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Providing care in Thailand

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  • 1. HelpAge International Asia Pacific Regional Conference 2012Rapid Ageing : A Caring Future Providing care in Thailand Dr Nantasak Thamanavat Director Institute of Geriatric Medicine Ministry of Public Health, Thailand
  • 2. Topics 1. The Needs of Thai Elderly 2. Response to the Needs of Thai Elderly 3. Problems and
  • 3. 1. The Needs ofThe Needs of Thai ElderlyThai Elderly Survey Feedback from Elderly voices, NGO Elderly Assembly National Elderly Planan
  • 4. Thailand Country Profile Life Expectancy 71.7Life Expectancy 71.7 (2011)(2011) At birthAt birth : Male 69.5: Male 69.5 Female 76.3Female 76.3 At SixtyAt Sixty : Male 19.4: Male 19.4 Female 21.9Female 21.9 Survey Census The Needs of Thai Elderly
  • 5. In 2040 : There will be 16.6 millions of Elderly population, accountable for 27% of Thai population Thailand will become an ‘aged society’ Projected number of population of Thailand 2010 & 2040 กลุ่มอายุกลุ่มอายุ 20102010 ((millionsmillions)) %% 20402040 ((millionsmillions)) %% Total 63.7 100.0 61.7 100.0 0-14 13.2 20.7 8.5 13.8 15-59 42.9 67.3 36.6 59.3 60+ 7.5 11.7 16.6 26.9 60-69 4.3 57.3 8.2 49.4 70-79 2.4 32.0 6.0 36.1 80+ 0.8 10.7 2.4 14.5 100.0 100.0: Prasantkul Pramote. Institute of Mahidol University: Prasantkul Pramote. Institute of Mahidol University
  • 6. Population Ageing , Future ChallengesTotal fertility rate below Replacement level * 201 0 1.5 , 20 10 The Needs of ThaiThe Needs of Thai ElderlyElderly
  • 7. General Characteristic of Thai Elderly Education Level : Primary Education 77% Unschooled 12.6% (Male 6.5% Female 17.5%)  Marital Status : Living with Spouse ; Male 79% Female 45% : Widow ; Male 14% Female 40%  Working Conditions : Earning income from working4th National Health Examination Survey 2008 –
  • 8. Source of income : (apart from monthly allowance) Adult Children 69% Works 38% Poverty line 1,600 baht per month (53 USD) : 16% of Elderly are under this poverty line Living Conditions4th National Health Examination Survey 2008 –
  • 9.  Home : Adapted to suit the elderly : 25%  Handrails: : Installed in a toilet and the bathroom: 10% : Installed in the bedroom : 3%  Using the stairs: 4th National Health Examination Survey 2008 –
  • 10. Current Health situation of Thai Elderly Classification of Thai Elderly 1. By Age Group : Young Old 60-69 Year 60 % : Medium Old 70-79 year 31 %
  • 11. Current Health situation of Thai Elderly Classification of Thai Elderly 2. By Dependency (National Health Examination Survey 4th 2008-2009) : Independence 8585% (6.99% (6.99 Million)Million) : Partial dependence 1414% (1.15% (1.15 Million)Million) : Total dependence 1% (0.08 Million)
  • 12. The Needs of ThaiThe Needs of Thai ElderlyElderly SurveySurvey Feedback from Elderly voices, NGO Elderly AssemblyElderly Assembly National Elderly PlanNational Elderly Plan
  • 13. Feedback from Elderly voices, NGO  Role of Organization / NGO on ThaiRole of Organization / NGO on Thai Elderly CareElderly Care : UNFPA (United Nations Population: UNFPA (United Nations Population Fund) ;Fund) ; Evidence-based Responsiveness toEvidence-based Responsiveness to the Emerging Challenges of thethe Emerging Challenges of the Population Ageing in ThailandPopulation Ageing in Thailand : JICA ;: JICA ;
  • 14. Feedback from Elderly voices, NGO  Role of Organization / NGO on ThaiRole of Organization / NGO on Thai Elderly CareElderly Care : Foundation of Older Persons’ Development (FOPDEV) Based in Chiang Mai, FOPDEV isBased in Chiang Mai, FOPDEV is network of grassroots NGOs with thenetwork of grassroots NGOs with the mission to work with and formission to work with and for disadvantaged older persons in Thailanddisadvantaged older persons in Thailand to improve the quality of their livesto improve the quality of their lives
  • 15. Feedback from Elderly voices, NGO  Role of Organization / NGO on ThaiRole of Organization / NGO on Thai Elderly CareElderly Care HelpAge International A global network striving for theA global network striving for the rights of disadvantaged older peoplerights of disadvantaged older people to economic and physical security;to economic and physical security; healthcare and social services ; andhealthcare and social services ; and support in their care giving rolesupport in their care giving role across the generationsacross the generations
