| China has entered the aging society,and the aging process is accelerating gradually.Home-based care has become one of the basic national policies of our country,because of the old national conditions.In 2015,the state council proposed to vigorously develop the home-based care service,and the home-based care service ushered in a new stage becoming comprehensive and rapid development.With the continuous development of home-based care services,hospice care has become an indispensable part of long-term care services for the elderly.And the development of hospice care has attracted public attention.Social work,as an important force for home-based care,should assist families to cope with the end-of-life challenges during the service.But now,there are fews of the studies focousing the hospice care for family caregivers.Family caregivers who are the clients not only facing the challenges at the end of a patient's life,but also facing the challenges after the death of patient.Therefore,this study focous on the process of family caregivers in the scenario of the home coping with the final challenge.It will review and summarize family caregivers' difficulties and strategies in this process.And then,it will give some suggestions for the social workers who are the servicer get into the clients'home to help family caregivers to solve hospice care challenges.In this study,a case study was used to study the six families of the hospice care project of M city X institution.Through literature review,observation method and interview method,relevant research data were collected to analyze the process of family caregiver's final challenge.The study found that:1.The family caregivers of dying life that occupy the home mainly through four stages:(1)just learned of the death sentence;(2)care for the patient stage;(3)maintain the daily life arrangement stage;(4)to deal with the life stage after death.2.The family caregivers are confronted with the conflict of meaning in the home scene.There are two sides to this conflict:?They were afraid to expect to be broken to death.?They feel the injustice of their fate when they are held to account.,?There is a conflict of responsibilities between them.?They struggle to rebuild their lives because of their remorse and regret.On the other hand,there is a conflict between the meaning of the family caregiver and the meaning of the patient and his family:?There are different explanations for the treatment.,?They blamed each other for the division of labor.?Their different explanations for family responsibilities often lead to misunderstandings.?Their ideas are in conflict with reality,leading to conflicts in family arrangements.The study also discusses the"multiplicity" features of the reconfiguration of family caregivers.The author thinks that the process of the family caregivers' meaning reconstruction is not only single line,but also multiple.1.The author analyzes the characteristics of the interaction between family caregivers,patients and other family members in the four stages of family life.2.The author discusses the multiple reconstructions of the meaning of family caregivers,which have several logical features:?In the process of dealing with some important events,the multi-party reconstruction of meaning is inevitable;?Different roles take part in the process of meaning reconstruction with their own understanding of responsibility,worry and interest.?The multi-dimensional reconstruction of meaning includes the means of meaning competition,meaning compromise and meaning consensus.It can be seen that the existentialist theory emphasizes one-sided reconstruction of the meaning of family caregivers.It cannot see the possibility of compromise and consensus in the process of meaningful interaction.It cannot provide a solution to the conflict of multiple construction of family caregivers in the home scene.3.At the end of this study,two Suggestions for social work intervention in hospice care are proposed:(1)the research focuses on the impulse point of the significance reconstruction of family caregivers,and actively guides the construction of positive life significance.Specifically,there are three approaches;?To adjust negative evaluation to positive evaluation;?Actively encourage greater communication.?Focus on the joy of life to ease the tension in the family.(2)Services need to focus on the differences in meaning among family members,and guide understanding of differences to facilitate meaningful consensus.There are three specific methods:?Create a common small goal to actively guide family caregivers to refactor positive life meaning.?Learning to take care of knowledge reduction misunderstandings create common small goals to actively guide family caregivers to reconstruct positive life meaning.?Improve the meaning of home environment adjustment.In theory,the findings are beneficial to make up for the deficiency of the research on hospice care challenge for family caregivers.It is helpful to provide theoretical basis for the intervention of hospice care for social work.In practice,this study examines the challenges faced by family caregivers in a home scene.It is helpful for family caregivers to find a reasonable coping style and to use the meaning of life to construct a way to meet the challenge.It is helpful to find the method and strategy of hospice care service,and provide advice for social work to intervene in hospice care.However,due to the researchers' ability to the limits and time arrangement,the study is single research method,and the limitations of research sample size deficiencies,as a result of the limitation of the researcher's experience and practical experience,the research data analysis is not enough in-depth and there are some limitations such as the subjectivity.Article is divided into seven chapters:first chapter is introduction,introduces the research background,objectives and significance,determines the research problem:family caregivers in the scenario that occupy the home to the final challenge process?What challenges do they face?How do you deal with the needs of your patients and other family members in the process of responding to these challenges?And how to realize the new meaning of life?The second chapter is literature review,through with the introduction of the related concepts,as well as to our country home endowment service development,the development of hospice care in our country,families of hospice service related research,the family caregivers cope with challenges in the process of related research,the existential theory in social work practice research review,determine the research focus:from theoretical perspective to explore family caregivers in the scenario that occupy the home construction conflicts and meaning reconstruction process.The third chapter is the research design,which introduces the theoretical framework of this study,namely,the study on the process of the family caregivers to cope with the end-of-life challenge from the perspective of existentialism.In addition,this chapter has established a case study method,and established the method of using literature method,observation method and interview method as data collection.In the fourth chapter,it is found that the four stages of the family caregiver's end-of-life life and the two types of conflict of meaning are summarized.The fifth chapter is discussed,the scenario that occupy the home's family caregivers and the significance of the patient and his family interaction characteristics were analyzed,and discuss the reconstruction of meaning of family caregivers multiplicity,suggesting that the shortage of the existentialism,and put forward the enlightenment to the social work intervention in home hospice care.The sixth chapter is the research conclusion and limitation,which is mainly to summarize the findings of this study and to reflect on the limitations of the research. |
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