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CARE CENTRES – A ROLE FOR PALLIATIVE CARE? Dato ’ Seri Dr T Devaraj Penang Hospice
CARE CENTRES – A ROLE FOR PALLIATIVE CARE? Dato ’ Seri Dr T Devaraj Penang Hospice

CARE CENTRES A ROLE FOR PALLIATIVE CARE?

CARE CENTRES – A ROLE FOR PALLIATIVE CARE? Dato ’ Seri Dr T Devaraj Penang Hospice

Dato’ Seri Dr T Devaraj Penang Hospice Society

CARE CENTRES – A ROLE FOR PALLIATIVE CARE? Dato ’ Seri Dr T Devaraj Penang Hospice
SOURCE: Takeo Ogawa, Ph.D Kumamoto Gakuen University
SOURCE: Takeo Ogawa, Ph.D
Kumamoto Gakuen University
SOURCE: Takeo Ogawa, Ph.D Kumamoto Gakuen University
SOURCE: Takeo Ogawa, Ph.D Kumamoto Gakuen University
SOURCE: Takeo Ogawa, Ph.D Kumamoto Gakuen University
THE SUN, 23 JANUARY 2012
THE SUN, 23 JANUARY 2012
Sunday Star , 16 Jan 2011
Sunday Star , 16 Jan 2011

Sunday Star , 16 Jan 2011

Sunday Star , 16 Jan 2011
Sunday Star , 16 Jan 2011
Sunday Star , 16 Jan 2011

WHO IS MY PARENT’S KEEPER ?

Historically - family, filial piety

Social changes - from

agricultural to industrial urbanization / modernization

WHO IS MY PARENT’S KEEPER ?  Historically - family, filial piety  Social changes -

Increasing ageing

Burden LTC physical, emotional, $

New values individualism, choice, independence

Costs of living rising

WHO IS MY PARENT’S KEEPER ?  Historically - family, filial piety  Social changes -
WHO IS MY PARENT’S KEEPER ?  Historically - family, filial piety  Social changes -

Role of state hands off, regulator, enforcer to care provider

WHO IS MY PARENT’S KEEPER ?  Historically - family, filial piety  Social changes -
WHO IS MY PARENT’S KEEPER ?  Historically - family, filial piety  Social changes -
WHO IS MY PARENT’S KEEPER ?  Historically - family, filial piety  Social changes -

MALAYSIAN SCENARIO

  • 2010 30 : 70

 Historically  Old folk homes - very few via state - elderly immigrants  charities
Historically
Old folk homes - very few via state - elderly
immigrants
charities -faith based, NGO’s
Orphanages
few, ethnic
mainly NGO’s
Think point of note:
Population rural: urban 1957 70 : 30
MALAYSIAN SCENARIO 2010 30 : 70  Historically  Old folk homes - very few via
1952
1952
1952
1952
1952
1952
1995

1995

1995
1995
Kinta Medical Centre – Kinta Healthcare Home Established in 1980
Kinta Medical Centre – Kinta Healthcare Home Established in 1980

Kinta Medical Centre Kinta Healthcare Home Established in 1980

Kinta Medical Centre – Kinta Healthcare Home Established in 1980
Kinta Medical Centre – Kinta Healthcare Home Established in 1980

CARE IN THE COMMUNITY

DEVELOPED COUNTRIES

DEVELOPING COUNTRIES

  • more recent, rapid

  • homes by NGO’s

  • little by state

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

 Gradual changes over decades  Care systems – residential homes nursing homes/ hospice home Who
Gradual changes over
decades
Care systems – residential
homes
nursing homes/ hospice
home
Who is my parents keeper?
*family
*state – support, funds, laws
CARE IN THE COMMUNITY DEVELOPED COUNTRIES DEVELOPING COUNTRIES  more recent, rapid  homes by NGO’s

AUSTRALIA AGED CARE

  • church based / others

 HOME CARE  support after hospitalization  aged care at home / dementia  day
HOME CARE
support after hospitalization
aged care at home / dementia
day therapy centers
RESIDENTIAL CARE
elderly ( independent living, assisted living, nursing
homes)
dementia
APPROACH OF STATE / FEDERAL GOVERNMENT
help – when at home
when in residential care
OTHER PLAYERS
private sector
SOURCE: Takeo Ogawa, Ph.D Kumamoto Gakuen University
SOURCE: Takeo Ogawa, Ph.D
Kumamoto Gakuen University
SOURCE: Takeo Ogawa, Ph.D; Kumamoto Gakuen University

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

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

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
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

www.jkm.gov.my

 Require approval of technical agencies – local council, fire and rescue dept, health dept 
Require approval of technical agencies – local council, fire and
rescue dept, health dept
Fulfils Dept of Social Welfare’s 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

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

NURSING HOMES  “nursing care” means any care for patient that is provided by a registered
NURSING HOMES  “nursing care” means any care for patient that is provided by a registered

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

KINDS OF RESIDENTIAL CARE NEEDS  Elderly  old  Frail  Disability  dementia 
KINDS OF RESIDENTIAL CARE NEEDS  Elderly  old  Frail  Disability  dementia 
PALLIATIVE CARE NURSE ON A HOME VISIT

PALLIATIVE CARE NURSE ON A HOME VISIT

PALLIATIVE CARE NURSE ON A HOME VISIT
PALLIATIVE CARE NURSE ON A HOME VISIT
PALLIATIVE CARE NURSE ON A HOME VISIT
WHEN ONE IS ILL PT TAKING CARE TO THE HOME 1992 HHP PT HOSP. CLINICS

WHEN ONE IS ILL

WHEN ONE IS ILL PT TAKING CARE TO THE HOME 1992 HHP PT
PT
PT

TAKING CARE TO THE HOME

1992 HHP
1992
HHP
WHEN ONE IS ILL PT TAKING CARE TO THE HOME 1992 HHP PT
PT
PT
WHEN ONE IS ILL PT TAKING CARE TO THE HOME 1992 HHP PT HOSP. CLINICS
HOSP. CLINICS
HOSP.
CLINICS
WHEN ONE IS ILL PT TAKING CARE TO THE HOME 1992 HHP PT HOSP. CLINICS

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
PT
RESIDENTIAL HOMES - ROLES FOR HOSPICE  Hospice care for residents requesting care  Support holistic
RH
RH
RESIDENTIAL HOMES - ROLES FOR HOSPICE  Hospice care for residents requesting care  Support holistic
RESIDENTIAL HOMES - ROLES FOR HOSPICE  Hospice care for residents requesting care  Support holistic