Establishing a supportive environment for elderly to delay and reverse frailty – a case study of hospital-community collaboration

Abstract

Introduction: According to Taiwan's Ministry of Health and Welfare, in March 2018 those over 65 years old among the country's population hit 14%, thus meeting the designation of being an aged society as defined by the World Health Organization(WHO). Moreover, a survey conducted by the Health Promotion Administration revealed that over 80% of the elderly reported having at least one diagnosed chronic disease. To address the increasing health needs of the population, WHO advocates improvement in both intrinsic ability and functionality of the aged group for their well-being. Taking place in Tanzi District of central Taiwan where the elderly account for 10.9% of the area's residents, this research develops a hospital-community collaborative network with a volunteer training mechanism in order to establish a supportive environment for the elderly for the prevention and delay of disability. Method: Under the construction of a supportive environment as the main framework, the research team explores various variables and sets up the Tanzi Age-friendly Communities Program. To integrate the resources of the 12 Tanzi District Care Centers, this study connects key stakeholders and develops a communication and mutual learning platform. The program recruited 30(8 males, 22 females)middle-aged and retirees to join as community volunteers, in which Taichung Tzu Chi Hospital Medical Team regularly conducts needs-based health promotion activities. Results: The members of the platform include leaders of the district, villages, and neighborhoods, along with representatives from the local health center, community development association, and local volunteer organization. Since 2012, the volunteers provides at least 140 hours of service yearly, serving more than 30,000 community members. The number of Care Centers increased from 2 to 12 in 2019, the number of participants has significantly grown from 260 to 380, and the coverage rate has reached 62.5% in Tanzi District. Conclusion: A hospital-community collaboration network can support and increase health service accessibility for the elderly. Taichung Tzu Chi Hospital presents this case study that focuses on the collaboration among stakeholders, facilitating older people's participation and cultivating their capacity to enhance their community. This reorientation of health service to create a supportive environment for the prevention and delay of frailty also achieves the goal of improving the elderly's intrinsic capacity and functional ability.