This document summarizes health and care for aging populations in Thailand. It discusses how Thailand has undergone rapid population aging, with those over 60 years old expected to exceed 30% of the population by 2050. To address this, Thailand has implemented national policies focused on active aging, health, security, and social participation for older adults. This includes expanding primary care, long-term care services, and home-based care through family care teams. Challenges remain in establishing proper care systems and health services to support the growing aging population as Thailand becomes a super-aged society.
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Health and Care in an Aging Society, Jiraporn Kespichayawattana, Chulalongkorn University
1. Health and Care in Aging Society:
Experience from Thailand
Jiraporn Kespichayawattana
R.N., APN., Ph.D.(Gerontological Nursing)
Faculty of Nursing, Chulalongkorn University
Bangkok, Thailand
Building Transformational Leadership towards Sustainable
Development Goals
2. Scope of Presentation
• Global Aging
• Thailand in Transition
• Health and care Needs of Thai Older
People
• Care system and services within the
National Context: Thailand’s experience
• Conclusion & Challenges
4. Source: UNDESA Population division, World population prospects:
the 2015 revision, DVD Edition, 2015.
5. • Ageing population become more
concerned especially in developing
countries
• The well-recognized increase in aged
population and increases in chronic
disease and disability.
• The most important challenge for the
aging population is how to increase the
lifespan and the quality of life.
7. Thailand: Profile
• Population - 66 million
• GDP 2015 US$ 13,562 per capita
(PPP)
• Total Health Expenditure
(2010NHA) US$194 per capita,
3.9% GDP
Health status
• Total fertility rate 1.59 (2017)
• Life expectancy at birth 74.1 yrs.
• Male 72 yrs. Female 78.8 yrs.
9. Thailand in Transition
• Thailand faces a rapidly growing population of
older persons. The population of older persons will
exceed the population of children around 2020.
• The proportion of older persons in total population
will increase from 16.9 % in 2016, 23.8 % in 2025
and nearly 30 % by 2050.
• The population of older persons will increase from
the current (2017) 10.0 million to 12.9 million in
2025 and exceed 20 million in 2050.
10. Aged Society
Complete aged Society
Super aged Society
Source : The Situation of the Thai Elderly 2014
> 10 %
(2005)
> 20 %
(2021)
> 28 %
(2031)
16.9 %
(2016)
Thailand Rapid Ageing Society
11.
12. Ageing population are
approximately 10 million
or about 16.9%
Average age 75 years
Men 72 years Women 78 years
Source : NESDB : 2016
SITUATION OF THAI ELDERLY
13.61%
56.5%
29.9%
Young-old = 60-69 years
Middle-Old = 70-79 years
Old-Old = 80 years or older
13. Living Alone or with Spouse is
increasing
Source: 2014 Survey of Older Persons in Thailand
14. Male
2.2 yrs16.4 yrs 1.7 yrs
Female
18.2 Yrs 2.9 yrs 2.6 Yrs
Age 60 ปี
LE = 80.3 ปี
(+20.3 yrs)
LE = 83.9 ปี
(+23.9 yrs)
Active Ageing: Independent Living Passive Ageing:
Assisted Living
( Home bound)
Dependent Living
(Frail /Bed Bound)
Ref:Sutthichai Jittapankun, 2010
15. Limitations in ADL and IADL
Source: 2014 Survey of Older Persons in Thailand
16. Burden of Diseases : DALY 2014 Top 10 cause of
DALY in 60+ years old
Male Female
Rank
Disease Disease
Stroke (CVD)
COPD
IHD
Diabetes
Cancer (Liver)
Cancer (Lung / Bronchus)
Dementia
Diabetes
Dementia
Arthritis
Cataract
CKD
17. RAPID INCREASING OF ELDERLY POPULATION:
THAILAND REACTIONS
How to
maintain
these elderly
population to
be
A POWER
not
A BURDEN?
