已婚女兒照顧失智父親之關係變化：系統觀點的探究

Abstract

"本研究以系統觀點探討已婚女兒成為失智父親照顧者之脈絡、已婚女兒與失智父親、以及與其他家人的關係變化。採用敘事研究法進行本研究,共訪談兩位已婚女兒。研究發現在父親失智初期,家庭延續過去因應模式,因此與母親關係親近的已婚女兒處理失智相關事務。當失智加劇,已婚女兒與母親一同照顧父親,形成緊密的父親-母親-女兒三角照顧關係。已婚女兒同時照顧父親,也安撫母親的情緒。整體而言,不論早期父女關係如何,與母親關係親近,則已婚女兒容易成為失智父親的照顧者。在已婚女兒成為照顧者之後,原本疏遠的父女關係也轉為親近,但在入住長照機構後父女關係可能出現再次轉折。已婚女兒也與極少分擔照顧責任、無提供經濟資源的兒子,關係疏離。過去探討失智照顧的文獻多聚焦在照顧者個人觀點或是照顧者-被照顧者兩人關係。不同於過去研究,本研究的獨特之處在於發現失智照顧歷程的父親-母親-女兒之三角照顧關係,並針對已婚女兒成為照顧者的家庭脈絡與文化脈絡進行討論。最後,依據研究結果對實務工作與未來研究提出相關建議。  The research, from the Systems perspective, explored the contextualization of married daughters who cared for their demented fathers, the change in the relationships between married daughters and the demented fathers, and the change in relationships between married daughters and the other family members. This study was conducted with narrative research. A total of 2 married daughters were interviewed. This study found that in the early stage of dementia, the family continued with the previous coping strategies and these married daughters who had close relationships with their mothers took on the dementia-related affairs. As dementia exacerbated, these married daughters and mothers took care of the father together, forming a close father-mother-daughter triangulation. These daughters were taking care of the fathers with dementia, while also soothing their mother’s mood. Regardless of the father-daughter relationships before the onset of dementia, the closer the mother-daughter relationship, the more likely these married daughters were to become caregivers for their fathers. Subsequently, after these daughters becoming caregivers, the father-daughter relationships transformed from distant to close, but there may be another turning point after those fathers moving into the long-term care institutions. Prior studies on the care of dementia have focused on the personal perspective of the family caregiver or the relationship between the caregiver and the family member with dementia. Unlike previous studies, the unique finding of this study is the father-mother-daughter triangulation in the care process. Finally, based on the research findings, some suggestions were made for practical work and future research.