[[alternative]]Ambiguous Loss and Coping Strategies of Dementia Family Caregivers-A Narrative Study

[[abstract]]本研究以敘事研究方法探究兩位女性失智症家庭照顧者的模糊性失落經驗及其因應方式，採用半結構的深度訪談法來收集研究資料，文獻主要是依據Pauline Boss的模糊性失落理論以及失智症家庭照顧者相關研究來進行研究分析。研究結果發現如下：失智症家庭照顧者的模糊性失落經驗包括失智知識未普及化與漸進式病程使照顧者難以辨識失智症、照顧者的複雜性情緒與缺乏正確疾病知識及照顧技巧有關、照顧心理負荷程度與失智症記憶退化有關、照顧者面對身體退化與未來隱憂增加生活不確定感、照顧者運用資源提升照顧希望感、照顧者以「愛」維繫與失智症者的心理連結、照顧過程找到希望感與意義感轉化照顧壓力、照顧者在失落流轉中培養堅強與意志力。失智症家庭照顧者面對模糊性失落的因應方式包括倫理關係賦予照顧信念、宗教信仰引領靈性觀成長、幽默感營造關係彈性、接納照顧限制促進自我照顧、角色重構轉換矛盾感、家人合作增加支持感、長輩示範催化希望感、照顧知識與訊息提升照顧認同感、在地化活動的便利與趣味感、支持團體帶動照顧普同感，以及華人文化的獨特照顧關係脈絡。照顧者均有自己的獨特方式去因應模糊性失落，而這些因應方式非恆定不變，會隨著照顧者的照顧歷程與需求而彈性改變。本研究除了依據研究結果提出討論與限制，也對於失智症家庭照顧者、專業助人工作者、失智症家庭照顧者的長期照顧資源，與未來研究方向提出相關建議。[[abstract]]This study adopted a narrative method to investigate ambiguous loss experiences and the coping strategies of two female dementia caregivers. The researcher processed with semi-constructed in-depth interview to gather the study materials. The literature supporting this research and analysis were mainly based on Pauline Boss’s ambiguous loss theory and other researches related to dementia caregivers. The researchfindings were as follows: Ambiguous loss experiences of dementia family caregivers included unfamiliar to dementia knowledge and progressive disease course made it difficult for caregiver to recognize dementia,complex emotions ofcaregiver related to lack of correct dementia knowledge and caring skills,the mental load of caregiverswas related tomemory decay of dementia family,caregivers used resources to enhance a sense of hope,caregivers apply “Love”to maintain mental connection with dementia family,caregivers faced both physical deterioration and burden of future,increasing uncertainty toward life,finding a sense of hope and meaning during care process to transform care pressure,caregiversdevelopedstrength and grit during different loss.The coping strategies of Dementiafamily caregivers experiencing ambiguous loss includedethical relationship provided caring belief,religious beliefs lead to spiritual growth,humor facilitates relationships elasticity,acceptance of care limitation andpromotion of self-care,rolereconstructionconverted the sense of contradiction,family cooperation increased support,the elders demonstration enhanced a sense of hope,knowledge and information of care enhanced sense of care Identity,convenience and fun in localized activities,support groups promoted care popularity,the unique care relationship context of Chinese culture. To sum up,these coping strategies were not eternal,instead,they will change flexibly during the caring process and the needs of caregivers.In addition to the discussions and limitations based on the research results, the study also provided suggestionsfor dementia caregivers, professional helpers,long-termcare resources and futher research direction