The Caregiving Daughter-in-Law : A Study of the Use of Day Care Services for Dementia

• Main Authors: Yu, Hui-Lin, 郁慧琳
• Other Authors: Hsieh, Mei O
• Format: Others
• Language: zh-TW
• Online Access: http://ndltd.ncl.edu.tw/handle/xbf8v2

碩士 === 國立政治大學 === 社會工作研究所 === 105 === As the population of Taiwan ages, the number of people living with dementia has seen growing fast, and the behavioral and psychological symptoms in dementia patients have also brought struggles and stress toward the family caregivers. Looking into the research literature of dementia caregivers, lights had been shed upon the women and the daughters, while the daughters-in-law were still remained obscure. This qualitative study focuses on the experiences of the daughter-in-law caregivers using day care services to discover its benefits and insufficiencies. The purposes of this studies are: 1. To explore the reasons of daughters-in-law becoming the main caregivers of dementia patients in families, their courses of decision making, and caregiving experiences; 2. To understand the shifts in lives of the daughters-in-law after becoming caregivers; 3. To understand the views, responses, and changes of the other family members toward the caregivers; 4. To explore the reasons and experiences of caregivers selecting day care services, and the continuing in services using; 5. To provide references for day care policies making and day care center services delivering. In-depth interviews are conducted with 9 female caregivers from day care centers of five cities, i.e. Taipei City, New Taipei City, Changhua County, Hsinchu City, and Tainan City, whom were all taking care of their mothers-in-law with dementia. Findings are concluded as followed: 1. Factors influencing the daughters-in-law to shoulder the responsibilities of caregivers are “marriage”, “living under the same roof”, “filial piety”, “expectations of other family members”, and “fatalism”, while these five factors are mutually interlacing and connected; 2. Due to different behavioral and psychological symptoms in patients, feelings and impressions of caregiving could be distinguished as “it’s similar to taking care of children”, “could always be misunderstood by familiy members”, and “regular hours could still be kept unaffected”; 3. Relationships between the interviewees and the care-receivers could be “in conflict” or “at peace”. But there are cases that the interviewees had put the pasts behind them, after their mothers-in-law had been affected by dementia and had become mild in temper, while day care services had also helped better situations; 4. As the interviewees have their own job and career, the caregiving duties have brought impacts such as “job arrangements are made centering the care-receivers”, “forced to give up on employment temporarily”, “caregiving duties and job could be balanced”, or “quit employment permanently”; 5. Care giving duties have affected the interviewees’ lives as “lifestyles and schedules were disrupted” or “living with no leisure hours at all”; 6. During the courses of caregiving, the roles of husbands could be identified as flowing between “alternate caregivers”, “conflicts coordinators”, “communicators”, and “bystanders”, which depends on the interviewees to bring up their need of help. Husbands’ attitudes toward their spouses in becoming caregivers could be noted as “grateful”, “this is your obligation”, “taking up the cudgels”, or “being powerless to do anything”; 7. As for the children of the caregivers, their reactions could be “providing timely assitances”, “keeping back from the patients”, or “taking up the cudgels for their mothers”. However, those who keep back from the dementia patient would still provide support and lend a hand to the caregivers out of the care and love for them; 8. The husbands’ families could be either “evading their duties” or “willing to share the burden and provide assistances”; 9. Considerations in applying for day care services are “the increasing stress in caregiving”, “to delay the deterioration in abilities of dementia patients”, “family economic issues”, and “alternate choices of caregiving”; 10. Utilizing day care services could be the decisions of “the caregiving daughters-in-law”, “joint decision by the husband and wife”, “daughters of the dementia patient”, or in certain circumstances “decided by the patient herself”; 11. With the help of day care services, advances toward the care-receivers are “delay or stabilization in abilities deterioration”, “improvements in interpersonal interactions”, “medical checks and assistances”, “personal interests nurturing”, and “maintaining regular life hours”. As for the caregivers, they could “appreciate respite hours”, “continue own employment”, “advance in caring techniques and health education”, “take part in welfare and support activities”, as well as “receive psychological support” from the day care service they applied for; 12. Government assistances such as “raising awareness of dementia in the public”, “improving spaces of day care centers”, “replenishing the caregiving workforce”, “implementing the policy of a day care center in each town”, “enhancing the promotion of day care services”, and “devising weekend/holiday day care services” are being anticipated for more desirable day care services. According to these stated findings, recommendations in relation to the daughter-in-law caregivers, service providers, and the lawmakers were proposed in hope of contributing toward future practices and policy making.