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Care plan must focus on at-risk families
2023/02/13 19:19

Care plan must focus on at-risk families

By Shen Chen-lan 沈政男

From Taipei Times

Not long ago, it was reported that after his wife and two mentally disabled sons died at home, an 85-year-old man surnamed Yang (), who has dementia, continued to live with their bodies for months in their home in New Taipei Citys Zhonghe District (中和).

The incident prompted calls for the city to increase community support for families in need and have authorities visit them more often.

However, authorities should make more of the limited resources they have and prioritize high-risk families.

The 10-year Long-term Care Plan 2.0 has since its inception in 2017 helped many families. The plan focuses on community care, mainly offering in-home and daytime care services, and in rare cases 24-hour services. Few families with members who have dementia or a disability can rely on the plan for services during the night, on holidays or in unexpected situations.

It is no wonder that such families think the plan’s resources are insufficient and hesitate to call its 1966 hotline when in need. Some families even refuse its services when social workers recommend it to them.

Social workers and agencies involved in care services use a set of criteria to assess what services are needed on a case-by-case basis.

Take for example Yang’s family: The father having dementia and his sons being mentally disabled means they already met two criteria.

However, the authorities failed to monitor their needs based on these two factors. It should be reviewed whether Yang’s case was registered on the plan’s dementia care platform and whether a case manager was assigned to him. If there was, how often did the manager contact the family? Did the manager visit them or contact them by telephone?

If a person refuses to be registered as a case under the plan, doctors and nurses can try to persuade their family to have them enrolled, as medical professionals are often seen as more trustworthy.

For example, during the COVID-19 pandemic, if a family feared that a visit to their home by the plan’s social workers might expose them to the disease, medical professionals would explain the preventive measures the visitors would take to put the family at ease.

As for people with mental problems, the public healthcare system mainly focuses on the risk of self-injury and injury to others, as well as addiction to drugs or alcohol and domestic violence.

Yang’s sons were not deemed a risk, so no frequent visits were scheduled.

In cases where people with mental problems cannot take care of themselves or develop physical health issues, the plan should provide services to them.

Yang’s case is a warning for Taiwanese society.

Should the plan remain limited to community care, or should it be expanded to include 24-hour care? More than 200,000 foreign caregivers work in Taiwan, indicating that many people rely on care services. For them, a few hours of care per day under the plan is not enough.

Had Yang’s family hired a foreign caregiver, the deaths could have been prevented.

However, could they afford the to pay NT$30,000 per month for such services?

The Long-term Care Plan 2.0 should focus on high-risk households, as the nation’s resources to monitor people in need are limited.

A larger share of resources should be assigned to such families. This would be more important than registering more cases in the plan’s database.

Shen Chen-lan is a physician.

Translated by Eddy Chang

【善用有限的照顧資源 優先關注高風險家庭】