Development of Community Health System for the Elderly Care at Risk for Falls: a Case Study of Duthung Subdistrict, Mueang district, Yasothon Province

Abstract

This participatory action research was to develop and evaluate the community health system for the care of the elderly at risk of falls. The samples were all elderly people aged 60 years and over (480 individuals) in Duthung sub-district, Mueang District, Yasothon Province, caregivers and stakeholders. The process consisted of four steps: (1) Planning, (2) Action, (3) Observing and (4) Reflecting. The screening results showed that the falls risk in elderly was at 22.5%. The operations in the past were lack of participation from relevant stakeholders and with unclear model. The community health system plan that developed in this study included (1) screening and health promotion for the elderly at risk, (2) caring for the elderly in fall group, and (3) continuity care system development. After the implemenation, the elderly had knowledge, knew the channels and were able to ask for help in the event of an emergency. They received home visits through stakeholder participation resulting in significant satisfaction (p<0.05). The established community health system consisted of six components; (1) set up a committee, (2) screening and health promotion of the elderly at risk, (3) building potential of the elderly, caregivers, and health worker; (4) home visits and continuity care for high-risk elderly; (5) development of a system for accessing emergency medical services; and (6) development of a database system for the elderly. This community health system including health promotion, prevention, primary care, referral and ongoing treatment could be used for the implementation of the elderly care in any community. Long-term monitoring and evaluation of the intervention should be continuously assessed.