Providing care in Thailand

HelpAge International Asia Pacific Regional

Conference 2012Rapid Ageing : A Caring FutureProviding care in

ThailandDr Nantasak Thamanavat

Director Institute of Geriatric Medicine

Ministry of Public Health, Thailand

Topics

1. The Needs of Thai Elderly2. Response to the Needs of Thai Elderly

3. Problems and Problem Solving

4. Way forwards

1. The Needs of The Needs of Thai ElderlyThai Elderly

Survey Feedback from Elderly voices, NGO

Elderly AssemblyNational Elderly Planan

Thailand Country ProfileLife Expectancy 71.7 Life Expectancy 71.7 (2011)(2011)

At birth At birth : Male 69.5: Male 69.5Female 76.3Female 76.3

At SixtyAt Sixty : Male 19.4 : Male 19.4 Female 21.9Female 21.9

At Sixty-fiveAt Sixty-five : Male 16.1 : Male 16.1 Female 18.1Female 18.1

Total Fertility rate 1.5Total Fertility rate 1.5

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

กลุ่��มอายุ�กลุ่��มอายุ�

2010 2010

((millionsmillions)) %%

2040 2040

((millionsmillions)) %%

Total 637.1 0 0 .

0 617.1 0 0 .

0

-014 132 207. 8.5 138.-155

9 429. 673. 366. 593.60 75. 117. 166. 269.

-606

9 43. 573. 82. 494.-707

9 24. 320. 60. 361.80+ 08. 107. 24. 145.

1 0 0 .0

1 0 0 .0

: Prasantkul Pramote. Institute of Mahidol : Prasantkul Pramote. Institute of Mahidol UniversityUniversity

Population Ageing , Future ChallengesTotal fertility rate below

Replacement level

*2010

1.5

,2010

The Needs of Thai The 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 working 39 %(Private Business): No income 9%4 th National Health

Examination Survey 200 8 2009–

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 Conditions : Living with spouse 17%: Living alone 7%

4 th National Health Examination Survey 200

8 2009–

Home

: Adapted to suit the elderly : 25%

Handrails:: Installed in a toilet and the bathroom: 10%: Installed in the bedroom : 3%

Using the stairs:: Have to use the stairs every day: 58%4 th National Health

Examination Survey 200 8 2009–

Current Health situation of Thai Elderly

Classification of Thai Elderly1. By Age Group

: Young Old 60-69 Year 60 %

: Medium Old 70-79 year 31 %

: Oldest Old 80+ year 9 %

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 115 115 Million)Million)

: Total dependence 1 008 Million)- Home bound - Poverty- Bed bound - Neglected,

abandoned


Survey Survey Feedback from Elderly voices, NGO

Elderly AssemblyElderly AssemblyNational Elderly PlanNational Elderly Plan

Feedback from Elderly voices, NGO

Role of Organization / NGO on Thai Elderly Role of Organization / NGO on Thai Elderly CareCare

: UNFPA (United Nations Population Fund) ;: UNFPA (United Nations Population Fund) ;

Evidence-based Responsiveness to the Evidence-based Responsiveness to the Emerging Challenges of the Population Emerging Challenges of the Population Ageing in ThailandAgeing in Thailand

: JICA ; : JICA ;

Project Community Based Integrated Project Community Based Integrated Services of Health Care and Social Welfare Services of Health Care and Social Welfare for Thai Older Persons (CTOP Model)for Thai Older Persons (CTOP Model)


Role of Organization / NGO on Thai Role of Organization / NGO on Thai Elderly Care Elderly Care

: Foundation of Older Persons’ Development (FOPDEV)

Based in Chiang Mai, FOPDEV is network Based in Chiang Mai, FOPDEV is network of grassroots NGOs with the mission to of grassroots NGOs with the mission to work with and for disadvantaged older work with and for disadvantaged older

persons in Thailand to improve the persons in Thailand to improve the quality of their livesquality of their lives


Role of Organization / NGO on Thai Elderly CareRole of Organization / NGO on Thai Elderly Care

HelpAge International A global network striving for the rights of A global network striving for the rights of

disadvantaged older people to economic and disadvantaged older people to economic and physical security; healthcare and social physical security; healthcare and social

services ; and support in their care giving role services ; and support in their care giving role across the generationsacross the generations

Senior Citizen Council of Thailand (SCCT)Senior Citizen Association of Thailand

(SCAT)


- Senior Citizen Council of Senior Citizen Council of Thailand (SCCT)Thailand (SCCT)

: Representative and : Representative and Member from every Province Member from every Province

: Annual Assembly Meeting: Annual Assembly Meeting

: Role in National : Role in National Committee for the ElderlyCommittee for the Elderly

: Elderly voices : Elderly voices

The Needs of Thai Elderly


National Elderly Assembly, National Health Assembly

National Elderly Plan

National Health Act. 2003: National Health Assembly

: : Elderly Long Term Care 2009

National Health Policy, Laws and Regulations




National Elderly PlanInternational Elderly Policy

National Plan for older persons (1st

1982 2001– 1982 2001– , 2, 2nd nd 2002 – 2002 – 2021)2021)

** Revision of Second National Plan Revision of Second National Plan for Older Person 2009for Older Person 2009


The Needs of Thai The Needs of Thai ElderlyElderlySurvey Feedback from Elderly voices, NGO


