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

Section 6: Policy and Programme Responses
referral system and covers inpatient care at public or
private facilities subject to a ceiling for reimbursement
in the case of private outlets.
In recognition of the increasing demand for quality
health care provision for elderly, the Ministry of
Public Health established the Institute of Geriatric
Medicine in 1992. The Institute serves as a focal point
to develop and transfer new knowledge and
technologies on gerontology as well as to develop new
effective models of health care for older persons. By
2007, all government hospitals have clinics to
provide health services specifically for older persons.
In addition, government hospitals are to have
especially designated fast lanes for older persons
using outpatient services and to have announcements
and notices explaining services that are readily
understandable to older persons.
The Ministry of Public Health launched the Home
Health Care Project in 2005 as a proactive health care
service for the elderly at the community level. It is
directed at older persons who are discharged from
hospitals and need continuing care at home or who
are chronically ill or with disabilities and need
monitoring. As of 2006, the project was underway in
all regional central hospitals and provincial hospitals
as well as 65 per cent of the community hospitals. In
addition, several other projects exist to provide home
and community health care integrated with social
services e.g. the Bangkok 7 Model and the
Community Based Health Care and Social Services
Model (MSDHS 2007).
6.6 Other social services and projects
Homes for the aged. In line with the emphasis of the
family as ultimately responsible for elderly members,
long term institutional residences for the aged are
considered only as a last resort by the Thai
government as a way of dealing with elder care.
Moreover, there has traditionally been widespread
aversion among the public to such long term care
facilities (Knodel, Saengtienchai and Sittitrai 1995).
Thus the number of government supported
institutional homes for older persons is very small with
only a few thousand residents. The first such home
for the aged was set up in 1953 by the Department of
Public Welfare for older persons who are poor,
homeless and have no one to care for them. The
number of homes under central government
administration expanded to 20 until 12 were recently
transferred to local administration organizations. In
2006, the role of the eight that still operated by the
central government was expanded to provide day care
services to nonresident older persons who stay with
their families. To reflect this the homes are now called
Social Welfare and Development Centres for the
Elderly. Also, four additional such centres were
established bringing the total number to 12 such
centres with an estimated 36,000 persons accessing
services annually (MSDHS 2007). Several charitable
organizations, mostly religious-related, also operate
old-age homes.
Social service centres. The Department of Social
Welfare opened the first social service centre for
elderly in 1979. At present there are 19 such centres
operated by the central and local government
administrations (National Commission of the Elderly
2005). The centres provide in-house services and
emergency shelter for older persons. The in-house
services provided include day-care, therapeutic and
rehabilitation services, medical screening and
treatment, counseling, religious and recreation activities.
Multi-Purpose Senior Citizen Centres. In 2006 a
pilot project to establish Multi-Purpose Senior
Citizen Centres was approved by the Bureau of
Empowerment for Older Persons. The project is
intended to involve both the family and community
in the activities of the centres and to encourage older
persons to contribute and manage their own
problems. Services are provided both at the centre
and at home with the intention to strengthen both
the physical and mental well-being of older persons
in the community. The project is being launched in
8 areas of the four regions and Bangkok (TGDRIF
2007, MSDHS 2007)
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