Kasom Chanawongse

The population of Khon Province in 2007 was 1,752,414, of which 185,790, 10.6 %, were elderly (aged over 60). Khon Kaen City’s population is over 130,000, with an average household size of 4 people, 22.3% of which are headed by females. The fertility rate of the city is below the replacement rate of 1.9. 

The national aged population is projected to rise sharply, doubling by 2025 to 19.9% (12.9 million), and the rising aged dependency ratio means a reduction in income per capita, and a heavy fiscal burden on the public old-age pension and health care programs. 

All Thailand’s elderly citizens are covered for free medical care, but no specific long-term care facilities or preventative medical services are included in the Universal Health Care Scheme, with services oriented to institution and acute care based services. Health care provision to the aged is limited, and long-term care is expected to be provided at home by family members.

The Department of Social Welfare has set up a welfare fund, which provides 500 baht per month (around US$14) to more than 400,000 older persons, and local councils / municipalities administer a monthly cash maintenance allowance for the disadvantaged poor elderly, which is received by 66,118 people (71.0% of those who are entitled). 

Formal social security measures in Khon Kaen follow national policies, with over half of the budget from central government. Participation in a contributory social insurance pension scheme is mandatory, except for workers in the informal sector (which includes most workers). With the more aged population, the scheme will be unsustainable in its present form, meaning either increased government spending or reduced pension payouts, which would push many older people into, or even deeper into poverty. 

Initiatives at the community level though, are providing a productive and healthy life for elderly citizens. Ninety percent of Ministry of Health hospitals provide a fast-track medical / physiotherapy health care system and clinics especially for the elderly. The health clinics also provide a network for the exchange of elderly health care experience.

In the sub-districts and villages of Khon Kaen Municipality (numbering 2,000), home visits are made by medical staff to both sick and healthy aged citizens. Innovatively, the medical staff are accompanied by volunteer care givers on these home visits. Under the care of each volunteer are 15 subjects - 10 elderly citizens and 5 of the poorest / sickest elderly who require intensive assistance. As well as physical health checkups, the multi-discipline professional teams provide nutrition, drug administration and exercise care and assistance. The volunteers also provide transportation to take the doctors to patients’ homes, and patients to hospitals, as well as to community and religious activity centers, and on recreational trips outdoors. The volunteer service even offers assistance with home renovations for the elderly. In return, and as an incentive, the volunteers know that they will be first in line as recipients of such services when they require them, as reward for their hard work; and so the system continues. 

A number of social welfare activities are arranged by the Municipality to support the elderly, and for the elderly themselves to provide services to the community. Khon Kaen Municipality stipulates that each Tambol (sub-district) establishes one senior population club, which receives financial support even if just one activity is arranged.

In a country where the elderly are traditionally respected for passing on their knowledge and wisdom, Khon Kaen Municipality also promotes the aged as expert tutors and educators. Those who are enrolled in this system are each classified as to their skills, and sent to 11 schools by the municipality, in accordance with the requests of each school. They teach subjects as diverse as art, handicraft, agriculture, computing and management science.