THAILAND: Rapid Rise in Proportion of Elderly Population

BANGKOK (Thai News Service), August 20, 2007: Faced with a seismic shift of 14 million baby boomers into the country's dependent elderly population by 2025, Thai society and its economy risk being ripped apart. The impact of the spiralling number of aged and dependent on Thai society will undoubtedly be violent but problems may be avoided if the public and private sectors work together. A study by Worawet Suwanrada, an economics lecturer at Chulalongkorn University, shows that, as of this year, every six Thai adults are working to support one elderly person. In 18 years time, the ratio will be reduced to just three adults working for every old person. What is more, Thailand will have to face a shift of 14 million baby boomers into the country's dependent elderly population by 2025. The once-large structure of Thai families is gradually giving way to a single-family structure. As people have fewer children and migrate into the cities, the family safety net, long taken for granted, is growing smaller. Pakorn Pantu, director of the Bureau of Social Welfare Services at the Ministry of Social Development and Human Security, refers to the "violent" impact of the spiralling number of aged and dependent on Thai society, but says problems may be avoided if the public and private sectors work together – with the government providing clear and sustainable policies and regulations, while the private sector meets the very fundamental human need for support and care in old age. But so far progress has been lopsided, Pakorn admits. With uncertain and unclear policies and laws relating to care for the aged, the private sector – usually hospitals – is left to cope. But it does so at a price. So what happens to those without the financial means ? With the gap between Thailand's rich and poor widening, the problem is creating growing social and official alarm. Disparate government policies have long encouraged the elderly to stay with their families and communities for as long as possible. Responsibility for their interests has been delegated to local government, with the central government doing little more than monitoring standards. In countries like Japan and Singapore, financial incentives are used to mitigate the burden on citizens of caring for the aged. Activities related to care for the aged are closely monitored and regulated by the Healh Ministry. In Thailand, there is a total lack of over-arching laws and regulations that clearly define care for the elderly and the scope of work involved. This particularly affects nursing homes, which have elements of both social and medical services, and the consequence is a lack of development of the system and its ancillary industries. Due to the intensive nature of long-term care – as opposed to acute care in hospital nursing – nursing homes often have difficulty recruiting capable staff. The shortage of specialised nurses and doctors specialising in geriatric medicine is a major drawback. It is a worldwide problem, and countries such as Canada and the UK are recruiting nurses and assistants abroad. To combat the shortage, some nursing homes train their own caregivers with both theory and practice courses. But giving care is just one function, albeit a very important one, in a web of services. In some geriatric hospitals, doctors work with nutritionists, nurses, physiotherapists, psychologists and other specialists to devise the best programmes for patients. Real estate developers have been looking to break into the industry and create nursing home complexes. But bot all think that nursing homes for the elderly are a gold mine. They are not the most profitable of healthcare businesses. While hospitals want a quick turnover of patients, nurisng homes specialise in long-term care. Some hospitals thus closed their nursing home business to make room for expansion of chronic kidney disease and haemodialysis centres. In an atmosphere of crisis it is easy to be overwhelmed by talk of policies, laws and capital. But one must never forget the patients themselves, despite their swelling numbers. Source: Thai News Service