| 摘要: | 本研究旨在瞭解重度失能老年女性的失能歷程經驗、被子女照顧經驗；以及她們過去的生命經驗如何影響其解讀此被照顧關係與經驗。本研究以兩位年約八十五歲的老年女性為研究對象，各進行三到四次，每次兩小時的深度訪談。以敘說分析方法將個別訪談資料整理成其生命故事、失能歷程與被子女照顧經驗，並進行分析詮釋。綜合兩位個案研究的分析詮釋，結果如下：
一、老年女性的重度失能歷程，均歷經長時間的調適階段：
(一)忽視疾病與失能前兆，否認自身的痛苦與匱乏；
(二)經歷疾病或意外所造成的失能狀態，意識上無法再忽視；
(三)不願放棄一絲希望，試圖緩解失能的嚴重程度；
(四)體會任何努力終究徒勞無功，逐漸放棄希望；
(五)失能時間越久，日益人際阻隔與自我疏離，甚至進入心理死亡狀態；
(六)哀悼一切失落，準備死亡到來。
二、重度失能老年女性被子女照顧經驗之內涵：
(一)學習以示弱作為生存姿態：為了生存及維繫跟子女間的情感，重度失能老年女性以等待、沉默、忍耐等方式來減輕子女負擔，適應被照顧的角色。
(二)子女試圖逃離因失能而受疾病折磨的老年母親：子女面對年老母親的生命流逝、功能殘缺與病痛折磨等，無意識中產生各種逃避與抗拒行為。
(三)子女積極照顧行動背後的無形拒絕與隔離：子女過度為失能老年母親安排生活、做決定，忽視其情感溝通需求；或者強調鼓勵其康復，亦是拒絕承受年老母親重度失能的事實。
(四)居家照顧服務介入，成為老年母親與子女關係的兩面刃：居家照顧服務能分擔子女辛勞，但該資源介入也成為子女逃避照顧失能母親的理由。
(五)對身心痛苦極盡偏執地忍耐，源自於對子女的愛和體諒：重度失能老年女性在層層生理限制下，仍保有對子女付出關懷的生命目標；但極盡偏執忍耐痛苦不但造成身體健康惡化，也剝奪了子女的照顧功能。
(六)「在家養老」為其重要的幸福感來源：因經濟能力限制，家庭的資源只剩「家人」，能夠在家養老為失能老年女性幸福感來源與重要外在資源。
三、 重度失能老年女性過去的生命經驗與被子女照顧關係的關聯性：
(一) 老年女性對於重度失能處境與被子女照顧關係的看待，源自生命經驗中所內化的人格特質與人際態度；
(二) 重度失能老年女性的生命韌性，成為其經歷失能災難的生存助力，並驅動其朝向善終。
最後，本研究最後針對以上研究發現進行討論，並提供未來研究者對相關議題進一步的參考方向，提出具體實務建議。
The purpose of this study is focus on knowing the process about elderly women from health to major disabled, and experience of being taken care by their children; to know what does it happen in the relationship and experience of being taken care by their children instead of taking care of them.
The two elderly women in this study are take interviews individually three to four times, two hours per time. Narrative Research in this case helps me to realize personally life story, the process being disabled and being taken care by their own children. I give a interpretation in the end. Summarize the two cases’ interpretations we can find:
I. The process of elderly women being major disabled has a long time to get over and being adapted:
i. Ignore the sign of disease and disabled and deny the feeling of pain and lack of themselves.
ii. Suffer from disabled situation of illness or accidents, and can’t ignore them anymore in her conscious.
iii. Do not give up any hope, trying to put off the severity of disabled.
iv. Knowing every works will fail, and let it go gradually.
v. When the time being disabled gets longer, the isolation between people will become obvious, even mental state will be exhausted.
vi. Mourn everything they had, and waiting for the end of life.
II. The meaning of the experience of elderly women who is severely disable and been taken care by their children:
i. Learning how to show their weakness: in order to live and keep the connect with their children, they have to be waiting, silent, holding back their feelings to reduce the children’s burden, and get used to being looked after.
ii. The children tried to run away from the frustration due to their mother’s disable and torture with disease: facing the fact of their mother that suffer from disable and pain, counting days, and having many rejective behavior or avoidance in their unconscious mind.
iii. Invisible rejection and isolation behind the active care of children : too many arrangements for their mother who is disabled and old, they decide how their mother to live a day, make decisions for them, and do so many things but no need for their emotional communication; they emphasize too much they will be complete cure and get back to origin life, and this is a fact that deny the reality that their mother is major disabled and this is the process of life.
iv. When home care service is a good thing and a bad thing between aged mother and her children: home care service can provide the children sharing the responsibility for the burden taking care for their aged mother, but it has become a reason to their children escaping from taking care of their mother..
v. Extremely stand the pain as regard physical and mental sufferings, and the tolerance which is because of the love and consideration to her children: these elderly women with severely disable are limited to physical conditions, and still have passion to concern about their children. But extremely stand pain is decreasing their health, and bereaving the chance for their children looking after them.
vi. "Home care by their children" is the most important source of happiness : they look after their mother themselves is because of they have little money to afford a professional care, and they are the only resource of family. It’s a great happiness to these severely disabled elderly women being taken care at home.
III. The connection between the experience of severely disabled elderly women’s past and the relationship being taken care by their children:
i. Due to the experience of internalization personality and the attitude how they deal with people, it’s about the relationship between children as a care giver and being severely disabled to the elderly women.
ii. It becomes a support helping them not being knocked down through the disaster which they experience disabled and overcome with their toughness, and finally leads these old ladies to a good end.
In conclusion, the results were discussed and suggestions were addressed. |
