Health service delivery models for elderly people: A systematic review

Exploring the implementation of multidisciplinary collaboration at nursing homes in Jakarta, Indonesia: A descriptive phenomenological study

Background

A well-functioning multidisciplinary team optimizes resource utilization and reduces care redundancy, fragmentation, and wastage. Collaborative efforts yield a clearer understanding of older people's needs and desires, significantly reducing hospitalization days. Despite limited studies, particularly in Indonesia, investigating professionals' experiences in implementing multidisciplinary collaboration in government nursing homes, nursing care quality remains a concern.

Objective

This study aimed to explore the implementation of multidisciplinary collaboration in nursing homes from the perspectives of various disciplines.

Methods

A descriptive phenomenological study was used with semi-structured interviews and focus group discussions with multidisciplinary care providers, including nurses, doctors, social workers, physiotherapists, psychologists, occupational and recreational activity instructors, and clergy in nursing homes owned by the Jakarta provincial government. A total of 64 participants were involved, and data were collected from September 2022 to July 2023. Data were analyzed using content-based analysis.

Results

Three main themes emerged: 1) context of multiple collaborations, 2) barriers to implementing multiple collaborations, and 3) impacts of non-optimal multidisciplinary collaborations. Nursing home management's multidisciplinary teams predominantly implement professional-centered care with limited support systems. While providers generally perceive collaboration positively, shared responsibility and joint work among professionals are lacking.

Conclusion

This study highlights the need to improve multidisciplinary collaboration in nursing homes to enhance care quality for older individuals. While providers view collaboration positively, barriers like a lack of shared responsibility and joint work persist. Enhancing teamwork cohesion through improved communication and integrated case reporting systems is crucial. Addressing human resource and systemic barriers is also vital. By overcoming these challenges, nursing homes can optimize resource use, reduce care redundancy, and better meet the diverse needs of older residents.

Effectiveness of home care intervention on family ability to do caregiving at home and increase the independence among elderly with dementia

Background:

Dementia had effect on the dependence status of the elderly. Living in family can increase independence among elderly. The purpose of the study was to determine the effectiveness of home care intervention on the family’s ability to conduct caregiving at home as well as the independence of the elderly with dementia. Also, to determine the effect of family ability to conduct caregiving at home on the independence of the elderly with dementia.

Design and Methods:

This study used quasi-experimental with cross-sectional design. The sample size was 40 respondents into two groups and it was selected using simple random technique. Data were collected from January to June 2021. The intervention group received home care intervention, and the control group did not receive any treatment. The outcome was measured using questionnaire and analyzed using paired t-test and linear regression test.

Results:

This study showed that home care intervention is effective in improving the family’s ability to do home care (p value <0.05) as well as the independence of the elderly with dementia (p value <0.05). In addition, the ability of family to conduct caregiving at home had effect on the independence of the elderly with dementia (p value <0.05).

Conclusion:

The home care intervention was effective in improving family ability and independence of elderly with dementia. This intervention was developed based on caregiver empowerment. It can be the guideline of family to conduct home care.