| Summary: | 碩士 === 國立陽明大學 === 臨床護理研究所 === 92 === The purpose of this study was to explore the process of formal caregivers’ appraisal and management of sexual expression by the institutionalized elderly with dementia in Taiwan. The participants in this study were institutionalized elders with dementia and their formal caregivers. Data were collected using in-depth, face-to-face interviews of 11 formal caregivers, and by observing 25 institutional elderly with dementia for a three day period. All observed data were written down and interview data were tape recorded and then transcribed verbatim. Content analysis was conducted according to guidelines provided by Miles and Huberman’s (1994) qualitative data methodology. The results indicated that the sexual expressions of institutionalized elderly with dementia included: physically intimate touch, sexual expression without touching others, and sexual talk. A residents’ sexual expression was judged appropriate by caregivers based on criteria such as the harmfulness of the sexual event to residents, family or staff, whether the event was acceptable within social norms, that the event fell within the policies set by the institution, and by the factor(s) leading to the event. The formal caregivers’ appraisal could be influenced by their own personal characteristics such as gender, age, experience, morals and values, and by the known characteristics of the residents being observed such as their level of daily activities. Management of inappropriate sexual expression included preventing the occurrence or continuation of a sexual event, making new regulations based on actions or factors that typically may lead to an event, and punishment and inhibition. The findings of this study can provide the basis to develop on-the-job training programs for sexual education of residents with dementia in institutions. To provide better care, it is recommended that an inventory regarding sexual expression for clinical and research use be constructed from the research results.
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