Transcript Realities of health and formal long-term care integration

Realities of health and formal longterm care integration
International Association of Gerontology and Geriatrics
2ND Africa Region Conference
6-8 December 2016
Nairobi, Kenya
Dr. Muthoni Gichu
Ministry of Health, Kenya
Health changes may be unexpected!
No one plans to have their health change or wants
to admit they might need long term care someday.
Marlene S. Stum, Ph.D. Family Economics and Gerontology. 2012.
Long-Term Care
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Help with activities of daily living (ADLs)
and remaining independent
◦ Eating, bathing, dressing, transferring, walking,
toileting, taking medications, shopping
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Wide range of services (personal, social,
and medical)
Variety of settings (in-home, community,
assisted living, and skilled nursing facility)
Marlene S. Stum, Ph.D. Family Economics and Gerontology. 2012.
Framework
The Constitution of Kenya 2010 provides
the overarching legal framework to
ensure a comprehensive rights-based
approach to health services delivery
 It provides that every person has a right
to the highest attainable standard of
health
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According to the Vision 2030, priority will be
given to the community and household level
through a decentralized national health care
system
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This is aided by the devolution of health
services, ensuring that health service delivery
gets close to all Kenyans
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Ministry of health’s commitment to
guaranteeing highest possible standards of
health in Kenya

The Kenya Health Policy 2012-2030- offers
guidelines to ensure momentous improvement
in the status of health in Kenya, in line with
the provision of the new constitution of Kenya
2010,Vision 2030, and other global
commitments
lifecycle cohorts
i. Pregnancy and the newborn child (up to
28 days of age)
ii. Early childhood (28 days to 5 years)
iii. Late childhood (6 to 12 years)
iv. Adolescence and youth (13 to 24 years)
v. Adulthood (25 to 59 years)
vi. Elderly (60 years and over)
Explore
future demographic trends
 policies to support family carers, longterm care workers,
 financing arrangements
 long-term care insurance
 value for investment in long-term care
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Financing Long Term Care:
Dilemmas and Decisions
◦ “We planned for a shorter and healthier
retirement”
◦ “I never expected to live so long!”
◦ “If I avoid it . . . it won’t happen right!”
◦ “I think my health insurance will pay”
Marlene S. Sturn Ph D. Family Economics and Gerontology. 2012
Characteristics of LT care
Physical or mental, temporary or permanent
Need based on functional disabilities
Promotes or maintains health and independence
in functional abilities and quality of life
 To enable us to die peacefully and with dignity
 Multiple services and multiple professions
spanning broad spectrum
 Multifaceted
 Designed around unique needs of the individual
 Service can change over time
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Who needs LTC
Chronic – permanent or indefinite period
of time
 Impaired – a decrease in or loss of ability
to perform
 Disabled – short or long term; varies by
age group
 Functional ability – person’s ability to
perform the basic activities of daily living
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Understanding demand for LTC
Patient represent “mosaic of subsegments” of the population. Often comorbid conditions
 Services can be organized across
dimensions of users
 Some users of LT care have significant
differences from other users
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Organisation of LTC
Informal organization – most LT care is
provided by family and friends
 Each community may be different
regarding availability of services
 Ideal system – client oriented continuum
of care.
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Providers of LTC
Hospitals
 Nursing homes (most private)
 Home health agencies
 Hospices (a number that are functional)
 Adult day service programs
 Housing organizations
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Opportunities
CHVs
 Draft Healthy Ageing Strategy
 Palliative care platform
 NHIF cover for older persons- package
 Capacity building
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Create a plan for your situation
Financial goals and expectations
 Characteristics of family members
 Financial resources
 Human resources
 Geography
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Marlene S. Sturn. Ph D. Family Economics and Gerontology 2012.
Thank you