The Development of Long-term Care System for the Dependent Elderly in Community of Muang District at Phetchabun Province.

Abstract

Dependent elders tend to increase around the world and including Thailand. This is an important and challenging problem of health care service. This research and development aimed to develop a long-term care system for the dependent elderly in the community of Muang district at Phetchabun province. The study was divided into 3 phases including; phase 1: the descriptive study with retrospective review was designed to study contextual and problems in the Long Term Care (LTC) system; phases 2: LTC system development  and phases 3: evaluation of developed-LTC system through quasi-experimental research. The sample consisted of 38 caregivers who underwent Smart CG development, and the elderly with dependency condition were divided into 2 groups, namely the group before LTC system development that period during October 2019 to September 2020 and the group after LTC system development that period during October 2020 to September 2021. The research tool consisted of caregiver knowledge assessment form, skills assessment form and Barthel ADL index form. Data were collected and statistically analyzed by SPSS program. The statistics used including number, percentage, mean, standard deviation, paired t-test, McNemar test and Chi-square test.

The results showed that the developed- LTC system consisted of 4 systems including; 1) Quality Care plan preparation system 2) Elderly care giver development system (Smart CG (care giver) 3) Home visiting system with Buddy CG and 4) Trigger monitoring. After the implementation of the developed LTC system, the care plan preparation was significantly higher than before the development of the LTC system (94.5%, 89.9%, p=0.005). Importantly, the elderly in the homebound group that ADL score of 5-11 and the bed-ridden group that ADL score of 0-4 was significantly lower than before the LTC development (58.3%, 37.5 %, p<0.001, 50.0%, 20.8%, p<0.001). However, the incidence of new bedsore and the healing of bedsore were not significantly different (p>0.05). In conclusion, the developed LTC system increase the effective of optimize care for the elderly with dependency. Therefore, the administrators should be extended the developed-LTC system to cover all districts in Phetchabun province.