National Elderly PlanInternational Elderly Policy

Madrid International Plan of Action on

AgingOlder persons and development

Advancing health and wellbeing into old age

Ensuring enabling and supportive Environment

2. Response to the Needs of Thai ElderlyLaws Regulations National Committee for The Elderly

Government Policy, Issues

Relevant MinistryMonitor and Evaluation

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 Economic and Social Development Board: Integrate issue of population Aging into main stream National Development Agenda

Thai Constitution

Thai Older Persons Act 2003 Thai Older Persons Act 2003 : National Committee for the Elderly

คณะกรรมการผู้��สู�งอายุ�แห่�งชาติ�


Thai Older Persons Act 2003 Thai Older Persons Act 2003 : National Committee on the Elderly: Elderly Fund

คณะกรรมการผู้��สู�งอายุ�แห่�งชาติ� คณะกรรมการบร�ห่ารกองทุ�นผู้��สู�งอายุ�


Thai Older Persons ActThai Older Persons Act: The provision of the 2003 Act … 12 areas: The provision of the 2003 Act … 12 areas

Health Services ReligiousOccupation

Social ActivitySocial Activity Facilities FacilitiesPublic TransportationPublic Transportation


Entrance fees exemption Entrance fees exemption AllowanceAllowance Abuse Abuse

LegalLegal Accommodation Accommodation Funeral Funeral


2. Response to the Needs of Thai ElderlyLaws Regulations Laws Regulations

National Committee for The Elderly

Government Policy, IssuesGovernment Policy, IssuesRelevant MinistryRelevant MinistryMonitor and EvaluationMonitor and Evaluation

National Centers / Policy advocacy

Long Term Care sub-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

Care Giver : Formal

Care Giver

: National Saving Fund 2010: National Saving Fund 2010

กองทุ�นการออมแห่�งชาติ� กองทุ�นการออมแห่�งชาติ� ((กอชกอช.).)

Start : 8 May 2012Start : 8 May 2012

50 บาทุ แติ�ไม�เก�น 13,200 บาทุ ติ�อปี�

2. Response to the Needs of Thai Elderly

2. Response to the Needs of Thai ElderlyLaws Regulations Laws Regulations

National Committee for National Committee for The ElderlyThe Elderly


Relevant MinistryRelevant MinistryMonitor and EvaluationMonitor and Evaluation

: 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 Age 55

2. Response to the Needs of Thai ElderlyGovernment Policy, Issues


Laws Regulations Laws Regulations National Committee for The National Committee for The ElderlyElderly

Government Policy, IssuesGovernment Policy, IssuesRelevant Ministry & Local Administration

Monitor and EvaluationMonitor and Evaluation

Ministry of Public HealthAdministrative Committee on Elderly HealthOperative Committee on Elderly Health: 9 Departments

National Health Security Office National Health Assembly Ministry of Social Development and

Human Security Ministry of Interior, Ministry of Labor

2. Response to the Needs of Thai ElderlyRelevant Ministry & Local Administration

Old Age Care Program from Old 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)


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

*Cataract Surgery 165,248 cases Heart Surgery 7,210 cases


Relevant Ministry & Local Administration

Old Age Care Program from Ministry of Old Age Care Program from Ministry of Public Health with Ministry of Science and Public Health with Ministry of Science and TechnologyTechnology

: 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 2008-2010 : Dental Implant for Over Complete Denture 2008-2010 (Target 10,000 cases)(Target 10,000 cases)

: 2012 -2015 (Target 8,400 cases): 2012 -2015 (Target 8,400 cases)

90,000 cases90,000 cases 5,000 cases 5,000 cases



Old Age Care Program from Ministry of Old 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 Care approx. 900,000 Health Care Volunteer in 2009Volunteer in 2009



Old Age Care Program from Ministry of Public Health

: Health Promotion Temple Project (2,000 Temple)

: Public Nursing Home (Pilot Project)



Mosque : Elderly Community Rehabilitation Model 2011

3,500+ Mosque in 36 Provinces


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


Old Age Care Program from Ministry of Public Health: Elderly Health Club (Register with Senior Citizen Council of

Thailand 12,000 Clubs)


Population Ageing , Future ChallengesRole of Local Administration

(Community Nursing Home, Community Rehabilitation)

Role of Community

(Elderly Club,Health Voulunteer)


2. Response to the Needs of Thai ElderlyLaws Regulations

National Committee for The Elderly



Monitoring and Evaluation

Topics



4. Way forwards

3.Problems and Problem Solving

Standard of Elderly CareHuman Resources (Professional, Nonprofessional)

Balance between Community and Institutional Care

Long Term Care Financial System


Standard of Elderly Care: Institutional Care (Hospital Nursing Home Residential Home): Non-institutional Care (Home Care)


Human Resources: Professional, Doctor, Nurse, PM&R, Occupationist, Nutritionist, Social worker, Care Manager !: Non-professional, Nurse Assistance,Paid Care Giver, Family Care Giver,


Balance between Community and Institutional Care: Intermediate Care: Community Based Home Care

Ratio of Elderly Health expenditure under National Health SystemCivil

ServantWelfare

Social Securi

ty

Universal Health

Care Scheme

Under 60

75

%99

%8 7 %

Age 6 0 and

Over

25

%1 % 13

3.Problems and Problem SolvingLong Term Care Financial System

Symbol Represent Thai Elderly

Suwannabhum Airport

Topics



4. Way forwards

Future Challenges

1.Elderly Care Giver

2.Urban Elderly Care Model

3.Elderly Care During Disaster

4. Elderly Long Term Care

4. Way forwards

Thank you for your

Attention

Providing care in Thailand

Environment

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