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題名：中高齡智障者雙老家庭之居住模式建構
作者：王文娟
作者(外文)：Wang, Wenchuan
校院名稱：東海大學
系所名稱：社會工作學系
指導教授：簡春安
學位類別：博士
出版日期：2012
主題關鍵詞：中高齡智障者；雙老家庭；親子家園；居住模式；old parents and their children with intellectual disability；double-ageing family；homeland for parents and children；mode of habitation
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台灣中高齡智障者雙老家庭數量逐年攀升，這些雙老家庭在此生命階段所須承擔的生理、心理與社會的壓力不同以往，然國內目前針對雙老家庭議題研究相當闕如，因之本研究採用質性研究的方法，探討中高齡智能障礙者雙老家庭對於居住模式的看法，藉以發展並建構適合台灣社會脈絡與文化之居住模式，研究中共計訪談十九位研究參與者，包括八位中高齡智能障礙者的父母、八位實務工作，以及三位智能障礙機構管理者。研究發現，中高齡智能障礙者的父母在此生命階段中往往面臨六種層面的壓力負荷，包括髮蒼視茫的“老身”、荷包漸空的“老本“、同樣體弱的“老伴”、智能障礙子女生理老化、對未來不確定以及正式支持體系福利供需GAP之六層壓力負荷。然而其雖面臨如此的壓力，但卻往往因著責任面、情感面以及現實面等交雜因素，選擇持續照顧其智能障礙子代，並對宜居模式有著「安身」、「安生」與「安心」的想望。故本研究構思親子家園模式，企圖滿足中高齡智障者雙老家庭對於「三安」的期待，此模式為傳統機構式居住模式的變型，強調專業照顧確保生活品質、運用非專業人力的輔助以及全人原則的設施配搭，並考量設置地點區位資源的可近性，然而，此種新型模式可能出現適法性、身障機構意願、潛在使用者的接受度以及社區鄰里接納度的考驗。因此，在面對雙老家庭“內憂外患”下的高壓歷程階段，且其存有代間照顧之∞臍帶觀點，以及在華人文化與世代照顧責任的脈絡下，對於「在地老化」以及「生活品質」概念宜有新的詮釋，並應建構適性適所之光譜式居住模式。故在政策規劃方面，建議重塑國家、社會與家庭之三角關係，設計更具貼近性的福利服務，以及示範、獎助興建多元型態的居住模式；在社工實務方面，建議以案主（家）為中心、創新身心障礙團體/機構的服務取向，以及倡議友善環境。
The amount of the double-ageing families that contain old parents and their children with intellectual disability has become higher and higher year by year. In order to develop and construct the mode of habitation that is suitable for the social context and culture of Taiwan, and due to the different physiological, psychological and social pressure these double-ageing families have to face necessarily in such a stage of life, as well as the lack of the related research concerning the issue of the double-ageing family nowadays, this research set out to probe into the view the double-ageing families that raise children with intellectual disability have of the mode of habitation, by applying qualitative method. This research has interviewed 19 research participants that include 8 parents who raise children with intellectual disability, 8 practitioners, and 3 managers of the institutions of the intellectual disabled people. This research discovers that during such a stage of life, there are 6 levels of pressure loads the parents of the intellectual disabled people usually have to face: the white-headed, blurred vision “old body”, the money-losing “old capital”, the equally weak “old mate”, the physiological ageing of the intellectual disabled children, the uncertainty concerning the future, and the GAP of the welfare supply and demand of the formal supporting system. However, due to the complex mixed reasons such as the responsibilities, the affects and the actuality, while facing different levels of pressure loads, the parents still choose to take care of their intellectual disabled children continuously, with the hope of “body safety”, “life safety”, and “mind safety”, concerning the suitable mode of habitation. In light of this, concerning the “three safeties”, in order to fulfill the hope of the double-ageing families that contain old parents and their children with intellectual disability, this research has designed the mode of the homeland for parents and children. This mode has not only transformed the traditional institutional mode of habitation, but also put emphasis on the life-quality-ensuring professional care, the application of the assistance of amateurs, and the arrangement of facilities of the holistic principle, while taking the accessibility of regional resources of the located area into consideration. Nevertheless, this new mode is also put into the trials of legality, the wish of the institutions of physical disabled people, the acceptance of the potential users, and the acceptance of the neighborhood. Therefore, on the high pressure courses and stages of the double-ageing families under the “internal revolt and foreign invasion”, the umbilical conception of the inter-generational care, the Chinese culture, and the responsibility of generational care, it is necessary to provide a new interpretation of the concept of “ageing in place” and “quality of life”, as well as construct a personality-and-place-suitable spectral mode of habitation. For this reason, on the side of policy-making, this research suggests that not only the triangular relation among the state, society, and family should be rebuilt, but also the more close welfare services and multiple modes of habitation should be designed, constructed and rewarded. On the side of social work practices, this research also suggests the client (family)-centered approach, the innovation of service orientation of groups/institutions of the physical and intellectual disabled people, and the promotion of a friendly environment.
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