While there is an increasing need for institutional long-term care, however, there is still lack of neither good practice guideline nor registration bodies to regulate institutional long-term care. This study aims to explore the caring practice and to recommend model of institutional long –term care in Thailand. Qualitative research method, such as focus group discussion and in-dept interviews were carried out for seeking opinion and practice experience from the academic expertise, care providers, care receivers and policy maker of 60 participants.
It was revolved that there were 2 models of Institutional long-term care; 1) low care model for older person who need social care and assisted living with minimal health care such as, residential home and assisted living. The staff included social worker, nurse, care assistant, physiotherapist and occupational therapist and 2) high care model for older person who need continuing care, nursing care and somewhat medical care, due to being frail or chronically ill, thus the staff included nurses, care assistant and medical doctors. This type of institution were nursing home, long-term care hospital and hospice care unit. The caring would focus on holistic care, comfort and spiritual care. In each model need to include philosophy of care and minimum care standard.
Policy recommendation are: to divide institutional long-term care into two levels, low care and high care; assigning low care institution to register with Ministry of Social Development and Human Security and the high care facility to register with Ministry of Public Health; to develop a minimum care standard at national level; to establish nursing home by local authority and encourage the private sector to particulate in providing care; and encourage community hospital to provide intermediate care. For practice recommendation, to have a clearer criteria for nursing home setting, to develop a dependent assessment tools, to provide sufficient information related to national policy on private setting, encourage volunteer in caring for older person, and media communication in a positive way.