion sampling method to recruit 8 homedwelling people, who agreed to participate in interviews with their families. Then, according to the interview guidelines, in-depth interviews were conducted monthly for 3 months. The interview participants comprised 4 men and 4 women, and the average age of the participants was 66. The study results revealed that: (1) Seven (87.5%) of the home-dwelling participants had poor or inadequate family support. The service intervention provided significant benefits regarding family affection, welfare services, care needs, and health knowledge. (2) Economic security and care needs were the major problems encountered by elderly people with disabilities. (3) Family remains the primary support resource for elderly people with disabilities. (4) Generally, elderly people with disabilities had insufficient awareness of welfare services. (5) The dimension analysis of family support contained three domains, emotional support, informational support, and instrumental support. These domains were found to significantly influence the integrity of family support. This study concludes that home-dwelling elderly people with disabilities require comprehensive family and social welfare support. In addition, self-enrichment and a positive attitude are the key factors enabling these people to maintain their dignity and enhance their self-value.