Extended Family Care: Home Visit for Older People – Case Study of the First Patient

Extended Family Care is a program aimed at providing continuous care for older people through a multigenerational approach. In this program, the involvement of the extended family becomes the key to strengthening the physical, emotional, and social well-being of older people holistically. Extended Family Care is implemented through home visit activities, which aim to enhance the role of the extended family in the healthcare of older people. In this program, the Foundation not only conducts visits to provide direct care but also trains the families of older people to continue care independently at home. By empowering families in the healthcare of older people, it is hoped that intergenerational relationships will be strengthened and the well-being of older people can be well maintained.

The Extended Family Care program, part of Sahaja Caring, was first implemented through a collaboration with Puskesmas I Denpasar Utara. In carrying out this program, we provided free services to four older people with diverse health conditions, through a series of five visits to ensure the health needs of older people were fully met. Below is a detailed explanation of our first patient’s condition:

Mrs. SA, 61 years old, has a history of diabetes and hypertension, as well as limited mobility due to several falls. She can only sit or lie down because of pain in her hands and legs, which severely hinders basic activities such as going to the toilet, eating, and bathing, requiring assistance from others. Additionally, poor personal hygiene caused skin irritation in the form of redness and itching, adding to her discomfort.

In Mrs. SA’s case, the main challenge faced was the lack of family support and knowledge. This impacted the difficulty in implementing sustainable care. During our visits, we trained Mrs. SA to perform Range of Motion (ROM) exercises to reduce stiffness caused by minimal daily physical activity. Additionally, we provided education on the use of diabetes medications to control blood sugar and emphasized the importance of maintaining personal hygiene to prevent further complications.

During the home visit, there was slight progress in her mobility; Mrs. SA was able to start moving her hands and legs, as well as stand and walk with the help of a walker. Unfortunately, this progress did not last long. This was due to the lack of self-care implementation outside of our visits. The ROM exercises that were taught were not performed regularly, and personal hygiene remained neglected despite the simple guidance provided. Furthermore, insulin use was not administered because no family members were available to assist in the process.

This condition highlights the need for more intensive intervention, including actively involving the family in care. However, during the home visits, we often found that family members were rarely present. Even when they were present, their responses showed indifference, such as choosing to rest or sleep instead of paying attention to the care being provided for Mrs. SA. This lack of concern prevented Mrs. SA from receiving the necessary support to implement daily care.

To address the lack of family involvement, we attempted to establish more intensive communication via phone or messaging to remind them about the care schedule. We also coordinated with the Puskesmas to help provide additional support if the family remained difficult to involve. These steps are expected to improve the sustainability of care, although challenges on the family side persist.

At the end of the visits, we provided assistance in the form of a bed frame to improve her comfort, support standing and walking exercises, and enhance her mobility and independence. With this assistance, we hope she can experience increased comfort in carrying out daily activities and receive the support needed to become more independent in movement. The bed frame we provided is also expected to offer stability and comfort while resting, which in turn supports her physical recovery and strengthening. Through these measures, we strive to make a positive contribution to her quality of life so that she can carry out activities more freely and without obstacles.

“When we help others, we are not just giving, but also receiving invaluable happiness and satisfaction. For the kindness we spread will return to us in ways we never expect.”