The Development of Songkhla Provincial Administrative

Organization of the Elderly Day Care Model

Supaporn Kanokpet

, Wallapa Choeibuakaew

Graduate Student in Public Health, Faculty of Health and Sport Science, Thaksin University, Thailand

Faculty of Health and Sport Science, Thaksin University, Thailand

Keywords Elderly, Day Care, Model, Provincial Administrative Organization (PAO)

Abstract The purpose of this study was to develop Songkhla Provincial Administrative Organization of elderly care

model (SEDC Model) which is expected to fit Songkhla PAO context. The model was framed by following

the concept analysis process from literature review and data from stakeholder opinions. Four Songkhla PAO

administrators and six staff answered the opened-end question on “SEDC infrastructure and facility;

management; and service characteristics”. Ten elderly were asked for “service requirement and expected

services”. The result revealed three critical aspects of SEDC model: objectives, SEDC attributes and quality

assurance body. (1)The objectives of SEDC were to:1) promote the elderly’s maximum level of independence,

2) maintain and rehab the elderly’s present level of functioning, 3) delay and prevent further deterioration, 4)

increase the elderly’s social skills and adaptation and 5) be an integral part of community service network

for the elderly. (2)The attributes of the model were management, facility, staffing, services, connecting and

documentation. (3)The quality assurance referring to the ‘Mississippi Division of Medicaid Adult Day Care

Services Quality Assurance Standards’ consisted of overall requirement, facility, staffing, service and target

population and documentation. The dimension of connecting was added to the quality assurance system. The

further study should refine the SEDC model from the expert aspects and SPAO council. The model is expected

to generate to PAO of elderly day care over Thailand.

1 INTRODUCTION

The global population aged 60 years or over were 962

million in 2017, more than twice as large as in 1980

when there were only 382 million worldwide. The

number of oldsters is predicted to double again by

2050, when it is projected to reach nearly 2.1 billion

(United Nation, 2017). Every second, there are two

people turning to 60 years old. In Thailand, the

number of the elderly has dramatically increased from

10.7% in 2002 to more than 17% in 2019. The

estimated Thailand’s elderly population in the

midyear of 2019 was 11.358 million from the total

population of 66.374 million (Mahidol university

institute of population and social research, 2019). In

2021, Thailand will become a complete-aged society

and in 2031 will become a super-aged society

(National statistical office, 2018). In 2018, there were

210,921 elderly (14.72%) in Songkhla province and

projected to be 15% by the end of 2019 Department

of Older person: 2018) since Thai society has been

turning to a single family in the past 3 decades.

Majority of adults work full time and have their own

families. Thus, the elderly are left at home. Therefore,

the day care service to promote elderly health, well-

being and quality of life is needed.

Elderly day care is the service providing to

oldsters during daytime to maintain their physical and

mental health as well as their health rehabilitation

(Gunpong, 2017; Benjapon, 2015). The day care

includes programs, services, and facilities designed to

assist the elderly a community. The national adult day

care service association (US) passed the 6 standards

for the day care services: target population,

administration and organization, service, staffing,

facility and evaluation (NADSA. et al: 1997). The

ratio of the elderly day care staff to the elderly ranges

from 1:4 to 1:10 in the US day care agencies. From

the conducted observation, the elderly care model

includes community based option, residential living

apartment, community retirement care, active adult

retirement community, geriatric outpatient clinic,

nursing home, hospice care, dementia and

798

Kanokpet, S. and Choeibuakaew, W.

The Development of Songkhla Provincial Administrative Organization of the Elderly Day Care Model.

DOI: 10.5220/0009910507980801

In Proceedings of the 3rd Yogyakarta International Seminar on Health, Physical Education, and Spor t Science in conjunction with the 2nd Conference on Interdisciplinary Approach in Sports

(YISHPESS and CoIS 2019), pages 798-801

ISBN: 978-989-758-457-2

Alzheimer’s care, assisted living residence and day

care service. Nimasturaet al: 2018; Department of

Older Person: 2017; Aungkana: 2018

For the quality assurance and accreditation, the

Mississippi Division of Medicaid Adult Day Care

Services Quality Assurance Standards is widely

applied (Mississippi Division of Medicaid, 2019)

This consists of 5 requirements as shown in table

below.

Table 1: Mississippi Division of Medicaid Adult Day

Care Services Quality Assurance Standards.

equirements Details

1.Overall

equirement

-Administration and organization

.Facility -General requirements

-Atmosphere and design

-Safety and sanitation

-Evaluation

.Staffing -Lines of supervision and

responsibility

-Basic requirements for all

staff/volunteers

-Staff position

.Service and

arget population

-Target population

-services

-Community relation

.Documentation

equirement

-Quality improvement plan

-General record policies

-Participant records

-Administrative records

-Assessment and individual plan

of services and supports

-Access and audit

Local administration in Thailand was introduced

in corresponding to Government Administration Act

1933. In 1933-1955, there was a provincial council

representing for local administration. Later on, 1956-

1997, the Provincial Administrative Organization

(PAO) was developed and operated. Since 1997, the

PAO Act has been enacted and applied up until now.

PAO authorities consist of provincial infrastructure,

economic, social, education, public health, career

promotion and public services. The president and

members of PAO come from an election and work for

a term of four years. Moreover, Determining Plan and

Procedures in Decentralizations to the Local

Administrative Organization Act 1998 requires PAO

to provide public services regarding to social needs.

