노인장기요양보험에서 치매노인과 요양보호사의 관계와 돌봄 경험에 관한 연구

A Study on Relationships between the Elderly with dementia and Care workers under the Long-term Care Insurance for the Elderly in Korea

본 연구의 목적은 치매노인과 요양보호사의 관계와 돌봄 경험에 대해 이해하는데 있다. 질적연구방법론을 채택해서 19명의 요양보호사와 ‘반구조화된 심층인터뷰(semi-structured in-depth interviews)’를 실시했다. 연구결과에 따르면, 첫째, 요양보호사들은 언어적인 교류와 몸짓, 행동, 느낌, 상대 알아보기 등 비언어적인 교류를 통해 치매노인과 관계를 맺었다. 그러나, 경증과 중증치매노인 간에 관계 방식에 차이가 있었다. 둘째, 요양보호사는 치매노인을 돌보는 것이 너무 힘들다고 느끼고 있었다. 일부 요양보호사는 기억을 점차 잃는 치매노인을 돌보며 안타까움을 느끼고 잘 돌보려고 애쓰고 작은 변화에 보람을 느꼈다. 그러나 일부는 문제행동이 많거나 중중의 치매노인을 꺼리거나 잘 돌보지 않는 등 대상화(othering)하고, 선별주의 행위를 했다. 셋째, 요양보호사는 치매노인의 요구에 전적으로 맞추는 등 돌봄기술을 체득해 활용했다.

The aim of the study is to understand relationships between the elderly with dementia and care workers under the long-term care insurance for the elderly in Korea. I adopted qualitative research methods and conducted semi-structured in-depth interviews with nineteen care workers. It was found that most of care workers had relationships with the elderly with dementia through the verbal or non-verbal communications such as gesture, behaviour, feeling, and recognition. However, some care workers reported that they easily formed relationships with the elderly with mild dementia through the conversations. Other care workers had difficulties with having relationships with the elderly with severe dementia since they were not able to properly talk with such elderly as a result from behavioural and psychological symptoms in dementia(BPSD). In addition, it was found that some care workers appear to show the cream-skimming behaviour since they were reluctant or inappropriately to take care of the elderly with BPSD. Therefore, the study suggests that education and training on dementia for care workers should be emphasized to improve the understanding of and caring for the elderly with dementia and to support relationships between them.