  • 16. Feedback from Elderly voices, NGO - Senior Citizen Council ofSenior Citizen Council of Thailand (SCCT)Thailand (SCCT) : Representative and Member: Representative and Member from every Provincefrom every Province : Annual Assembly Meeting: Annual Assembly Meeting : Role in National Committee: Role in National Committee for the Elderlyfor the Elderly : Elderly voices: Elderly voices
  • 17. The Needs of Thai Elderly Survey Feedback from Elderly voices, NGO National Elderly Assembly, National
  • 18.  National Health Act. 2003 : National Health Assembly :: Elderly Long Term Care 2009 National Health Policy, Laws and Regulations
  • 19. The Needs of ThaiThe Needs of Thai ElderlyElderly Survey Feedback from Elderly voices, NGO National Elderly Assembly, National Health Assembly 
  • 20.  National Plan for older persons (1st 1982 – 20011982 – 2001, 2, 2ndnd 2002 – 2021)2002 – 2021) **Revision of Second National Plan forRevision of Second National Plan for Older Person 2009Older Person 2009 National Health Policy, Laws and Regulations
  • 21. The Needs of ThaiThe Needs of Thai ElderlyElderly Survey Feedback from Elderly voices, NGO National Elderly Assembly, National Health Assembly 
  • 22. Madrid International Plan of Action on Aging Older persons and development Advancing health and wellbeing into old age Ensuring enabling and supportive Environment
  • 23. 2. Response to the Needs of Thai Elderly Laws Regulations National Committee for The Elderly Government Policy, Issues 
  • 24.  2007 Thai Constitution : Section 9 Article 53 : States that persons 60 or Older insufficient income for living have the right to receive Welfare, Public amenities and assistance from the States  11th National Five year plan 2012- 2016 : Formulate from National Thai Constitution
  • 25. Thai Older Persons Act 2003Thai Older Persons Act 2003 : National Committee for the Elderly คณะกรรมการผู้สูงอายุแห่งชาติ National Health Policy, Laws and Regulations
  • 26. Thai Older Persons Act 2003Thai Older Persons Act 2003 : National Committee on the Elderly : Elderly Fund คณะกรรมการผู้สูงอายุแห่งชาติ คณะกรรมการบริหาร กองทุนผู้สูงอายุ National Health Policy, Laws and Regulations
  • 27.  Thai Older Persons ActThai Older Persons Act : The provision of the 2003 Act … 12: The provision of the 2003 Act … 12 areasareas Health Services Religious Occupation National Health Policy, Laws and Regulations
  • 28. Entrance fees exemptionEntrance fees exemption AllowanceAllowance AbuseAbuse National Health Policy, Laws and Regulations
  • 29. 2. Response to the Needs of Thai Elderly Laws RegulationsLaws Regulations National Committee for The Elderly Government Policy,Government Policy, IssuesIssues 
  • 30. National Centers / Policy advocacy committee Chair by Permanent Secretary, Ministry of Public Health - Home Care - Home Base Rehabilitation - Home Health Care - Home Nursing Services - Intermediate Care - Care Giver : Informal
  • 31. : National Saving Fund 2010: National Saving Fund 2010 กองทุนการออมแห่งชาติกองทุนการออมแห่งชาติ ((กอชกอช.).) Start : 8 May 2012Start : 8 May 2012 50 บาท แต่ไม่เกิน 13,200 บาท ต่อปี 2. Response to the Needs of Thai Elderly
  • 32. 2. Response to the Needs of Thai Elderly Laws RegulationsLaws Regulations National CommitteeNational Committee for The Elderlyfor The Elderly Government Policy, Issues 
  • 33. : Monthly Subsistence: Monthly Subsistence Allowances to Thai ElderlyAllowances to Thai Elderly - 60 – 69 Year 600 baht (20 usd) - 70 – 79 Year 700 baht - 80 – 89 Year 800 baht - +90 Year 1,000- +90 Year 1,000 baht 2. Response to the Needs of Thai ElderlyGovernment Policy, Issues
  • 34. Social Security : Old Age Pension Fund: Old Age Pension Fund (2014)(2014) - Payment at lease 180 months - Get Pension Fund from 2. Response to the Needs of Thai ElderlyGovernment Policy, Issues
  • 35. 2. Response to the Needs of Thai Elderly Laws RegulationsLaws Regulations National Committee forNational Committee for The ElderlyThe Elderly Government Policy,Government Policy, IssuesIssues Relevant Ministry &
  • 36.  Ministry of Public Health Administrative Committee on Elderly Health Operative Committee on Elderly Health : 9 Departments  National Health Security Office  National Health Assembly  Ministry of Social Development 2. Response to the Needs of Thai ElderlyRelevant Ministry & Local Administration
