ELDERLY DISABILITY IN THAILAND: RECOMMENDATIONS FOR LONG-TERM CARE POLICIES IN THE COMING ERAS

Abstract

As the elderly population is growing rapidly in Thailand, the risk of disability and chronic illness is expected to grow rapidly with increased longevity. Furthermore, it is not clear whether the risk factors of disability can be changed in the existing social system. There are three aims of this study that include 1) investigating any factors that may have contributed to the prevalence of disabilities among the country’s elderly population between 2002 through 2011; 2) identifying what needs to be done urgently to improve the quality of life for the elderly whose conditions are long term; and 3) developing a sustainable and feasible LTC delivery over the next ten years. We used data derived from Thailand’s cross-sectional Survey of Older Persons 2002, 2007, and 2011, which was conducted by the National Statistical Office, in order to conduct risk factor assessments. Six activities that include eating, dressing, squatting, lifting 5 kg, climbing up 2–3 stairs, and using transportation were compared. SPSS 18 was utilized in descriptive analysis as well as in logistic regression. Sample probability weights were applied to data for each year. Additionally, in-depth interviews were conducted with 11 key policy makers regarding the Development system of Long Term Care for Older Persons in Thailand. Interviews in the Thai language were copied and translated into English by the bilingual researcher. A thematic code and sub-codes were created by two independent investigators after transcripts were subjected to an NVivo 8. Over all three surveys, the most prevalent disability in the sample population was lifting 5 kg (30.7%). Elderly who reported that they were not working due to retirement were associated with higher risk factors than other factors. The key informants raised six issues that need to be solved urgently including an imbalance in care services, poor management systems, the need for skill among informal caregivers, a health workforce shortage, and problems with regulations and the information system. These surveys mentioned that in the next ten years, the long-term care scheme should be family-community based. Since those who did not work seven days before their interviews had higher risk for disability in our study, we suppose that older people who are not working due to retirement may be at a higher risk for experiencing disability in the future compared to those still working. This result suggests that raising the mandatory retirement age might be associated with reduced risk of some disabilities. The quality of life for those elderly individuals suffering from long-term conditions could be improved by providing integration services, consolidation of the regulatory system, building a LTC workforce, developing a delivery infrastructure, and investing in elderly health groups. LTC in the next decade must make use of the capabilities of society through a comprehensive policy. Because of these increasing needs, everyone should raise their awareness and be ready for ageing.