Background and Objectives: The comprehensive geriatric assessment (CGA) is a multidimensional and multidisciplinary evaluation and management process to identify and address the needs of an older person (OP). However, there are several challenges faced in its implementation which limit its full potential and utility to promote healthy aging. This paper aimed to describe the issues and challenges of those involved in the conduct of the traditional paper-based CGA, specifically older persons and the research and health facility-based assessors. Methods: This is a descriptive convergent parallel mixed-methods study utilizing both quantitative and qualitative data from the UP Manila Wellness Initiative for Seniors and Elders research program. Mixed methods of data collection were conducted online, namely survey and focus group discussions (FGD). Purposively recruited OPs aged 60 years and above who previously underwent CGA served as online survey respondents. Similarly, purposively recruited healthcare professionals (HCP) who conduct research-based and facility-based CGA participated in the FGDs. STATA and NVivo PRO Plus were used to analyze the quantitative and qualitative data, respectively. Descriptive statistics were used namely frequencies, percentages, mean, standard deviation, and median. Guided by the interpretivist paradigm, thematic analysis was conducted. Triangulation of results was done by the multidisciplinary team. Results: A total of 30 OPs with mean age of 67.1 years (SD±5.7) responded to the online survey. A total of 10 healthcare professionals, mostly geriatricians, participated in two separate FGDs. : Most (83%) liked the comprehesiveness of the CGA. However, OPs had difficulties with the following: follow-ups (43%), sensitive questions (40%), and recall (23%). Thirty percent (30%) rated the CGA as long to too long. HCP assessors’ challenges were related to the participants/patients, assessors, and operational factors. Participant/ patient-related factors include health conditions, follow-up issues, language, sensory impairment, and familiarity with the tools. Assessors-related factors include competency, missing information, illegible handwriting, and asking sensitive questions. Operations-related factors include the length of the questionnaire and process, physical set up, fragmented system, data storage and protection, and inadequate human resource. Conclusion The common issues and challenges identified by the older persons and healthcare professional assessors in the conduct of paper-based CGA include the length of the CGA, sensitive questions, and follow-up issues. Addressing these issues and challenges is necessary to maximize the utility of the comprehensive geriatric assessment in promoting healthy aging. With the advent of technology, digitizing the paper-based CGA is a promising approach to address these challenges.
geriatric assessment ; Philippines

Background and Objectives With the global population aging, there is an emerging need for access to quality longterm care (LTC) services. Many countries have developed LTC systems while others are at the infancy stage. This paper aimed to provide an overview of the country’s readiness for LTC based on the perspectives of relevant stakeholders. Specifically, it described the roles, initiatives, and challenges of relevant organizations and community leaders for LTC provision. It also described the older persons (OPs) and carers’ perspectives towards LTC including their awareness, capacity, and preferences.
Home Care Services ; Long-Term Care ; Nursing Homes ; Philippines

BACKGROUND AND OBJECTIVES

With the global population aging, there is an emerging need for access to quality longterm care (LTC) services. Many countries have developed LTC systems while others are at the infancy stage. This paper aimed to provide an overview of the country’s readiness for LTC based on the perspectives of relevant stakeholders. Specifically, it described the roles, initiatives, and challenges of relevant organizations and community leaders for LTC provision. It also described the older persons (OPs) and carers’ perspectives towards LTC including their awareness, capacity, and preferences.

METHODS

The study utilized a descriptive design using qualitative methods of data collection namely key informant interviews (KIIs) and focus group discussions (FGDs). Participating institutions and their designated representatives were purposively sampled as key informants. OPs and carers from select barangays in NCR and Region IVA participated in the FGDs. Guided by the interpretivism approach, thematic analysis was performed. A trained research assistant coded the FGD and KII transcripts through the Nvivo PRO plus software and verified by the first author. Themes were reviewed and validated by the multidisciplinary team.

RESULTS

A total of 15 KIIs and two FGDs were conducted. The participating institutions and organizations were found to have varied roles and initiatives relevant to LTC; from strategic planning, development of policies and standards of care, training and capacity-building, and up to the actual implementation of LTC services. Identified challenges include implementation issues, financial issues, lack of political and stakeholder support, OPs and familial issues, and lack of knowledge on LTC.

Participants shared their description on what LTC is, an LTC facility, and the conditions of those in LTC facility. OPs expressed their willingness to utilize LTC services and identified several factors related to their preferred LTC arrangements. Carers identified various topics related to taking care of OPs that they would like to learn.

CONCLUSION

The roles, initiatives, and awareness of relevant stakeholders, older persons, and carers towards LTC were found to greatly vary. Policy makers, health workforce, families, communities, and the older persons themselves should have a better understanding of longterm care before they can provide or utilize the system. With the current landscape of LTC provision, the country still has a long way to go in achieving the integrated continuum of LTC appropriate to promote healthy aging. Promoting awareness, integrating LTC in the current programs and services for older persons in the country, capacitating the formal and non-formal caregivers, and strengthening collaborations are recommended.

Further research on quantitative measures of readiness for long-term care with focus on the health system and in-depth studies on the varieties or models of long-term care are recommended.

Home Care Services ; Long-term Care ; Nursing Homes ; Philippines