  • 37.  Old Age Care Program fromOld Age Care Program from Ministry of Public HealthMinistry of Public Health : Universal Health Care Program: Universal Health Care Program 20012001 : Capitation 2,834 baht/person (62: Capitation 2,834 baht/person (62 million persons)million persons) 2. Response to the Needs of Thai ElderlyRelevant Ministry & Local Administration
  • 38.  Old Age Care Program from Ministry of Public Health : *Eye - Heart Project to Celebrate 72 Anniversary of His Majesty the King Birthday 1999-2001 (Cataract Surgery, Heart Surgery) : 2012 – 2013 Heart Surgery for all Age Group 10,000 cases 84th King Birthday 2. Response to the Needs of Thai ElderlyRelevant Ministry & Local Administration
  • 39.  Old Age Care Program from MinistryOld Age Care Program from Ministry of Public Health with Ministry ofof Public Health with Ministry of Science and TechnologyScience and Technology : Complete Denture for Elderly 2004-2007 (Target: Complete Denture for Elderly 2004-2007 (Target 90,000 cases)90,000 cases) : Dental Implant for Over Complete Denture 2008-: Dental Implant for Over Complete Denture 2008- 2010 (Target 10,000 cases)2010 (Target 10,000 cases) : 2012 -2015 (Target 8,400 cases): 2012 -2015 (Target 8,400 cases) Relevant Ministry & Local Administration 2. Response to the Needs of Thai Elderly
  • 40.  Old Age Care Program from Ministry ofOld Age Care Program from Ministry of Public HealthPublic Health : Health Care Volunteer Training Project: Health Care Volunteer Training Project : Elderly Care Volunteer: Elderly Care Volunteer approx. 900,000 Health Careapprox. 900,000 Health Care Relevant Ministry & Local Administration 2. Response to the Needs of Thai Elderly
  • 41. Old Age Care Program from Ministry of Public Health : Health Promotion Temple Project (2,000 Temple) Relevant Ministry & Local Administration 2. Response to the Needs of Thai Elderly
  • 42.  Mosque : Elderly Community Rehabilitation Model 2011  3,500+ Mosque in 36 Provinces 2. Response to the Needs of Thai ElderlyRelevant Ministry & Local Administration
  • 43.  Old Age Care Program from Ministry of Social Development and Human Security : Multi-Purpose Senior Center in Community (Pilot Project) : Elderly Fund (Personal Elderly Loan) : Residential Home 2. Response to the Needs of Thai ElderlyRelevant Ministry & Local Administration
  • 44. Old Age Care Program from Ministry of Public Health : Elderly Health Club (Register with Senior Citizen Council of Thailand 12,000 Clubs) 2. Response to the Needs of Thai ElderlyRelevant Ministry & Local Administration
  • 45. Population Ageing , Future Challenges Role of Local Administration (Community Nursing Home, Community Rehabilitation) Role of Community (Elderly 2. Response to the Needs of Thai ElderlyRelevant Ministry & Local Administration
  • 46. 2. Response to the Needs of Thai Elderly Laws Regulations National Committee for The Elderly Government Policy, Issues Relevant Ministry & Local Administration
  • 47. Topics 1. The Needs of Thai Elderly 2. Response to the Needs of Thai Elderly 3. Problems and
  • 48. 3.Problems and Problem Solving Standard of Elderly Care Human Resources (Professional, Nonprofessional) Balance between Community and Institutional Care
  • 49. 3.Problems and Problem Solving Standard of Elderly Care : Institutional Care (Hospital Nursing Home Residential Home) : Non-institutional Care (Home Care)
  • 50. 3.Problems and Problem Solving Human Resources : Professional, Doctor, Nurse, PM&R, Occupationist, Nutritionist, Social worker, Care Manager ! : Non-professional, Nurse
  • 51. 3.Problems and Problem Solving Balance between Community and Institutional Care : Intermediate Care : Community Based Home Care
  • 52. Ratio of Elderly Health expenditure under National Health System Civil Servant Welfare Social Securit y Universal Health Care Scheme Under 60 75% 99% 87% Age 60 25% 1% 13% 3.Problems and Problem SolvingLong Term Care Financial System
  • 53. Symbol Represent Thai Elderly Suwann abhum Airport
  • 54. Topics 1. The Needs of Thai Elderly 2. Response to the Needs of Thai Elderly 3. Problems and
  • 55. Future Challenges 1. Elderly Care Giver 2. Urban Elderly Care Model 3. Elderly Care 4. Way forwards
  • 56. Thank you for your Attention