The Study on Empowering the Elderly

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The Study on Empowering the Elderly In 4
Accredited HPHs in Thailand
Auamkul, N Jongvanich, J Teechamahachai, C and
Liengpanskul, S
The 13th International Conference on Health
Promoting Hospital, Dublin, Ireland May 18-20,
2005
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Standard of HPH Thailand
1 Leadership 2 Resource management 3 Supportive
physical, social and learning env. for
health 4 HP for staffs 5 HP for clients and
relatives 6 HP for people in the
community 7 Result
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Thailand
H P H s
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Objective
To study the driver, the system and the process
conducted to empower the elderly for health in 4
accredited health promoting hospitals in Thailand.
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Method
Method - Qualitative study - Interviewing - O
bservation - Reviewing the document
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2 Nakon Ratchasima
1 Chiangmai
Study Sites HPH
3 Cholburi
4 Songkla
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Study Population - Administrators - Hospital
director - Member of the local adm. - Service
providers - Physicians - nurses - Public
health personnel, etc - Health
Volunteers - Aging people and their families
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Result
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Hospital 1
(Mae aye Hospital)

• Community hospital in the northern region
• Thai people and highland population, migrant
  people
• Health problems HIV/AIDS, COPD
• Risk group orphans, elderly people

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Mae aye Hospital
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Hospital 1

• Visionary leadership
• Accreditation HA and HPH
• Intersectoral co-operation
• Public and private sector co ordination
• Active outreach approach
• Integrated service for people of all age groups
• Mobilization of external resources

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Hospital 1
Empowering the aging people

• Integrated health service
• Holistic care
• Strengthening community action
• Income generation
• Village fund
• Friend help friend Home visit
• Health personnel as facilitators

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Learning process
VISUAL
Learners
AUDITORY
KINESTHETIC
Learners
Learners
AKV, AVK, VKA, KAV and KVA
Source Markavas The Open Mind (1996) in
Scholtes, P.R, The Leaders Handbook, 1998, p
35-36
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Plan
Act-Plan
Act-Plan
Theory
Application
Do-Study
Do-Study
Do-Study
PLAN
ACT
DO
STUDY
Continuous Quality Improvement
Source Schlotes, P.R. The Leaders Handbook,
1998, P. 34
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Supportive Env.
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HP for the clients
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HP for the community
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Hospital 1
Result of empowerment

• Elderly people
• Healthy and happy
• Elderly people who stay alone was taken care
• Community
• Mutual support
• Hospital workload on curative service

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Hospital 2
(Dan Khun Tod Hospital)

• Community hospital in the northeastern region
• Visionary leadership
• Intersectoral co-operation
• Accreditation HA HPH
• Integrate health service from hospital to family
  and community
• Empower patient and family
• Empower elderly people club

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Hospital 2
Planning together
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Strategic Map
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Chronic disease patient
Result Decrease readmission
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TB patients
Result Average increase of lung capacities 100
cc. /mo. in 85 of patients participated in this
empowering activities
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Hospital 2
Result

• Elderly people
• knowledge and skill
• quality of life
• Hospital
• readmission rate

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Hospital 3
(Aue Udom Hospital)

• Community hospital in the central region
• Vision
• Create learning environment for health in the
  hospital
• Empowering aging patients
• Empowering the caregivers of aging patients and
  chronic disease patients
• Integrated health service from hospital to family
  and community

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Hospital 3
Diabetic Volunteers in the Community

• Empower the elderly diabetic patients to be
  volunteers
• Facilitate them to organize activities eg.
  Exercise, food controlling, relaxation activity,
  self-evaluation and blood sugar level controlling

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Hospital 3
Result

• Elderly people
• drug intake
• FBS less than 140 mg/ml increased from 17 to 38
• FBS less than 180 mg/ml decreased from 52 to 24
• QOL
• Hospital
• workload
• expense

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Hospital 4
(Rattaphum Hospital)

• Community hospital in the southern region
• Visionary leadership
• Accreditation HPH
• One of the empowerment activities for the elderly
  people is Exploring Rattaphum Club

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Hospital 4
Exploring Rattaphum Club

• Started since October 2001
• A group of six people initiated the idea of
  walking together for health (The director of the
  Rattaphum Hospital was one of the pioneers)
• Not only walking for physical health but also for
  mental, social and spiritual health
• Have regular activity on every Sunday since
  28/10/01

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Hospital 4
Schedules

• Appointment notification (verse) before next
  Sunday
• Prompt start at 6.30 a.m., 2-3 km. walking
  distance
• If it is too far to walk, they will go by car
  pool and get off to walk
• If the route is unsafe to walk, they will go
  there by car and do other type of physical
  exercise
• The guide or the owner of the place visited will
  explain and provide information

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Hospital 4
Schedules (cont.)

• During breakfast
• Read the next appointment verse
• Read the last visit poetry, using the southern
  culture style
• Introduce new member
• Entertainment singing, story telling
• Knowledge sharing on health, economics,
  religious, culture, etc.
• Comment and discussion

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Hospital 4
Result Elderly and other member

• knowledge and skill on exercise for health
• knowledge about good people / model people,
  products, activities and places in their own
  district
• Able to provide the success story and district
  information to others
• self esteem, proud to be Rattaphum people,
  Thai people
• Healthy and happy

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Hospital 4
Result (cont.) Club

• Members increased from 15 to 130
• Average number of members that join every Sunday
  was 70-80
• Until 6/3/05 the activities were held 157 times

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Hospital 4
Result (cont.)

• Community
• unity
• Hospital
• workload on curative service
• health communicators
• Expansion of networking

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Conclusion
Driver
System
Result

• Leadership
• Vision
• Good governance
• Com. responsibility
• Soc. reponsibility

• Strategic plan
• Inf. sys.
• HRD Emp.
• HR management
• Sufficient resources
• Healthy workplace
• Service system
• In hosp.
• Outreach
• ActivegtPassive
• Networking system

• Client
• satisfaction
• health literacy
• well-being QOL

• Hospital
• readmission
• reach the target set
• Award
• Cert. of recog.

• Org. culture
• core value
• Pop. health oriented
• People centered
• Holistic approach
• Soc./com. resp.
• Shared vision
• Clear obj.
• CQI/LO

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Understanding needs of the elderly (4 basic
needs - to live - to learn - to love
beloved - to leave legacy)
Conclusion
Holistic care (body, mind, heart and spirit)
Manifestation of need discipline vision
alert passion (love to do) conscience (do
whats right)
Healthy Elderly People
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Recommendation

• Need leadership
• Building capacity of the health personal
  empowerment
• Create supportive environment for empowerment
• Build partnership
• Need knowledge sharing and knowledge management
  for continuous quality improvement

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Thank You
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Sawasdee