25. Ageing Challenges
Active
Ageing
Demand of Care
(Health & Social Care)
Better elderly living for longevity
(Income, Re-employment, welfare services
environment, engagement & connection)
HR Development
(Prof, para, non-prof, volunteer caregivers)
R & D Innovation
(Smart gadgets for smart elder)
Well preparedness for Active Ageing
(Health, Income Security, Housing, Participation)
26. Thailand Strategies for Active Ageing
1. Preparedness and readiness for quality
aging
2. Promotion and development of the elderly
3. Social protection for the elderly
4. Creating a national comprehensive system
for integrative implementation
5. Processing and disseminating knowledge
on the elderly and monitoring
27. National Policy For Healthy Aging
Integration & Collaboration : 4 Ministries
Ministry of Public Health
Ministry of Social Development
and Human Security
Ministry of Interior
Ministry of Education
Source : Health Dept. MOPH
28. Thai Active and Healthy Ageing
2. Strong (Health)
The elderly have
good health
1. Social
Participation
Families and
communities as
a strong
institution 3. Security
The welfare system
and support services
with quality,
standards, access.
Source : Health Dept. MOPH
29. Health
• More focus on Health Prevention & Promotion
through elderly group/ club
• Promoting geriatric/ health screening,
assessment in community
• Launch several projects related to health and
well-being of the elderly such as cataract
screening & treatment, dental hygiene, free
dentures, flu vaccine
• Develop primary care system for the elderly,
LTC system, health volunteers in community
30.
31. Security
• Monthly allowance for all Thai elders
• Encourage and support ageing friendly
environment/ universal design
• Encourage local government to be more
active in improving well-being of the
elderly
• National Policy for Saving Funds
32. Participation
• In Thai society, older persons generally are
respected and valued as resources for
cultural and traditional Thai customs and
knowledge
• Encourage social participation of the elderly
through elderly club, Brain Bank Project,
Volunteering
• Many elderly clubs in regional parts are very
active and well-known for active
participation of the elderly
37. Paradigm Shift in Care Services
• Acute Care -> Community Care ->
Home Health Care
• Primary Care Unit (PCU) – Family Nurse
• Continuity of Care (COC)
• Home Ward
• Family Care Team
50. Long term Care System
•National Long Term Care Action Plan 2014
•Focusing on strengthening community based
care for older persons/ disability
•Several models were developed all over the
country during past five years
•Now moving towards System Based LTC not
Project Based LTC
•National Health Security Office (NHSO) launched
the National LTC project last year
51. Ministry of Public Health
Permanent
Secretary
Cluster of Medical
Service
Development
Cluster of Public
Health
Development
Cluster of
Health
Service
Support
Office of Permanent
Secretary
• Area Health
Board 1 – 12
• Provincial
Administration
• Provincial Public
Health Offices
• District Health
offices
• Subdistrict =
SHPH
• Department
of Health
Family
Care
Team
Health
Volunteer
(1,000,000+ )
Training course :
- Care Manager
- Caregiver
• Department
of Health
Service
Support
LTC
team
Care Plan Community
Board
52. Care personnel
Family Care
Team
-Consult/Give an advice
-Joint plan of care for the elderly
Care manager
Caregiver
Family Volunteers
-Assessment
-Make Elderly Care Plan
-CM 1 person : 35 – 40 elderly
people.
-Assessment/Care for the elderly
-care of the dependent group
-CG 1 person : 5 – 10 elderly
people.
-Care for family members.
Source : Health Dept. MOPH
56. Older Person Grouping
Group 1: Healthy and Independent
Group 2: Partially dependent (Home bound)
Group 3: Totally dependent (Bed bound)
57. Healthy/
Independent
Partially
dependent/
Homebound
Totally
Dependent/
Bedbound
• Health prevention
• Health Promotion
• Social participation
• Volunteering
• Active &
Contribution to
family/ society
• Secondary health
prevention
• Maintain functional
activities ADL,
support IADL
• Home & environment
modification
• Support caregiver &
family
• Rehabilitation
•Complication
prevention
•Symptom control
•Support caregiver &
family
•Support ADL & IADL
•Palliative care
59. Challenges
• Demographic changes put challenging on
preparation for all sectors to improve
health, care system
• As Thailand becomes ageing society,
health services and proper care systems
especially for OPs need to be well-
established and improving
• Services oriented toward geriatric and
long term care need to be more focused
62. Lumsonthi Model
•The rural district located 120 km.
from the province
• District hospital collaborate with the
Local administration organization
•Established care-team including
family member, semi-volunteer care
worker, HC staff, Hospital staff
(medical doctor, nurse practitioner,
mental health nurse,
physiotherapist)
•The local administration organization
funds the salary for care worker
