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頁面建立日期
2018.10.08

頁面更新日期
2019.10.21

長期照顧者 Long-term Caregiver


簡介 Introduction

照顧者是指照顧殘疾人士、長者及幼童的起居飲食的人士。以殘疾人士的照顧者為例,他們大多需廿四小時為殘疾者提供醫療的支援及管理,以致個人的照顧,包括:如廁、洗澡及餵食(游佩珊, 2018) 。 雖然政府沒有就照顧者提供統計資料,但香港婦女中心協會 (2011) 由 零散的資料中,可反映社會上有為數不少的照顧者。根據《 2015 年香港統計月刊專題文章:殘疾人士及長期病患者》的資料,香港至少有 203,700 名與殘疾人士同住的照顧者及 175,600 名與長期病患者同住的照顧者。 而《主題性住戶統計調查報告書 - 第四十號報告書 - 長者的社會與人口狀況、健康狀況及自我照顧能力》中反映,有 133,400 名居家長者需要別人幫助起居生活。這些數據都未能全面反映認知障礙症、中風或其他老年問題的照顧者的數字。除了一般的幼童及兒童需要關顧外,有特殊學習需要 (SEN) 的兒童及人士 ( 尤其是幼年及在學期 ) 更需要各種不同的照顧。具體來說,教育局 2015/16 年度統計數字顯示,有特殊學習需要 (SEN) 的學生約有 7,700 人。總括而言,數以萬計的照顧者一直默默地為家人及社會付出。 照顧者壓力不但影響受助者及照顧者的身心健康,照顧者往往因困在家裡照顧家人要困在家中,形成社會的隔離 ( 謝樹基 , 2018) 。此外,他們不少為全職照顧者,財政資源有限,受助者的醫療開支及平日生活費都顯得緊絀。人口老年化令照顧重任不能限於家人所負擔,政府及不同的組織都著力就照顧者的需要,提供不同的支援及服務,減輕照顧者的重擔,並減輕提早將受助者送往院舍的需要 ( 智經研究中心 , 2016) 。

A caregiver or carer in this text is defined as a person who helps another person who has impairments related to disabilities or old age as well as toddlers and minors in daily chores and activities. For caregivers who take care of a person with chronic illness or impairments, their around-the-clock duties include managing their medication and health management as well as all sorts of personal care such as toileting, bathing and feeding ( 游佩珊 , 2018) . Although government statistics on caregivers is unavailable, some scattered data illustrated that there are a huge number of hidden caregivers in the community ( 香港婦女中心協會 , 2011) . According to the Hong Kong Monthly Digest of Statistics (2015), there are at least 203,700 caregivers living with people with disabilities while 175,600 people are providing care for chronically ill patients at home. In addition, the Household Survey Report - Report No. 40 - Social and Population Status, Health Status and Self-care Capacity of the Elderly reveals that 133,400 senior citizens require help from others in daily activities. These statistics may not accurately reflect the number of caregivers of people with old age issues such as dementia, stroke or other geriatric problems are not included. In addition to ordinary toddlers and minors require babysitting and care, children and people with special education needs (SEN) need different sorts of care, particularly those who are under intensive training and education. To be more specific in the figures of SEN students, there is about 7,700 students from primary and secondary schools require different sorts of care according to Education Bureau statistics 2015/16. To sum up, there is a huge number of unsung heros providing cares of their love ones and contributing in the community in silence . Caregivers stress is not only asspcoated with physical and psychological wellbeing of caregivers and patients, but it also leads to social alienation as caregivers are usually trapped at home with patients for intensive care ( 謝樹基 , 2018) . Furthermore, as the majority of them are full-time caregivers, they have limited financial resources to cover the medical expenditures and make two ends meet. Caregiving of the aging population is no longer limited to the family responsibilities; government and many organizations recognize the needs of caregivers and develop various support and services to avoid caregiver burn-out and pre-mature institutionalization of people with disabilities or old age ( 智經研究中心 , 2016) .

作者/Author: Carmen K.M. Yau

新聞及政府資訊 News&Government Information

陳景寧. (2017). 【長期照顧篇二】看不見的女性家庭照顧者. 網氏.
本文就女性家庭照顧者的處境與需求,提出服務方案,包括發展降低照顧者負荷的服務及建立照顧者的社會安全制度。
引文
洪藹婷. (2017). 一年3照顧者謀殺親人 政策沒到位?「自殺是一個最大的指控!」. 香港01.
特首林鄭月娥的第一份施政報告推出不少安老政策,與現時的長者人口及申請數字相比,服務的增幅還是不足,文中評批有關的服務欠缺彈性,亦不合長者及照顧者的需要。
引文
謝樹基 、 趙雨龍. (2018). 殘疾照顧者:慘過做工人 24小時無休 壓力爆煲. 明報.
筆者研究表示 家屬照顧者壓力不會因有家傭幫忙而減少,比沒有家傭的照顧者更高,要兼顧的事情反而增多。過半家屬照顧者精神健康欠佳,常感到焦慮、失眠和抑鬱。就以精神病患者為例,互助組織忽略支援照顧者,建議為照顧者提供有系統和長遠的支援。
引文
智經研究中心. (2016). 沒有牆的世界 誰來看顧「照顧者」?. 信報.
長期病患者和殘疾人士的數字一直上升,長期護理需要大多落在配偶、子女或父母等親屬。 文中分析社區照顧服務不足,例如社會福利署的院舍照顧服務、殘疾幼兒暫託服務、殘疾人士的住宿暫顧服務等都不足以舒緩照顧者的壓力。另外亦分析現時的照顧者津貼的情況,應參考英國的照顧者津貼門檻及護老者津貼的申請資格。
引文

