Population Ageing and the Well-Being of Older Persons in Thailand ...

Section 4: Health Status
similar to those shown in panel A. However, based
on this broader definition of functional limitations,
the share who receive assistance from a caregiver is far
lower constituting slightly less than half overall.
Among the different sub-categories of elderly, only
among the oldest, i.e. those aged 80 and above, and
to a lesser extent among the urban elderly do more
than half have a caregiver.
The large majority of older persons (almost 90 per
cent) when asked who helped them most with their
daily activities responded that they did these activities
by themselves, presumably in most cases because the
did not need assistance. 13 Table 4.3 indicates who
serves as primary caregivers for all older persons who
had someone helping with daily activities as well as
separately for the subset of older persons who were
unable to do at least one of the basic daily activities
by themselves. Results are also presented separately
for married and unmarried respondents since a spouse
could be a primary caregiver only for those who are
married.
Substantial differences are evident between older men
and women with respect caregivers. For men, a wife
is the most common caregiver while for women a child
or child-in-law most frequently fulfilled this role.
Among elderly overall, more than half of the men with
a caregiver indicated that their spouse serves in this
role compared to only 13 per cent of women. A large
part of this difference arises because of the higher levels
of widowhood among women, a condition that
obviously precludes spouses as caregivers. When
restricted to elderly who are currently married, the
difference in the per cent of men and women who
cite a spouse as the main caregiver narrows considerably.
Still it is clear that even among married older
persons, wives are more likely to serve as primary
caregivers for the husband than the reverse. Nevertheless,
husbands still account for over 40 per cent of
the caregivers of married women in general and just
over half of the primary caregivers of wives who have
at least one limitation on a basic daily living activity.
As for unmarried older persons, children are by far
the most common primary caregiver with little
difference between older men and older women.
Regardless of marital status or gender almost all
caregivers are family members. In the case of married
older persons very few reported a non-relative as a
primary caregiver. Among non-married, non-relatives
as primary caregivers are also uncommon although
less so for women than men. In most cases (81 per
cent) these non-relatives were servants. Since the
survey excluded institutionalized older persons,
however, the role non-family caregivers is likely
understated.
4.5 Summing Up
Based on this brief review of the health of older
persons in Thailand several findings are worth
highlighting. An important caveat, however, is to
point out that the quality of data on older age
mortality, functional limitations, and many other
relevant aspects of health is such that considerable
uncertainty surrounds the estimates. Despite these
limitations, the various estimates of active life
expectancy as well as the ability to carry out activities
of daily living make clear that during most of their
elderly years, older Thais are in sufficiently decent
health to take care of themselves. Also the per cent of
older persons who report their health as good or very
good has recently been increasing. As a result, the
period during which the assistance of a coresident or
nearby caregiver is needed to help with basic activities
is typically only a matter of a few years. This in turn
has important bearing on the implications of
changing living arrangements described in the
following section.
At present at least, a substantial majority of older
persons who have difficulties carrying out the most
essential daily activities on their own have a personal
caregiver, the vast majority of whom co-reside with
the older person. However, those who have mobility
problems but can take care of themselves in terms of
the basic activities, are far less likely to have a caregiver
assisting them. Also contributing to a need for a
caregiver in daily activities is the considerable
proportions of older persons who have problems with
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