Development of a Health Care System for Bedridden Older Adults in the Community

Abstract

This research and development study aimed to examine the current situation of care for bedridden older adults in the community and to develop and evaluate a health care system for bedridden older adults in the community. The study sample consisted of individuals involved in the care of bedridden older adults and family caregivers, totaling 40 participants. The study was conducted in three phases: 1) assessment of the current situation of care for bedridden older adults in the community; 2) development of a health care system for bedridden older adults in the community; and 3) evaluation of the health care system for bedridden older adults in the community. The research instruments included a focus group discussion guide, a social support assessment questionnaire, a quality of life assessment questionnaire, and a satisfaction questionnaire regarding the health care system for bedridden older adults in the community. Data were analyzed using descriptive statistics and the Wilcoxon signed-rank test.

The results showed that the health care system for bedridden older adults in the community involved responsible organizations from both the health care team and the Subdistrict Administrative Organization, which provided care-related equipment and arranged care assistants for dependent older adults in the community; however, the system was not yet comprehensive or fully integrated across all relevant organizations. The developed community-based care system comprised six components: 1) assessment of dependency levels and support needs, 2) support for establishing a social welfare system to enhance access to health services for dependent older adults, 3) home visits for bedridden older adults, 4) home environment modification, 5) access to emergency services, and 6) development of caregivers’ knowledge and caregiving skills. The evaluation of the implementation of the health care system in the community, as assessed by the social support of caregivers of bedridden older adults before and after system development, demonstrated a statistically significant difference (p-value = 0.048), whereas caregivers’ quality of life did not show a statistically significant difference (p-value = 0.44). The findings suggest that the health care system in the community for bedridden older adults should be further applied and evaluated to examine its effectiveness in promoting the quality of life of caregivers of bedridden older adults.