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題名:家庭照顧與公共照顧服務使用—照顧的承擔或協調
作者:李佩芳
作者(外文):Lee, Pei-Fang
校院名稱:國立中正大學
系所名稱:社會福利研究所
指導教授:鄭文輝
鄭清霞
學位類別:博士
出版日期:2017
主題關鍵詞:家庭照顧者照顧價值觀長期照顧制度公共照顧服務Family caregiverCare valueLong-term care systemPublic care services
原始連結:連回原系統網址new window
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本研究以深度訪談的方式,訪問雲林縣與嘉義縣市23戶長期使用公共照顧服務達五年以上,被照顧者失能程度達中度以上的家庭照顧者。依照顧者對於照顧責任的認定與公共照顧使用樣態,將家庭照顧者區分為承擔型及協調型之照顧者;並分別從媳婦、子女及配偶照顧者的角度,瞭解照顧者本身對於照顧工作的態度、對失能者照顧需求的想法、周圍家庭成員對照顧工作的影響,並同時探查其對公共照顧服務使用的狀態與態度。
本研究主要分析結果有下列三項︰
一、承擔型的家庭照顧者,深受其他家庭成員的影響,而影響他們對於公共照顧服務的使用;在使用公共照顧的態度上,也多會從照顧者轉換為輔助者跟監督者,以確保服務進行的質量。他們視公共照顧服務為補充性質,而現行制度會依家庭照顧者涉入程度決定核給時數的設計,也容易使這些家庭照顧者的照顧負擔無法減輕。
二、協調型的家庭照顧者,相對不易受到其他家庭成員的影響,他們也多積極促成家庭成員的參與;他們在使用公共照顧的態度上,將公共照顧視為取代性質,讓照顧者的照顧勞務可以短時間被取代、分攤。同時,他們會積極運用公共照顧服務,以機構喘息及居家服務混合使用居多,協調型的配偶照顧者則會考慮在照顧負荷超過可負擔程度時,將被照顧者送往機構式服務。
三、整體而言,在本研究的受訪者家戶中,女性仍是最重要的照顧勞務提供者,不管她們是身為妻子、媳婦或是女兒;男性會成為照顧者則是通常導因於其他因素的影響而必須承擔照顧責任。在華人傳統的家庭價值觀下,以父系家庭為核心的家庭關係,女性成為當然的照顧勞務提供者,並因隨著其身份別而來的家戶結構所限制。公共照顧服務若期待可以更加穩定的開展並為人民所信賴,便要嚴肅的面對這個父權結構的發展與變遷,才能使得未來世代的高齡者及其照顧者,整體的照顧福祉獲得保障。
This study interviewed caregivers of 23 families with disable elders who were appraised to be severer than intermediate degree and have used public care services for more than five years in Yun-lin and Chia-yi areas. Two types of family caregivers are classified as undertaker-oriented or coordinator-oriented, based on their recognition of care responsibility and the use pattern of public care services. These family caregivers are also identified by their family status as daughter-in-law, children or spouse. Then this study explored caregiver's attitudes toward daily care work, the need of care recipients, influences of other family members and the choice of public care services.
Three major findings of the study are as following:
1. Undertaker-oriented caregivers are more affected by other family menbers and are inclined to be care supervisors or collaborators when public care services are introduced. They regard public care services as supplementary to their own care work. Since public care services are provided considering family care resources, undertaker-oriented caregivers’ care burden could not be reduced under current public care system.
2. On the contrary, the coordinator-oriented caregivers are relatively less vulnerable to influences of other family members, and can promote their participation in care work. They regard public care services as substitute to their own care work that can be replaced or shared by the formal caregiver for a short time. They seek actively more use of public care services, especially, respite services and would consider institutional service as alternative care if they were over-burned.
3. Generally speaking, women are still major family caregivers in Taiwan, whether they are wives, daughters or daughters-in-law. Men only take the care responsibility under some special situations. In a traditional Taiwanese family, the Patriarchalism is the core feature of the family care values, thus women become main care providers who are oppressed by the family structure. The public care services can well develop to be a reliable system unless the patriarchal structure and its changes can be seriously faced that the care welfare of both caregivers and care recipients can be well acquired in the future aged society.
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