At 81, Salee Wattanachat is well aware of the risks and unwanted complications -- some of them life-threatening -- if she undergoes joint replacement surgery to relieve the nagging pain in her knees. She decided to opt for physical therapy and aquatic exercise programmes that work to ease her discomfort.
"I am not able to walk long distances. I don't want to have surgery. The risks and the complications following surgery run high for people of my age," said Ms Salee, who also had a slipped disc.
On Tuesdays and Thursdays, her daughter takes her to the Din Daeng Health Centre for the Elderly on Mit Maitri Road in Din Daeng district for the aquatic therapy exercise programme. The programme is part of a physical therapy course offered by the centre situated next to the Thai-Japan Bangkok Youth Centre.
On Mondays, Wednesdays and Fridays, Ms Salee enjoys recreational activities the health centre has to offer.
"Cold water makes me feel good and invigorates me," she said. "More importantly, all services are free."
Ms Salee used to be charged about 1,200 baht per hour when she used a therapeutic pool and facilities at a private hospital.
Being strategically located in the heart of city, the rehabilitation centre is easily accessible.
"It takes minutes for us to get to and from the centre. It's quite convenient for us," said Ms Salee who lives with her daughter at Din Daeng Flats.
Therapy sessions have relieved the pain in her knees gradually, allowing her to walk longer distances.
"I am now able to walk to and from the centre. It helps save travel costs," she said.
Social worker Uakamol Rugsrithong, who heads the Din Daeng Health Centre for the Elderly, said the aquatic therapy treatment services were launched in February last year.
Being a part of City Hall's healthcare policy, the services have received a positive response from elderly people who live close to the centre.
The centre is operated by the Social Development Centre. Before, it was under the Ministry of Social Development and Welfare.
The centre is equipped with a 15m by 8m hydrotherapy pool.
Other facilities include water circuits, a swim jet pool, a spa room, a sauna, a head massage machine and a shoulder massage machine.
Ms Uakamol said the BMA was concerned about the health and welfare of its senior citizens. In response to this, the agency introduced the hydrotherapy services, in addition to social and recreational activities.
The hydrotherapy services are available on Tuesdays and Thursdays from 9am to 4pm. Therapeutic treatment services which usually last about three hours are offered to groups of up to 20 people.
About 35 people use the services each day. The centre has 1,400 members.
People aged over 60, who don't rely on wheelchairs, are eligible to use the services. The pool and the facilities must not be used by people who have an open wound or skin problem.
"People who use our services must be able to take care of themselves. We have two therapists to help our members," Ms Uakamol said.
Therapist Ruangrith Rattanalapoo said aquatic therapy exercise is a good form of physical activity for older people, with no risk of injuries from falling down. This is because water acts as a cushion for the body's weight-bearing joints, and reduces strain on the joints and muscles.
Elderly people enjoy themselves as they exercise in a hydrotherapy session.
The water pressure also helps joint stability, he said.
He said normal exercise that people at all ages do often puts stress on muscles and joints, which could potentially lead to muscle soreness and injury.
The therapy approach in the hydrotherapy pool involves the use of hot and cold water to stimulate bodily reactions, water circuits, and saunas he said.
Alternating between hot and cold treatments can enhance body functions. A warm aquatic environment can particularly help reduce joint inflammation and promote blood circulation, he said.
The pool features a hydraulic pool floor that allows therapists to choose the right depth for members, making it easy for them to move and exercise, Mr Ruangrith said.
"That means a member is able to exercise standing in water from waist to shoulder depth," he said.
Facilities also include a chair lift to raise and lower patients who are not able to get in and out the pool using the steps, he said. The centre takes the health and safety of users seriously to protect both members and staff.
All members are required to follow the centre's rules regarding appropriate clothing for water-based exercises and body cleanliness and hygiene before using the pool and facilities, he said.
"In a session, we want to have a small group of about 20 so we can take personal care of the entire group's members," he added.
Mr Ruangrith said the therapy provides a safe and comfortable environment.
The pool comes with hand rails to ensure that members are able to move safely and help improve their physical skills. While bath safety mats are used to prevent people slipping and falling on wet floors, he said.
Proper sanitation procedures are carried out to ensure healthy conditions in the pool and prevent transmission of waterborne diseases.
Tools and facilities in the centre are checked and maintained three times a week to ensure quality and safety, he said.
