中華心理衛生協會

 Purpose: Homecare service is a type of formal care that is an essential long-term care policy in Taiwan. Its practice varies by ethnic group, culture, and social network. The goal of this study is to demonstrate how professionalism, institutional and organizational arrangement, and specific cultural practices shape the practice of homecare services from the view point of homecare workers. To capture the dynamic and diverse manifestations of carework, I applied the concept of bodywork as the analytical approach to investigate homecare practices in Nanao, Yi-Lan County, Taiwan. Bodywork is defined as paid labor carried out on the bodies of others and the management of embodied emotional experience and display. I used inter-corporeal and temporal-spatial aspects to describe the daily activities of homecare workers, the care relationships between them, the care recipients, and the tribal communities in which they living in. Methods: I conducted 6 in-depth interviews with female careworkers and engaged in participant observation of the carework in recipients' homes, in the homecare organizations, and in the tribes. I used ethnographic qualitative analysis to evaluate the data. Result: The major results are as follows: First, Nanao homecare service has collective characteristics, such as shared religious meaning, and tribe-centered indigenous care workers and recipients. The homecare workers are themselves also the main caregivers in their own homes and churches. Second, in daily care practices, homecare workers develop multiple strategies, and have the ability to take on multiple involvements and play multifunctional roles. In this way, they create practices that fit the varied and changing needs of their care recipients. When medicine and funds are scarce, they try fill in the gaps however they can, although it is extra work. The care workers have accumulated rich personal and local knowledge, but this knowledge is not recognized or adopted by the organization supervisors, or the government evaluation and care assessment system. Third, I found that the tribes/villages not only form the background for care practices, but are also important factors in daily care activity and care relationships for homecare workers. The homecare workers regard themselves as members of the tribe first, and second as a homecare worker, so they weave their own personal social network into their care practices. These practices become care strategies that cross or blur the body boundary between worker and recipient. However, the private social bond challenges the standard professional worker/recipient relationship, which government policy and the home care organizations expect. In addition, the care setting is flexible. Care might be provided outside of the recipient's home to coordinate with the daily tempo of the individual and the tribe. The actors involved in home carework are not merely the homecare workers and their care recipients; the whole tribe is included. This inclusion shapes the careworkers' work commitment and identity. Gaga, the Atayal essential traditional common law, is also embodied in home care practices between careworkers and elders. Conclusions: The analysis supports the conclusion that the government and society should value a variety of bodywork practices in homecare services. It is important to consider the specific social and cultural context in which care recipients are situated. There should not be an expectation that care practices in different cultures, areas, or organizations should be identical across situations. Home care service may not only be a labor experience, but also a kind of social relationship.