| 摘要: | 本論文研究之雙重照顧資源的定義係指同時使用兩項正式照顧服務，研究對象為同時使用機構式照顧與聘僱外籍家庭看護工者。研究目的為瞭解家屬決策失能長者使用雙重照顧資源的因素及決策過程，並從不同的時間序列探討聘僱外籍看護工與選擇機構式照顧的先後順序與兩項服務模式之關係。
本研究採質性取向的研究方法，並以深度訪談進行資料蒐集，受訪者共有10名家屬，分別與長者關係包括2名女兒、5名為兒子及3名為媳婦。研究結果顯示長者的需求是會隨著時間推移所變動，因此單一的照顧服務已無法繼續滿足其需求；另從家屬角度分析雙重照顧服務使用原因，發現照顧場域與生活空間的區隔必要性乃是家屬選用機構式服務的主要因素，但又受限於機構式服務人力配置無法滿足照顧者個別性的照顧需求，故仍採取自聘外籍看護工方式確保照顧品質；而在照顧照顧項目與分工上，家屬與機構主要呈現職務分工取向；外籍看護工與家屬呈現替代模式；機構與外籍看護工之間則依照顧項目不同呈現不同關係。
最後，本研究建議：（1）應該發展「整合式」的長期照顧服務；（2）建構無縫隙的照顧體系；（3）提升整體照顧品質：機構與外籍看護工的品質把關；（4）機構人力比的修訂。
Abstract
The definition of Dual Care Resources in the present research refers to utilizing two formal care services. The research objects are those who utilize both institutional care and foreign care workers’ service. The research objective is to understand the reason why the family chooses to utilize dual care resources, and their decision-making process; furthermore, to discuss the priority between hiring foreign care workers and receiving institutional care in different time series, and the relationship between the two kinds of services.
This research employs qualitative-approach studying method, and collects data through in-depth interviews. Ten family members were interviewed; their relationships with the elderly are two daughters, five sons and three daughter-in-laws. The result of the research shows that the need of the elderly varies with time; hence single care service is not capable of satisfying their requirements. This research also analyses the reason the family members decide to employ dual care services, and found that the need to separate care space and living space is the main reason the family members choose institutional care, and the limitation of institutional care, that is, the institutional care is not capable of satisfying everyone’s individual needs owing to manpower distribution, causes the family members hiring foreign care workers to ensure the caring quality. Regarding each care work and division of labors, the family members and the institute employ task-specificity hypothesis, the family members and the foreign care workers are hierarchical- compensatory model, and the institute and the foreign care workers are of different relationships according to different care works.
In conclusion, this research suggests that: (1) an integrated long-term care service should be developed; (2) construct a seamless care system; (3) improve the care quality and ensure the quality of institutes and foreign care workers; and (4) modify the ratio of institute’s manpower. |
