居家照顧服務疑似受暴長者的樣態、服務需求、求助行為和因應方式

Characteristics, Service Needs, Help-seeking Behaviors, and Ways of Coping in Elders Suspected as Domestic Violence Victims in Home-helper Service Settings

人口老化使得失能和失智人數增加，受暴個案人數成長，老人保護成為重要議題，只是相關研究並不多，因為保護個案潛藏社區，受訪意願不高，如何透過研究，探討長者受暴的樣態和因應行為，作為實務的參考實為當務之急。本研究目的是瞭解居家服務失能長者疑似遭受家庭暴力的樣態、服務需求、求助行為、和因應方式的情形，並針對研究結果提出實務因應原則。研究對象來自北、中、南、東四個區域內的居家服機構，由督導員轉介疑似或曾經受暴個案，取得個案同意，由訪員進行面對面的結構式問卷訪談，最後每區各取得30 位，總樣本數為120，取得的量化資料以SPSS 21.0 進行分析。研究結果顯示老人受暴類型比率依序為精神虐待、疏忽、身體虐待、遺棄，相對人主要是兒子，個人因素為情緒失控、失業、酒癮、精神疾患，家庭互動關係以溝通不佳和照顧壓力大為主，受暴者因素以失能為主。受害者使用最多的服務是長期照顧、關懷訪視、和經濟補助。不過，受暴長者不求助的居多，主因是體諒子女壓力、怕失去扶養依靠、家醜不可外揚。使用服務的障礙包括不知道有該項服務、不知道如何申請、怕別人笑、或不好意思。

The population is aging rapidly. The aging population has driven up both dependency and dementia rate in the elderly. The incidents of domestic violence against elders are also in the rise simultaneously. It has become one of the major social problems. Despite the importance of the issue, studies on the subject are scarce due to unreported cases and the unwillingness to participate by victims. It is crucial to research on the subject to unravel the characteristics of the violence and to draw implications for practices. This study aimed at exploring the actual state of elder abuse, service needs, help-seeking behaviors, and ways of coping in elders suspected as domestic violence victims in home-helper service settings. This study recruited elderly participants from home-helper agencies from the four areas, eastern, western, southern, and northern districts respectively, in Taiwan. Consent forms were distributed to the potential participants referred by the supervisors from home-helper agencies who in their capacities were familiar with the elders. A total of 120 elders were recruited with 30 of them from each district. Face-to-face interviews were carried out to collect data via a structured questionnaire by trained interviewers. Data were analyzed using IBM-SPSS 21.0. The result showed that mental abuse ranked as the most prevalent type of violence against elders in the home-helper service settings followed by negligence, physical abuse, and abandonment. Son appeared to be the primary offender across violence types. The reasons behind abuses included failures in temper control, unemployment, substance abuse, mental disorder, and strain in familial relationship, and caregiver strains. The major services victims of elder abuse used included long-term care, friendly visits, and financial supports. The primary barriers to service use included a lack of service awareness, familial shames in help-seeking, empathy with perpetrators’caregiving burden, and dependency on abusers’care. Implications for future services were drawn from the research findings.