Songkhla PAO has dealt with the increasing number

of elderly. Thus, Songkhla PAO plans to expand the

services by providing the elderly centers to cover the

full range of day care services. Many countries and

some private sectors in Thailand provide day care

service for the elderly which can be learnt and applied

to Songkhla PAO context. However, PAO is a unique

organization. In addition, Songkhla PAO is the first

PAO of Thailand which will initiate the day care

service for the elderly (PAO legislation 2016: Elderly

Day Care Center). The relevancy of the model is

concerned and is expected to generate to the coming

PAO of the elderly day care over Thailand.

2 OBJECTIVES

The objective of this study was to develop the

Songkhla Provincial Administrative Organization of

the elderly day care model (SEDC model).

3 RESEARCH METHODOLOGY

The research was conducted aiming at developing

SEDC model to fit the Songkhla PAO context. This

was framed based on literature review and data

collected from stakeholder opinion. Thus, the concept

analysis (Walker and Avant: 1995) was used for the

model development; (1)

A review of the literature was

conducted toward some books and articles on PAO’s

rules and regulations, standards and guidelines from

day care agencies. The database (i.e. Thai Jo,

CINAHL, Science Direct and Emerald Management)

were used by the searching terms of ‘day care’, ‘the

elderly day care’, ‘quality assurance & elderly day

care’, ‘requirement & elderly day care’, and

‘management’. (2) The data were collected from the

stakeholder’s and the elderly’s opinion. The main

questions to be answered by the 4 PAO administrators

and 5 SPAO staff were; (1) What are the necessary

infrastructures and facilities required from the

SEDC?, (2) What is the appropriate management of

the SEDC?, (3) What are the expected services

provided by the SEDC?. Then, ten elderly were

asked; (1) What services do you need from SEDC?

and (2) Which quality of the SEDC service do you

prefer. The collected data, then, were analyzed by

using thematic analysis. (3) The application of

concept analysis proposed by Walker and Avant was

used for concluding the components of elderly day

care model. The 5 steps (from 8 steps) were applied:

selecting a concept, determining the aim of analysis,

identifying all uses of the concept, defining attributes

and constructing a model case (SEDC model).

The Development of Songkhla Provincial Administrative Organization of the Elderly Day Care Model

799

4 FINDINGS

The first SEDC model consisted of six objectives and

six integrated components as shown in figure 1.

Figure 1Songkhla PAO Elderly Day Care model (SEDC

model)

Objectives of the SEDC were to: (1) promote the

elderly's maximum level of independence. (2)

maintain the elderly's present level of functioning. (3)

rehab the elderly's present level of functioning. (4)

delay and prevent further deterioration. (5) increase

the elderly's social skills and adaptation. (6) serve as

an integral part of the community service network for

the elderly.

The model consisted of integrated components of

; (1) management. (2) staffing. (3) facility. (4)

services. and (5) documentation. The details of a

particular system were presented in table 2. The

connecting and quality assurance were needed to

sustain the systems.

Table: 2. Components and details of SEDC Model

Components

of the SEDC

model

Component details

Management leadership (leadership style, visionary,

charisma, policy, good governance)

law and regulation

management process (authority and

responsibility, organization, plan,

implementation, direction, budget and

evaluation)

resources/ income seeking and allocating

Application of modern management

concept (lean, risk management etc.)

evaluation

Facility transportation

building design fitting for the

elderly/disables

safety and sanitation

beauty salon

religious corner

lockers for the elderly’s belongings

Services health screening

Counselling

health promotion (exercise, recreation,

meditation),

disease prevention (brain improvement,

music therapy, creation),

health rehabilitation (Thai massage,

physical therapy)

occupational therapy

quality of life enhancement

continuous education

‘friend reunion’ facility

Quality services: friendly, nice and

empathy

Staff management (board of directors, advisory

board, managerial board of the SEDC)

The SEDC staff (psychiatrist,

psychologist, nurse, physical therapist,

Thai massage officer, recreational staff,

occupational staff, the elderly assistants,

clerk, security guard, housekeeper)

volunteer and internship students (need

orientation and understanding a care plan

before work)

Documentati

Documentation was pivotal to:

-protect customer right

-promote the elderly health assessment

-respond to legal aspect

-provide data for referral case

-report for accreditation.

The required documents were legislation,

regulations, standards and guidelines,

customer right, consent forms, personal

contact, customer health history, daily

report, progress report etc.)

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2019) in conjunction with The 2nd Conference on Interdisciplinary Approach in Sports (CoIS 2019)

800

The quality Assurance was developed by modifying

the Mississippi Division of Medicaid Adult Day Care

Services Quality Assurance Standards which is the

international adult day care standards. The guideline

consists of Administration and Organization, facility,

staffing, services, and documentation. Then the

dimension of “connecting” emerging from systematic

review and data collection was added into the quality

assurance system. Connecting meant understanding

the customers/stakeholders, sharing with others

(agency, people, community etc.), and creating and

maintaining the collaboration. The SEDC model will

fit the Songkhla PAO context and be expected to be

generalized for the PAO of the elderly day care.

5 CONCLUSION, DISCUSSION

AND RECOMMENDATION

The SEDC model consists of some objectives,

components, and quality assurance. The model was

developed by the lesson learnt from the elderly day

care agencies, especially the one in the US. This is the

first PAO of the elderly day care. Thus, evaluation

and refinement of the model will be needed at the

early period of providing the services.

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