Development of a Participatory Care Model for Dependent Older Adults in a Subdistrict Elderly Care Center: The Chan Yai Model

Abstract

This research and development study aimed to examine the situation and determinants of care for dependent older adults, develop a participatory care model for a subdistrict elderly care center, and evaluate its effectiveness on activities of daily living. The study was conducted in three phases: situational analysis, model development, and model implementation with outcome evaluation. Participants comprised 193 individuals, including 132 dependent older adults and 61 stakeholders involved in the community-based care system. Research instruments included questionnaires, the Barthel Activities of Daily Living Index, in-depth interview guides, and focus group discussion guides. Quantitative data were analyzed using descriptive statistics,  t-test, one-way ANOVA, Pearson’s correlation coefficient, multiple linear regression, and paired  t-test. Qualitative data were analyzed using content analysis. The findings showed that most dependent older adults were female (68.18%), with a mean age of 74.58 years. The baseline mean ADL score was 12.94. Significant predictors of ADL were age, disease severity, dementia severity, family participation, and family support, collectively explaining 64.7% of the variance. The developed “Chan Yai Model” consisted of four collaborative sectors, three dependency groups, two operational mechanisms, and one coordinating center. After implementation, the mean ADL score increased from 12.94 ± 7.87 to 15.24 ± 4.76, with a statistically significant difference (p < .001). The model demonstrates potential for strengthening community-based long-term care through ADL-driven case management and participatory governance.