Development of a Long-Term Care Model for Dependent Older Adults Through Community Participation at Ban Dongyang Health Promoting Hospital

Abstract

        This study aimed to: 1) examine the situation and problems of long-term care for dependent older adults 2) develop a community-based long-term care model 3) evaluate the effectiveness of the developed model. This participatory action research was conducted at Ban Dongyang Health Promoting Hospital, Maha Sarakham Province, Thailand. The participants included 482 older adults, 30 dependent older adults, 30 primary caregivers, and community network members. The research instruments consisted of the Barthel Activities of Daily Living (ADL) Index, a knowledge test, a satisfaction questionnaire, and interview guidelines. Quantitative data were analyzed using descriptive statistics and paired t-test, while qualitative data were analyzed using content analysis.

        The results revealed that: 1) Regarding the situation and problems, 12.13% of older adults were dependent, with a mean ADL score of 8.90, indicating moderate to severe dependency. Caregivers had insufficient knowledge, and the continuity of care services was limited. 2) The developed model consisted of three key components: defining roles and responsibilities of community networks, enhancing caregivers’ capacity, and establishing a continuous care service system. 3) After six months of implementation, caregivers’ knowledge significantly increased (p < 0.001), with the mean score rising from 8.20 to 13.40. The ADL scores of dependent older adults also significantly improved (p < 0.001), increasing from 8.37 to 11.27. Caregivers reported the highest level of satisfaction with the model ( = 4.57, SD = 0.49). 4) The reflection phase indicated that the model enhanced caregivers’ knowledge and confidence, improved continuity of care, and strengthened the community health care system.

        In conclusion, the community-based long-term care model improved functional ability among dependent older adults. Enhancing caregivers’ capacity and promoting community participation contributed to strengthening the long-term care system at the primary care level. This model should be implemented in other communities to support healthy aging in an aging society.