Problems and Needs of Long-Term Care for Elderly Community Dwellers Supported by Long Term Care Fund in Khon Kaen Province

Abstract

This research aimed to investigate the situations of problems and needs of long-term care for elderly community dwellers supported by the Long-Term Care Fund in Khon Kaen province to provide recommendations to national public health policy. Data were collected, from March to August 2017 using surveys, observations, in-depth interviews, focus groups and reviews of relevant documents from 4,989 elderly, 308 family caregivers, 8 care managers, 64 persons involved in the systems and 28 participated observations. Data were analyzed using thematic analyses, percentages and 95% CI.

The results showed that: 1) long-term dependency situation of the elderly in the community were found 66% of the elderly that had chronic illness. The prevalence of long-term dependence of the elderly was 10.16% which included 1.88% with total dependency, 2.29% with severe dependency, and 5.99% moderate dependency. Regarding the ability of the elderly to perform their essential activities of daily living (ADL), it was found that 28.36% of them had limitations to perform essential ADL and 9.26% of them had dementia. 2) In terms of the situation of long-term care for the family caregivers, It was found that most family caregivers were daughters (45%) followed by spouses with nearly 20%. Additionally, more than half of caregivers were also elderly persons and 64% of them had chronic illnesses and 11% of them had disabilities. Additionally, 82% of them had the overall quality of life at a moderate level. 3) The study found that care managers experienced long-term care as a due to lack of understanding of the system. Unclear guidelines on how to implement the long-term care fund made it a major obstacle to the development of community long-term care system for the elderly.

Problems and needs of long-term care for the elderly community dwellers were likely to increase. To develop the community long term care system for the elderly, it was essential to advocate the long-term care policy as a public policy with supports from partnerships especially from local governments and health sectors to create a long-term care system that fit to the community’s contexts and situations as well as supporting the elderly society in the future.