Extended Family Care: Home Visit for Older People – Case Study of Our Third and Fourth 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 the conditions of our third and fourth patients:

Mrs. SN, 69 years old, suffers from diabetes, a disability due to the amputation of her right leg from complications of the disease, and difficulty chewing due to tooth loss. Her husband, Mr. PG, experiences persistent dizziness, especially when walking. On a daily basis, Mrs. SN spends most of her time lying down or sitting on the bed, while Mr. PG occasionally leaves the house to sit at the neighborhood security post. Although Mrs. SN uses diapers due to difficulties going to the toilet, she can still clean herself and change her diapers independently. Conversely, Mr. PG is afraid to bathe and struggles to use the bathroom for urination and defecation due to fear of falling. He relies on a bucket for bathing and containers for urine and feces.

This couple lives alone in their home. Although they have two married sons living separately, visits from their children or in-laws are infrequent, typically occurring only to deliver money used for buying food with the help of other relatives. Their house appears poorly maintained, with cluttered items and an unclean environment. Blood Glucose tests on Mrs. SN revealed consistently high sugar levels despite her taking medication, likely due to an inappropriate dosage. Mrs. SN admitted to buying medications at a pharmacy based on a past prescription without routine health check-ups. Similarly, Mr. PG complained about his condition not improving.

During the visits, we faced challenges in assisting this couple due to the absence of family members to discuss their conditions, which is a primary focus of this program emphasizing family involvement. Nevertheless, this did not deter our efforts to assist them. We focused on actionable steps to improve their quality of life, such as providing guidance for daily activities, supporting safe mobility, and ensuring their basic needs were met. Simple education was tailored to their limitations, including advice on skincare around the amputated area to prevent irritation or new wounds, guidance on safe body positions during vertigo episodes, and ensuring their surroundings posed minimal injury risks. Emotional support was also a vital part of our approach, helping them face challenges with a positive mindset.

For long-term solutions, we reported their conditions to the Puskesmas, hoping for further monitoring or additional assistance tailored to their needs. This approach aims to create a positive impact, even within their limited circumstances.