Thailand: Expert calls for long-term fund for elderly patients

BANGKOK (The Nation/ANN) - TDRI researcher warns of crisis if govt fails to plan for ageing society.

If they are not offered support, many people risk falling into difficulties when they lose their independence, physically and financially, in their final years. Dr Worawan Chandoevwit, an adviser on social security at the Thailand Development Research Institute (TDRI), has suggested that the government consider establishing a long-term care fund for the elderly. This is especially important as Thailand is almost a full-fledged aged society with at least one-fifth of the population to be more than 60 years old by 2021.

TDRI research suggests that each home-bound elderly person needs at least Bt10,000 a month for basic care. And the cost for each bedbound elderly person is even higher – about Bt20,000 a month. “If you spend less than that for elderly care, their quality of life will be lower than minimum standards,” Worawan said. By her definition, “basic care” refers to constant assistance from a caregiver, equipment such as walkers and toilet chairs, and consumables such as cotton buds, cotton sheets and adult diapers. This basic-care cost does not even include food, clothes, accommodation and medicine. 
Worawan said if the government did not provide basic care, many people were likely to fall into a difficult situation, given that not everyone had savings or supportive children to help them live comfortably through their retirement lives.About 370,000 elderly Thais have now become dependent on others, she said. “Within the next three decades, the number of homebound and bedridden elderly people will rise to 1.1 million,” Worawan predicted.
Although the National Health Security Office (NHSO) now operates a long-term care scheme for the elderly, it can help just 193,200 people. This year, the scheme has a budget of Bt1.15 billion.Worawan said the government should make more preparations for the country’s growing elderly population. “Let me tell you that so many elderly Thais have lived meagerly and struggled with substandard care,” she said. 
She said fewer elderly people would be in hospital beds now had proper elderly care been widely available in the past. Worawan said she believed a stronger long-term care fund for the elderly would be the right answer for society. 

“It’s not going to be expensive. People aged between 40 and 65 years old can pay just Bt500 a year during the first five years of the fund’s establishment. The amount of their contribution then will increase every five years, given that we have to take inflation into account,” she said. 
A TDRI survey, which covered more than 2,000 people, found that people were willing to pay more than Bt500 a year if that would provide them with long-term care in their final years. Worawan also said she expected the government to provide matching contributions to the fund, once it was established. She added that NHSO should manage the fund.Her concept was to provide not just basic materials and consumables but also a caregiver to each bed-bound elderly dependant. “If a person aged over 60 is certified as bedridden and home-bound by a doctor, he or she can receive long-term care via the fund,” Worawan said. 
According to her plan, there should be a caregiver at the side of a bedridden elderly person around-the-clock. This means there should be two persons taking turns to watch over the person. Family members who serve as caretakers would be paid by the fund.Worawan emphasised that the long-term care fund was different from medical treatment provided via various existing healthcare systems. “It’s not about medical services, it’s about the daily care,” she said. 

Asked whether contributions to the fund would eventually soar because of the growing elderly population, Worawan said the contribution amounts might not increase much if people learned to take better care of their health today. Tanyatip Sukpan, a certified nurse at the Tambon Ban Tamniab Hospital in Surat Thani’s Khiri Ratthanikhom district, said several bed-ridden dependants in her hometown had suffered from strokes partly because they ate too much salty and sweet food and did little physical exercise. 

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