Palliative care needs and Characteristics of Patients in Nursing Homes in Mueang Khon Kaen District, Khon Kaen Province, Thailand

ความต้องการการดูแลแบบประคับประคองและลักษณะของผู้ป่วยในศูนย์ดูแลผู้สูงอายุ อำเภอเมืองขอนแก่น จังหวัดขอนแก่น ประเทศไทย

Abstract

This study aimed to examine the characteristics of patients in elderly care centers (nursing homes) and explore their palliative care needs in Mueang Khon Kaen District, Khon Kaen Province. It was a retrospective descriptive study employing a document review of project materials from the “Development of a Palliative Care System for Older Persons in Elderly Care Centers,” conducted by the Karunruk Palliative Care Center, Srinagarind Hospital. Data were collected between July and October 2023 using a structured questionnaire covering four domains: general characteristics, care situations in elderly care centers, implementation of palliative care services, and referral and continuity of care.

            Of the eight nursing homes in the province, seven participated (response rate 87.5%). At the time of the survey, 76 residents were living in these facilities; 78.95% were aged over 65 years. Most residents (76.32%) were totally dependent, while 22.36% were partially dependent. The most common diagnoses were dementia (56.58%) and stroke (25%). Advance care planning implementation varied across facilities: one reported 100% coverage, one 40%, three 25%, and two 10%. Key palliative care needs were knowledge of enteral feeding in advanced dementia, management of behavioral and psychological symptoms of dementia, family conflict resolution, financial support for long-term neglected patients, clear hospital referral protocols for emergencies, confidence in honoring ACP, and end-of-life care in nursing homes. More than half of residents were totally dependent older adults with dementia who may benefit from palliative care. Recognizing these needs is essential for developing and strengthening an integrated palliative care model in nursing homes.