我們之間：探討主要家庭照顧者與失智者的溝通

Between us: an investigation of communication between primary family caregivers and individuals with dementia

目標：本研究探討主要家庭照顧者如何與失智者溝通。方法：從2023/10/01至2024/11/7期間，招募18位主要家庭照顧者，進行一對一深度訪談。結果：失智者在溝通過程中經常不按牌理出牌，年長的主要家庭照顧者比較寬容面對，以不激怒他們為要，即便受到失智者的語言傷害，也會選擇隱忍，彼此之間相依相守；但年輕的主要家庭照顧者則有不同的對待方式，即便知道孝順很重要，面對失智者的「花格格」個性，不排除大吵一架。討論：受到傳統儒家思想影響，即便失智者在溝通過程中不斷拋出難題，有些主要家庭照顧者選擇壓抑自己的情緒，有些選擇「直球對決」。未來應該提供主要家庭照顧者溝通訓練，特別是針對不同年齡層提供不同的照護及溝通思維，以建立彼此對等的溝通地位，讓主要家庭照顧者可以在照顧過程中保有自我，達成雙贏的局面。

Objectives: This study explored communication between primary family caregivers and individuals with dementia. Methods: A total of 18 primary family caregivers were recruited for in-depth one-on-one interviews conducted between October 1, 2023, and November 7, 2024. Results: The primary family caregivers reported that individuals with dementia in the process of memory loss often behaved unpredictably during communication. Caregivers tended to be lenient toward their family members with dementia, seeking to avoid angering them during interactions. Older caregivers typically chose to silently endure verbally hurtful language from family members with dementia and hoped for a mutually supportive relationship. By contrast, younger caregivers chose to express themselves during conflicts with family members with dementia, despite considering filial piety to be a crucial tradition in their culture. The study results suggested that communication between primary family caregivers and individuals with dementia is influenced by traditional Confucian values in Taiwan. When experiencing challenges during communication with such individuals, the primary family caregivers in this study often suppressed their own emotions, which may be a suboptimal approach to communication for both parties. Conclusions: Communication training should be provided to primary family caregivers of all ages. Such training can enable them to maintain their sense of self while caring for individuals with dementia, which can ultimately result in a win–win situation.