Providing care in Thailand

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

Topics
1. The Needs of Thai
Elderly
2. Response to the
Needs of Thai Elderly
3. Problems and

1. The Needs ofThe Needs of
Thai ElderlyThai Elderly
Survey
Feedback from
Elderly voices, NGO
Elderly Assembly
National Elderly Planan

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

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

Population Ageing , Future
ChallengesTotal fertility rate below
Replacement level
*
201
0
1.5
,
20
10
The Needs of ThaiThe Needs of Thai
ElderlyElderly

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 –

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

 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

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 %

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)

ElderlyElderly
SurveySurvey
Feedback from
Elderly voices, NGO
Elderly AssemblyElderly Assembly
National Elderly PlanNational Elderly Plan

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 ;

voices, NGO
: 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

voices, NGO
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

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

The Needs of Thai
Elderly
Survey
Feedback from
Elderly voices, NGO
National Elderly
Assembly, National

 National Health Act. 2003
: National Health Assembly
:: Elderly Long Term Care 2009
National Health Policy,
Laws and Regulations

ElderlyElderly
Survey
Feedback from Elderly
voices, NGO
National Elderly
Assembly, National
Health Assembly


 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

Madrid International Plan
of Action on Aging
Older persons and
development
Advancing health and
wellbeing into old age
Ensuring enabling and
supportive Environment

2. Response to the
Laws Regulations
National Committee
for The Elderly
Government Policy,
Issues


 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

Thai Older Persons Act 2003Thai Older Persons Act 2003
: National Committee for the
Elderly
คณะกรรมการผู้สูงอายุแห่งชาติ
National Health Policy, Laws
and Regulations

Thai Older Persons Act 2003Thai Older Persons Act 2003
: National Committee on the Elderly
: Elderly Fund
คณะกรรมการผู้สูงอายุแห่งชาติ คณะกรรมการบริหาร
กองทุนผู้สูงอายุ
and Regulations

 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
and Regulations

Entrance fees exemptionEntrance fees exemption
AllowanceAllowance AbuseAbuse
and Regulations

2. Response to the
Laws RegulationsLaws Regulations
for The Elderly
Government Policy,Government Policy,
IssuesIssues


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

: 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

2. Response to the
National CommitteeNational Committee
for The Elderlyfor The Elderly
Issues


: 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

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

2. Response to the
National Committee forNational Committee for
The ElderlyThe Elderly
Government Policy,Government Policy,
IssuesIssues
Relevant Ministry &

 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

 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
Administration

 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
Administration

 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

 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
Administration
2. Response to the

Old Age Care Program from
: Health Promotion Temple
Project (2,000 Temple)
Administration
2. Response to the

 Mosque : Elderly Community
Rehabilitation Model 2011
 3,500+ Mosque in
36 Provinces
2. Response to the
Administration

 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
Administration

Old Age Care Program from
: Elderly Health Club
(Register with Senior
Citizen Council of Thailand
12,000 Clubs)
2. Response to the
Administration

Population Ageing ,
Future Challenges
Role of Local Administration
(Community Nursing Home,
Community Rehabilitation)
Role of
Community
(Elderly
2. Response to the
Administration

2. Response to the
Laws Regulations
for The Elderly
Issues
Relevant Ministry &
Local Administration

3.Problems and
Problem Solving
Standard of Elderly Care
Human Resources
(Professional,
Nonprofessional)
Balance between Community
and Institutional Care

3.Problems and
Problem Solving
Standard of Elderly Care
: Institutional Care (Hospital
Nursing Home Residential
Home)
: Non-institutional Care
(Home Care)

3.Problems and
Problem Solving
Human Resources
: Professional, Doctor, Nurse,
PM&R, Occupationist,
Nutritionist, Social worker,
Care Manager !
: Non-professional, Nurse

3.Problems and
Problem Solving
Balance between Community
and Institutional Care
: Intermediate Care
: Community Based Home
Care

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

Symbol Represent Thai
Elderly
Suwann
abhum
Airport

Future
Challenges
1. Elderly Care Giver
2. Urban Elderly Care
Model
3. Elderly Care
4. Way forwards

Providing care in Thailand

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