影視作品 Movie and TV Series

陳大利. (2018). 黃金花.
黃金花一直視家庭重於一切,兩夫妻合力照顧患有自閉症兒子20 年,豈料老公有婚外情,辛苦維繫的家庭瞬間變得零散,不知所措的黃金花想過不同的解決方法,加上朋友們的支持,黃金花赫然醒悟:成為真正不再失敗的女人,原來還有更好的出路。
引文
黃進. (2017). 一念無明.
阿東患有躁鬱症,因父親離家不顧而弟弟早已移居外地,他只能獨力照顧重病的母親,二人猶如漫長的困獸鬥。有一天,他如常助母親洗澡發生意外,導致母親死亡,後來更需入院接受治療。其父獨居多年,後要接受醫院建議,將阿東接回板間房暫住,二人再重提母親之事,重新面對過去,父親體會到阿東當年作為照顧者的壓力,以及他的精神病受到社會的壓迫及歧視,最後擔上照顧阿東的責任,從新建立關係。
引文
林芷雅. (2017). 照顧者. 星期日檔案.
家人有病,照顧的重擔往往落在最親的親人身上,餵食、抹身、出入醫院,加上長期處於憂慮狀態,可以說是一種長期折磨,照顧工作難免令照顧者的身體狀況和心理質素下降。 不論是身為子女的長期照顧者,乃至兩老面對伴侶老、病、死的抑鬱與沉重。一場病、一次意外,令一個家庭長期處於困境矛盾中,特別是一下子由經濟支柱變成家中病患親人的照顧者,花光力氣照顧他人,卻原來不懂照顧自己、照顧情緒。
引文
香港電台. (2017). 護老者的哀歌. 視點31.
長期照顧病患家人引發的命案,近年屢見不鮮,訪問關注家居照顧服務大聯盟代表李鳳琼及救世軍護老者服務社工李晴芳,了解照顧者的困境,檢討政府的支援政策。
引文

學術文章 Academic Papers

Etters, L. et al. (2008). Caregiver burden among dementia patient caregivers: A review of the literature. Journal of the American Academy of Nurse Practitioners, 20(8), 423–428.
This study focuses on the relationships between caregiver burden with the characteristics of patient with dementia and their caregiver by reviewing peer-reviewed journals from 1996-2006 in nursing and other relevant journals. The characteristics of caregiving depends on the health of caregivers. The outcome of caregiving has a close relationship with gender, relationship with patient as well as the charecteristics of patients and caregivers. Among various interventions to alliviate caregiver burden, the results indicated that intervention requires a diversity of services so that caregivers could have a better quality of life as well as physical and psychological health. Decreaased caregiver burden at home can minimize the chance of institutionalization of dementia patients.
引文
George, L. K. & Gwyther, L. P. (1986). Caregiver well-being: A multidimensional examination of family caregivers of demented adults. The Gerontologist, 26(3), 253–259.
This study focuses on the well-being of caregivers of aged family member with memory impairment in terms of physical and mental health, financial resources and social participation. The results revealed that these caregivers tend to have more challenges on mental health and social participation. Furthermore, the characteristics of caregiving are more related to the well-being of caregiver than to the needs of the patients.
引文
Sörensen, S. et al. (2002). How effective are interventions with caregivers? An updated meta-analysis. The Gerontologist, 42(3), 356–372.
This article reviewed 78 studies on interventions for caregivers of the elderly to examine its effectiveness. Generally, these interventions can be helpful in terms of caregiver burden, depression, ability/knowledge as well as their subjective well-being and satisfaction. Among these six types of interventions, psycho-educational and psycho-therapeutic intervention showed most effectiveness and consistency in short-term outcomes.
引文
游佩珊. (2018). 誰是照顧者?-本港家庭照顧者人口及其需要. 社聯政策報, 24, 4–10.
本文旨在界定照顧者的定義及勾劃香港照顧者的特徵。香港人口老化及病患普遍化,長期照顧的需要激增,現時常規照顧服務並未能滿足需要,不少長者及 患者依賴家人無償照顧。當中以年過60 歲的照顧者最為受到關注,除擔心自己老化問題,又看不到被照顧 者將來的照顧支援。
引文

書籍 Books

Revenson, T. A. et al. (2016). Caregiving in the illness context.
This book covers psychological researches on caregiver stress in order to review the personal, social and structual factors affecting the health and wellbeing of caregivers. Also, behavioral interventions are introduced to enhance their health condition.
引文
劉倩萍. (2018). 真空  一個植物人照顧者的告白.
作者本與丈夫有一個幸福美好的家庭,丈夫突然中風,之後他的動作開始變得緩慢,意識也逐漸迷糊, 漸進入「真空」的過程,踏上了不一樣的照顧者之路。
引文
香港婦女中心協會. (2011). 照顧者生活需要探索性訪問研究報告書.
這研究報告邀請了9 位年齡由 33 至 77 歲的照顧者接受深入訪談,探討女性照顧者的日常照顧工作、所面對的困難、壓力和需要,及通過了解受訪者對社會資源運用的情況,提出有助改善照顧者生活的各項建議。受訪照顧者大多都是受關顧者生活上的唯一照顧者,她們的工作既瑣碎又重覆,佔據受訪者大部分的時間。 她們的生理健康上有不少的勞損,心理壓力大而且社交生活不足,加上經濟狀況窘迫,可運用的社區資源有限。文中建議政府應就照顧者的狀況作一全面統計,設立以地區為本的一站式服務中心,並立法保障照顧者的權益及提供津貼。
引文
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