Abstract
The research objective of project “Policy Recommendation for model development of health services system and appropriated environment for elderly people in Town Municipality” were to 1) develop the health and environmental services for the elderly in Pathum Thani municipality and Khelang Nakhon Municipality, 2 ) evaluation of health and environmental service arrangements for the elderly in Pathum Thani Municipality and Khelang Nakhon Municipality and 3) synthesize policy recommendations on providing appropriate health and environmental services for the elderly in urban communities. Study design was conduct with AIC- Participatory Action Research. Qualitative data was collected from community leaders, health volunteer’s worker and government workers. Quantitative data was collected from 1,399 elderly people from Pathum Thani Municipality and 1,912 in Khelang Nakhon Municipality. The results showed that the development of health services system and appropriated environment for elderly people in Town Municipality are difference between Pathum Thani Municipality and Khelang Nakhon Municipality. The model proposed by Khelang Nakhon Municipality are to proactively organize health services for the elderly, organize recreational activities regularly, educating the elderly, setting up funds for elderly, establishing goodness banks, promoting the careers of the elderly care for the neglected or unsupervised elderly, improve the home environment, reshape and lighting of the house, provide suitable and safe shelters such as railings. While Pathum Thani Municipality proposes a model for patient referral system, EMS emergency operations centers express health volunteers to check in regularly with bedridden patients, creating value for the elderly by exchanging learning activities and earning money, find a model for sale promote the ability of caregivers to be elderly at home, organize communities, provide a conducive environment for learning for the elderly, such as online learning and assessing the environment in the elderly's home to be safe. The result of evaluation of health and environmental service arrangement models for municipal elderly found that blood glucose levels, blood pressure, body weight, body Mass Index in elderly people of Pathum Thani Municipal higher than the municipality of Khelang Nakhon, except muscle mass. Elderly people in Pathum Thani Municipality could normally defecation and urination around 90-94%, while the elderly of Khelang Nakhon Municipality the ability to defecation and urine normally 96-97 % Mental health problems in the elderly of both municipalities showed 56-62% of elderly people had the same mental health as the average, 17-21% better mental health than the average person, 19-21 % lower mental health than the average person. For depression problem in the elderly found 97% of elderly people are satisfied with their lives right now. Around 14-15% of elderly feel empty life, 12-15% feel frequently bored, 14-17% are constantly anxious and unthinkable, 21-23% have anxiety about life ahead, 17-21% is feel not as good memory as others, 7-8% feel discouraged or sad, and 5-6 % feel life is worthless. Quality of life status result found that elderly people are satisfied with their health now to a considerable extent. Around 6 2 - 6 7 % were most satisfied with sleep. 68-72% feel moderated satisfied in life (e.g. happiness, peace, hope). 65-81% feel a very high level of self-satisfaction and 65-68% as well as high satisfaction in other quality of life. Satisfaction on the appropriate health and environmental service model for the elderly of both municipalities is satisfied with the development process of the service model, but the implementation of the service model has not been fully implemented due to the complexity of the operation and requires public participation. This includes integrating work from different sectors, which must be conducted continuously. Religiously relevant activity patterns can incentivize older people to come out and participate. For environmentally safe housing arrangements in Kalen Nakhon Municipality Seven elderly people received municipal funding to repair toilets and stairs. For the municipality, Pathum Thani has not yet undertaken to explore a safe housing environment for the elderly. The Policy recommendations on providing appropriate health and environmental services for the elderly in urban communities including development of local government potential, integration of health information between local governments and health authorities for the development of the elderly services system, specify of qualifications and potential of public health volunteers, promoting supports public participation in elderly people and providing safe housing. Moreover, enhancing the use of health insurance fund budgets at the local level and push the role of educational institutions in creating initiative-taking changes in healthcare provision for local elderly people.
