Abstract
A survey of institutional long-term care for persons, age 60 and over, in Thailand aims to study the background information on long-term care institutions. The number of personnel, competencies of care provider, types of services, and characteristics of care receivers in the north, north-eastern, central, Bangkok area, and the southern part of Thailand were investigated.
The findings revealed that there were 138 long-term care institutions, 49.28% situated in Bangkok with 43.48% being nursing homes. While residential homes provided all levels of care needed, nursing homes offered services ranging from care assistants for service at homes and palliative care in the institutions. However, 45% of nursing home had no professional nursing staff and 45.5% of institution had not been registered. Public residential homes had the highest number of beds while long-term care hospitals had the highest cost of services.
The majority of residents were female; ages 60-70, widowed, almost half had no adult children, and 86.8% had chronic illnesses. The most common illnesses were hypertension, arthritis, joint pain, diabetes, and heart disease. Information from health screening revealed that 41.6% had dementia and 29.5% had moderate to severe depression. From functional assessment, 15.9% were at a total dependency level. Interestingly, 52.3% of the residents had moderate to total dependency, 55.6% of them were in residential homes and need to be cared for 20-27 hours per week.
The majority of care providers was female, age range of 15 to 30 years old, had a high school level education, and was care assistants. Helper, occupational therapist and nurses were often found in the residential homes, nursing homes and long-term care hospital respectively while only social workers were found in the residential home. Although the majority of them had been trained in care of older persons, negative attitudes toward residents were still present. Work satisfaction was found at a high level while satisfaction for salary was at a moderate level. Nevertheless, they still wanted to continue working and gave more attention to knowledge, personal development and how to improve their standards of care giving.
The policy recommendation is: to promote collaboration between public and private sectors, encourage local authority to be a key provider, develop services to meet all level of care needs, set up care standards, and form a regulator and registration body. The practical recommendation is to promote the development of competent care providers and to provide more varieties of services. Further study using qualitative research methodology should be carried out for in-depth information.
