Develop and Disseminate an Evidence-Based Self-Supporting Care Model in Taiwan: A Study Protocol

Background: In 2016, disability population accounted for 16.19% (about 500,000 people) of Taiwan’s older adults, and it is estimated that by 2031, this segment of the population will be increasing to 1.2 million. The high prevalence of disability has significant implications for economic costs and the burden of long-term care. How to provide good care and enhance quality of life for disabled older adults is really a big issue for health care providers. The traditional way of caring older people in Taiwan, protecting their safety is the priority. The caregivers will do everything for older adults. Therefore, their functional status will be decreased. The concept of self-supporting care was from Dr. Takeuchi Takahito, who is a famous professor promoting dementia care in Japan. The self-supporting care emphasis on life autonomy and independence, aims to restore the ability of activities in daily living for disabled older adults. Learning experiences from Japan, Mr. Lin Jin-Li, the CEO of Senior Citizens Welfare and Protection Association of Yunlin Country in Taiwan, starts to introduce the “self-supporting care” model with three principles “non-restraint, non-diaper and non-bedridden” in different communities. Many cases report showed that, when providing proper care plans of water, nutrition, physical activity, toilet training, and social contacts, the clients’ ability of activities of daily living were improved. The caregivers were also able to gain a sense of achievement and recognition of their profession. However, there is only few empirical evidence about the effectiveness of self-supporting care model in Taiwan.

Purpose: The purpose of this study is to develop and disseminate an evidence-based self-supporting care model in different long term care settings and communities in Taiwan.

Methods: This will be a three-year study. In the first year, based on the literature review, we will develop a self-supporting care model for disabled older adults in long term care institutions and communities. The assessment criteria, standardized intervention protocols and evaluation tools will be developed. The educational materials and training program will be developed and provided for long term care professionals, nursing care aids and primary caregivers in communities. In the second year, an action research will be conducted. The self-supporting care model will be implemented for some clients in long term care institutions and at their homes. The qualitative and quantitative information will be collected to develop the evidence data. In the third year, an experimental study will be conducted to evaluate the effectiveness and the feasibility of the self-supporting care model. Through the testing and modification, the model will be disseminated in different communities.

Results: The results of the study will provide evidence to support the effectiveness of the self-supporting care models in different long-term care settings in Taiwan, which will help to improve the older adults’ autonomy, improve caregivers’ self-efficacy, and optimize the quality of the long-term care.

Conclusion: Different from traditional approach, this model will provide a new vision of life dignity for older adults and their caregivers in Taiwan. The research results will be also a reference for the government to implement the long-term care policy in the future.