Community Participation in the Home-bound and Bed-bound Elderly Care, Nakhon Pathom Province

Abstract

Purpose: The purposes of this study were to study community participation in the care of bed-bound and home-bound elderly in a sub-district of Nakhon Pathom Province.

Design:  Qualitative descriptive research

Methods:  The key informants were 5 home-bound elderly and 5 caregivers, 5 bed-bound elderly   caregivers, including home visiting health staff of Nakhon Pathom Hospital, 3 staff of Tambon Health Promoting Hospital, 5 village health volunteers (VHVs), 2 representatives of the Chief Executive of the Sub-District Administrative organization (SAO), and 4 community leaders. The research instruments consist of indept interview, focus group and  Barthel  activities of daily living form for the elderly.  Data were analyzed using frequency, percentage and content analysis.

Main findings: The results show that all five home-bound elders were between 65 and 86 years, with an average age of 72 years, and that they were mostly cared for by family members. The caregivers were 45-65 years old, with an average age of 54. The bed-bound elders were 68-89 years old, with an average age of 82. Most of them had suffered a stroke and were paralyzed before they were bed-bound  and fell into semiconsciousness. Most of the caregivers were their children, all of whom were 46-62 years old, with an average age of 51. Community participation included 1) participation in decision making by the Subdistrict Administrative Organization officials who accepted government policies and allocated budgets, and by the health team who increased the capacity of elderly care by being present as care managers and preparing caregivers, 2) participation in implementation, including annual check-up of the elderly to get them proper care, care by family doctor team, continuation of care of bedridden from the Mea-kai hospital, health team of Tambon Health Promoting Hospital visiting bed-bound and home-bound elders regularly, 3) participation in benefits through comprehensive care of the elderly, imparting health care knowledge to village health volunteers, improving service system for the elderly, 5) participation in evaluation by assessing each project after completion and involving people by answering satisfaction questionaires.

Conclusion and recommendation: the local government should inform the people about community participation in elderly care of all sectors to facilitate access to services for the caregivers of the elderly. In addition, the community should have innovations that connect the health care team and patients to communicate adverse health changes and facilitate emergency care.