Community Clinics a Boon for the Elderly

By Apidaree Treerukuarkul, Bangkok Post

February 16, 2009

Thailand  

Mukda Chaina has been taking care of her 82-year-old father, Ai, who suffers from Alzheimer's disease, for more than two years.

The first symptoms of the disease appeared in 2006 as he became forgetful and couldn't even remember whether he had eaten.

Gradually, the symptoms got worse. There were days when he could not sleep and would walk around the house at night.

Once a month, Mrs Mukda took her father to see a specialist at a hospital in the heart of town. They had to be at the hospital very early to confirm the appointment and would spend almost the whole day there.

"Sometimes I feel so depressed. Looking after an old man with Alzheimer's can really consume you both physically and mentally," she said.

The illness is not only a strain for the patient but also those who have to take care of them.

Of the 10 million senior Thai citizens, one million are expected to suffer from Alzheimer's, said Tasanee Tantirittisak, head of the neurological department at the Prasart Neurological Institute in Bangkok.

The National Health Security Office (NHSO) is trying to develop community clinics across the country to reach those suffering from the disease. A pilot community clinic was set up in 2007 at the San Sai Community Medical Unit in San Sai district in Chiang Mai.

The Klai Ban Klai Jai (Near House, Near Heart) project set out to offer better health care services to the community.

Amporn Iamsri, director of the San Sai Community Medical Unit, said there had been a good response to the project from residents.

A team of doctors, nurses, pharmacists and health volunteers visit patients at their homes.

"Meeting villagers, including visits to their homes, is part of the routine for every doctor and health official here," Dr Amporn said. "Villagers don't have to waste time travelling to the hospital. The home visits also boost doctor-patient relations."

Since Alzheimer's is not covered by the universal health care scheme, nursing care is essential. Dr Amporn said volunteers can be a big help to the patients and their carers, who also can get depressed.

Patients with serious symptoms are transferred to big hospitals in the city.

Ampai Saengkham, a health volunteer in San Sai district for 11 years, said she had two elderly cases, both suffering from Alzheimer's, under her care.
Both are over 70 and show similar symptoms - insomnia and an inability to take care of themselves.

For the patient's carer, a visit by health volunteers can help them relax, easing their stress by giving them someone to talk to, she said.

Community visits also allow volunteers to monitor the health of locals and share information with doctors, which is vital if service improvements are to be made at the community level, she said.

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