care centres – a role for palliative care_dato' seri dr t devaraj

7/31/2019 CARE CENTRES A ROLE FOR PALLIATIVE CARE_Dato' Seri Dr T Devaraj

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CARE CENTRESA ROLEFOR PALLIATIVE CARE?

Dato Seri Dr T

DevarajPenang Hospice Society


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THE ECONOMIST, 27 June 2009


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SOURCE: Takeo Ogawa, Ph.DKumamoto Gakuen University


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THE SUN, 23 JANUARY 2012


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THE SUN, 14 July 2011


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NST, 12 MARCH 2012


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Sunday Star , 16 Jan 2011

NST, 2 Nov 2011


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NST, 19 Sept 2011


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NST, 30 JUNE 2010


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WHO IS MY PARENTS KEEPER ?

Historically - family, filialpiety

Social changes - fromagricultural to industrialurbanization /

modernization Increasing ageing

Burden LTCphysical,emotional, $

New valuesindividualism,

choice, independence Costs of living rising

Role of statehands off,regulator, enforcer to careprovider

The Star, 18 Dec 2011


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NST, 13 Jan 2012


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MALAYSIAN SCENARIO

Historically

Old folk homes - very few via state - elderlyimmigrants

charities -faith based, NGOs

Orphanages few, ethnic

mainly NGOs

Think point of note:

Population rural: urban 1957 70 : 30

2010 30 : 70


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1952


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1995


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NST, 18 Oct 2011

Kinta Medical CentreKinta Healthcare Home Established in 1980


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CARE IN THE COMMUNITY

DEVELOPED COUNTRIES

Gradual changes overdecades

Care systemsresidential

homesnursing homes/ hospicehome

DEVELOPING COUNTRIES

more recent, rapid

homes by NGOs

little by state

Who is my parents keeper?*family *responsibility - family*statesupport, funds, laws *state - regulatory laws

*no funding


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AUSTRALIAAGED CARE 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 helpwhen at home

when in residential care OTHER PLAYERS private sector church based / others


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


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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 Act1998/2006

no nursing home registered yet in Penang


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CARE CENTRES The Law requires that every care centre is registered and utmost

importance is placed on the welfare, well-being and safety of itsresidents 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 agencieslocal 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 andaround centre

www.jkm.gov.my


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NURSING HOMES

nursing care means any care for patient that is provided bya registered nurse in accordance with the directions of aregistered medical practitioner or registered dentalpractitioner and accepted nursing practice

80. (1) (a) the medical management of patients vests in a registeredmedical practitioner or a visiting medical practitioner caring for thepatients in the premises

private nursing home means any premises, other than aGovernment nursing home, used or intended to be used forthe reception of, and the provision of nursing care, for personssuffering 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


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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


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PALLIATIVE CARE NURSE ON A HOME VISIT


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WHEN ONE IS ILL

PT

HOSP.

CLINICS

TAKING CARE TO THE HOME

HHP

1992PT


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RESIDENTIAL HOMES - ROLES FOR HOSPICE

Hospice care for residents requesting care

Support holistic care

Train staff towards holistic care

TAKING CARE TO THE HOME

RH

PT

care centres – a role for palliative care_dato' seri dr t devaraj

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