機構失智老人的性表達及其照護策略

Sexual Expression among the Institutionalized Elderly with Dementia, and Strategies for Sexual Care

儘管性需求隨著年齡的老化而減少，人類終其一生都有性的需要，然而受到生理因素、認知障礙、機構環境之隱密性、及社會心理因素等之影響，使機構失智老人性表達的適當性有時會與社會價值信念有所衝突，也造成機構照顧者在執行性照護時陷入倫理的兩難。因為缺乏明確的政策，照顧者各有不同的照護態度與方式，再加上教育資源不足，使其性照護面臨挑戰，故發展符合當地文化及機構理念之性照護政策，以維持處置策略的一致性及公平性便有其必要。且透過對失智者性表達方式及影響因素之了解，擬訂完善而人性化的性照護計畫，將可使失智老人的性表達在一合宜的範圍中展現。

Despite the general reduction in sexual needs with aging, human beings have sexual needs which are life long. This study looks at the overall lack of privacy, as well as at the biological, psychological and social changes that occur among the institutionalized elderly with dementia, and addresses the appropriateness of sexual expression. Conflicts involving social values, a lack of policies regarding sexual issues, and a lack of in-service training in institutions result in caregivers experiencing difficulty with the sexual issues faced by patients. It is essential to develop strategies which are consistent with culture and institutional philosophy. Through the understanding of sexual expression and its influencing factors among residents with dementia, caregivers can develop a care plan that allows residents to express appropriate sexual behavior.