การเสริมสร้างครอบครัวและชุมชนในการดูแลผู้สูงอายุติดเตียงและเจ็บป่วยระยะสุดท้าย

“Family and community empowerment for bedridden and palliative care for the
elderly” aimed to study the problems and obstacles for caring as well as to establish model
development to increase quality of life of the elderly bedridden. The combination between
quantitative and qualitative methods were performed with 45 primary caregivers in 14
communities of Khukhot Municipality, Lam Look Ka district, Pathum Thani province, and 20
key informants were also invited for in-depth interviews. The workshop for family and
community empowerment was performed by using Appreciation-Influence-Control (AIC) to
create a model development. Descriptive statistical analysis and content analysis were used
as the main tools for data conclusion and interpretation.

The findings indicated that the vast majority of elderly bedridden were female, aged
71-80 years. Stroke played an important cause of illness and they had long been suffered on
the bed for 1-5 years. All of them were totally dependent on their caretakers. The primary
caregivers were also female, aged 51-60 years, and most of them were married. Approximately
10% of the primary caregivers were demented, 36.36% were identified at high level of stress,
56.82% were depressed, and three-fourth were less happy than the normal people. Moreover,
the quality of life (QOL), measured by SF-36 Thai version, were found at low level.

Problems and obstacles for caring the elderly bedridden were (1) personal identity of
the elder (2) personal identity of the primary caregiver (3) low family relationship (4) lack of
medical system (5) lack of social and environment conditions. Social and health needs from
primary caregiver point of views were (1) improving emergency medical services (2)
handicapped registration for health rights (3) improving medical services (4) increasing
homecare for the elderly (5) holistic integration of home visit (6) appropriate health education
for primary caregiver (7) supporting medical equipment for daily living (8) supporting and
increasing some medical services and equipment in universal health coverage service.

Finally, the conclusion from the workshop indicated that: “emergency medical
services” “handicapped registration for health rights and medical accessibility” “development
of Village Health Volunteer” and “integrated health care team for the elderly” are the key
factors for health and well-being of the elderly bedridden, which need to be developed and
implemented.