兩代「三老」家庭照顧轉銜與老年遷移：老年父母、中老年智障者與手足

Care Transition and Moving in Old Age Among Older Two-Generation Families: Older Parents, Ageing Offspring with Intellectual Disability and Their Siblings

本研究目的在瞭解老年父母及其中老年智障者雙老家庭的照顧需求，並以Clapham（2005, 2010）提出的＂housing pathways＂模式探討其照顧與居住、社會與個人因素的關係。深度訪談新竹市30個雙老家庭：30位與父母同住且年齡40歲以上中老年智障者及其老年父母（60歲以上）。以主題分析方法進行資料分析。發現「雙老」家庭也可能是兩代「三老」家庭，老年衰弱父母及中老年智障者，由中老年手足照顧；多數中老年智障者及其老年父母未使用社會服務。智障者照顧轉銜和父母老年遷移綁在一起，前者途徑形式為「有規劃」和「未規劃」；後者為「不想搬」與「有搬遷」計畫；兩者途徑形式受家庭經濟與家庭互動關係，及父母個人自主性、對傳統照顧文化與房舍認同所影響；已經或可能接手照顧雙老的中老年手足的經濟狀況與照顧文化認同，必須納入考量。父母與手足個人傳統照顧文化認同、經濟及家庭互動關係，大過於失能程度與正式支持系統的影響。兩代「雙老」或「三老」家庭就地老化健康與社會照顧需求，亟待納入長照服務。 This study aims to explore care and moving in old age among older parents and their ageing sons/daughters with intellectual disability (ID), named as ＂older two-generation family＂. Also, ＂housing pathways＂ (Clapham, 2005, 2010) is employed to study the patterns and factors in relation to these families' housing and care transition. Thirty families, including older parents (≥60 year-old) and their ageing sons/daughters (≥40 year-old) with ID were invited and completed the in-depth interview which was conducted at their homes in Hsinchu City. A thematic approach was used in the analysis of the qualitative interviews. The findings showed that an older two-generation family might include not only older parents and ageing offspring with ID, but also the ageing siblings of the ageing adults with ID. These ageing siblings were likely to be the carers of older and frail parents and ageing adults with ID. Families including older parents and ageing adults with ID rarely used services which are provided for people with disability and older people from formal systems. The parents' care transition plan for ageing adults with ID and their own moving plan in old age were intersected, connecting parents' and siblings' individual, family and social contexts. Two types of pathways to both areas, namely care transition of ageing offspring with ID and older parents' moving, were identified: ＂planned＂ vs. ＂not planned＂ and ＂not considering moving＂ vs. ＂considering moving＂. The types of pathways of moving in old age and care transition among these families are related to individual parents' autonomy and parents home identity and both parents' and siblings' cultural identity as well as with the relationship and financial conditions of both the original and siblings' families. This study suggests that both the health and social care needs of these older two-generation families including older parents, ageing adults with ID and their ageing siblings should be considered a high priority by the long-term care scheme which is currently one of the main social policies in Taiwan.

This study aims to explore care and moving in old age among older parents and their ageing sons/daughters with intellectual disability (ID), named as ＂older two-generation family＂. Also, ＂housing pathways＂ (Clapham, 2005, 2010) is employed to study the patterns and factors in relation to these families' housing and care transition. Thirty families, including older parents (≥60 year-old) and their ageing sons/daughters (≥40 year-old) with ID were invited and completed the in-depth interview which was conducted at their homes in Hsinchu City. A thematic approach was used in the analysis of the qualitative interviews. The findings showed that an older two-generation family might include not only older parents and ageing offspring with ID, but also the ageing siblings of the ageing adults with ID. These ageing siblings were likely to be the carers of older and frail parents and ageing adults with ID. Families including older parents and ageing adults with ID rarely used services which are provided for people with disability and older people from formal systems. The parents' care transition plan for ageing adults with ID and their own moving plan in old age were intersected, connecting parents' and siblings' individual, family and social contexts. Two types of pathways to both areas, namely care transition of ageing offspring with ID and older parents' moving, were identified: ＂planned＂ vs. ＂not planned＂ and ＂not considering moving＂ vs. ＂considering moving＂. The types of pathways of moving in old age and care transition among these families are related to individual parents' autonomy and parents home identity and both parents' and siblings' cultural identity as well as with the relationship and financial conditions of both the original and siblings' families. This study suggests that both the health and social care needs of these older two-generation families including older parents, ageing adults with ID and their ageing siblings should be considered a high priority by the long-term care scheme which is currently one of the main social policies in Taiwan.