失智症長者入住專門照顧機構後其主要照顧者與機構工作人員的照顧關係──以主要照顧者觀點分析之

The Caring Relationship between Caregivers and Staff after Elders with Dementia Admitting to Specialized Care Institutions: Perspectives from Caregivers

研究目的：在失智長者入住機構後，照顧關係乃由主要照顧者與機構員工所建立。 此關係將影響長者、主要照顧者及機構三方，本研究欲瞭解失智長者入住機構後，主 要照顧者與工作人員發展照顧關係狀況。研究方法：以扎根理論的質性研究方法，訪 談來自臺灣不同地理區域服務老人失智症者的 24 小時照顧機構所推薦的 17 位主要照 顧者。研究發現與結論：資料分析後發現主要照顧者與機構工作人員發展照顧關係的 核心概念：「互為同理依存」關係，在此一關係涵蓋三個成分：主要照顧者針對失智長 者的入住機構初期適應、生活狀況改變與工作人員的溝通策略；主要照顧者重新定位 自身的角色；從照顧者的立場尋找長者入住機構生活的新意義。根據研究發現提出建 議，主要照顧者與機構合作從個人、環境層面協助失智長者生活適應；協助主要照顧 者發展對工作人員的同理、正向溝通表達訴求、衝突處理的能力；給予主要照顧者一 個參與長者機構生活的位置等。

After the elderly with dementia admitted to the long-term care institution, caring relationship is created and built by both the caregiver and staff. This relationship impacts the elderly, the family caregiver and the institution. The purpose of this paper is to explore the nature of caring relationship built by the caregiver and staff. Caregivers were introduced to this research by staff from long-term care institutions located in western Taiwan. In total, seventeen family caregivers were recruited and interviewed individually. Audiotaped interviews transcribed verbatim. The analytic strategies of grounded theory method were used. One core theme was identified: “the empathetic and co-dependent relationship”. Three basic components of the relationship were found: a) development of communication strategies for major changes in the elderly's life and for his/her adaptation, b) new definition of the caregiver's role after the elderly's admission, and c) the caregiver's new meaning of life. Based on findings, caregivers and staff are suggested to work together for elders' adaptation. Staff is suggested to create opportunity for family caregivers' involvement in elders' residential lives. More implications for research and practice were discussed.