CARE CENTRES A ROLE FOR PALLIATIVE CARE?

Dato Seri Dr T Devaraj Penang Hospice Society

THE ECONOMIST, 27 June 2009

SOURCE: Takeo Ogawa, Ph.D Kumamoto Gakuen University

THE SUN, 23 JANUARY 2012

THE SUN, 14 July 2011

NST, 12 MARCH 2012

NST, 2 Nov 2011 Sunday Star , 16 Jan 2011

NST, 19 Sept 2011

NST, 30 JUNE 2010

The Star, 18 Dec 2011

WHO IS MY PARENTS KEEPER ?

Historically - family, filial piety Social changes - from agricultural to industrial urbanization / modernization Increasing ageing Burden LTC physical, emotional, $ New values individualism, choice, independence Costs of living rising Role of state hands off, regulator, enforcer to care provider

NST, 13 Jan 2012

MALAYSIAN SCENARIO
Historically

Old folk homes - very few via state - elderly immigrants charities -faith based, NGOs
few, ethnic mainly NGOs

Orphanages

Think point of note: Population rural: urban 1957 70 : 30 2010 30 : 70

1952

1995

NST, 18 Oct 2011

Kinta Medical Centre Kinta Healthcare Home Established in 1980

CARE IN THE COMMUNITY

DEVELOPED COUNTRIES Gradual changes over decades Care systems residential homes nursing homes/ hospice home Who is my parents keeper? *family *state support, funds, laws DEVELOPING COUNTRIES more recent, rapid

homes by NGOs little by state

*responsibility - family *state - regulatory laws *no funding

AUSTRALIA AGED CARE

HOME CARE

RESIDENTIAL CARE

support after hospitalization aged care at home / dementia day therapy centers
elderly ( independent living, assisted living, nursing homes) dementia help when at home when in residential care private sector church based / others

APPROACH OF STATE / FEDERAL GOVERNMENT

OTHER PLAYERS

SOURCE: Takeo Ogawa, Ph.D Kumamoto Gakuen University

SOURCE: Takeo Ogawa, Ph.D; Kumamoto Gakuen University

SOURCE: Takeo Ogawa, Ph.D Kumamoto Gakuen University

MALAYSIAN LAWS
Current Laws:
Care

Centre Act 1993 elderly, orphanages, children (day care), OKU Jan 2012 only 1332 registered / 1886 not registered

Private

Health Care Facilities and Services Act 1998/2006 no nursing home registered yet in Penang

CARE CENTRES

The Law requires that every care centre is registered and utmost importance is placed on the welfare, well-being and safety of its residents or persons who receive care at a centre Day Care Centre and Residential Care Centre Register with Registrar of Companies or ROS Require approval of technical agencies local council, fire and rescue dept, health dept Fulfils Dept of Social Welfares minimum standards as follows: ratio caregiver and residents / persons received for care comply with the minimum space balanced and nutritional diet approved programme of daily activities equipped suitable, safe and adequate furniture, equipment maintains hygiene, healthy and safe environment within and around centre www.jkm.gov.my

NURSING HOMES

nursing care means any care for patient that is provided by a registered nurse in accordance with the directions of a registered medical practitioner or registered dental practitioner and accepted nursing practice
80. (1) (a) the medical management of patients vests in a registered medical practitioner or a visiting medical practitioner caring for the patients in the premises

private nursing home means any premises, other than a Government nursing home, used or intended to be used for the reception of, and the provision of nursing care, for persons suffering or convalescing from any sickness, injury or infirmity Standards for private nursing homes (regulations 353 - 374
Private Health Care Facilities and Services Act & Regulations 1998 / 2006

NB. Not a single nursing home registered to date in Penang

KINDS OF RESIDENTIAL CARE NEEDS

Elderly old Frail Disability dementia Chronic illness elderly others

Think Point: welfare vs care continuum need for a holistic approach

PALLIATIVE CARE NURSE ON A HOME VISIT

WHEN ONE IS ILL

HOSP.

CLINICS

PT

TAKING CARE TO THE HOME

HHP 1992

PT

RESIDENTIAL HOMES - ROLES FOR HOSPICE

Hospice

care for residents requesting care Support holistic care Train staff towards holistic care

TAKING CARE TO THE HOME

PT

RH