Provision of Long-Term Care and Payment Options for Elderly People Living in Kuala Lumpur and Selangor, Malaysia

Abstract

Background This dissertation attempts to assess Malaysia’s readiness to tackle the challenges associated with the provision and financing of long term care services brought about by rapid population ageing. This is done by conducting research on a sample of individual respondents and a number of care institutions from Selangor and Kuala Lumpur. The research objectives are (1) to investigate if there is appropriate placement of elderly Malaysians in nursing homes, care centres and at home; (2) to determine if the nursing home and care centre services provided meet the minimum requirements set by the authorities; and (3) to find out if elderly Malaysians who need long-term care are able to finance their long-term care needs in a sustainable manner and to gain an understanding of the payment options available for long-term care services. Methodology Quantitative methods were used for hypothesis testing and statistical analysis, while qualitative methods were used to study the subjective experience of long-term care services provided in nursing homes, care centres or at home, and whether participants had sufficient money to pay for long-term care services. 419 participants were interviewed. Of these 419 participants, 154 were residents of nursing homes and 154 were provided with services from care centres. 111 were staying at home. The number of nursing homes and care centres assessed were 9 and 3 respectively. Results The results for research objective 1 reveal that there is inappropriate placement in relation to the actual level of care needed by elderly Malaysians in Selangor and Kuala Lumpur. Elderly persons in nursing homes and care centres have median Barthel Index scores of 35 whilst elderly living at home have a median Barthel Index score of 50. The Kruskal-Wallis H test is used to determine if there are any significant differences in the scores across the three types of care placements. There is a statistically significant difference between the Barthel Index scores of the elderly participants across the three types of placements (H(2) = 17.20, p < .001), with a mean rank of 204.44 for those in nursing homes, 187.48 for those in care centres, and 248.95 for those in home care. There is a significant difference in the Barthel Index scores between those placed in care centres (M = 36.14) and those in home care (M = 51.35) at the p