After suffering from various illnesses for about a decade, a 60-year-old bedridden woman has shown signs of recovery over the past two years thanks to carers deployed to visit her home regularly under a National Health Security Office (NHSO) programme.
"I have never thought I would be able to walk again," said Suban Kamphatu, a resident at Warin Chamrap district of northeastern Ubon Ratchathani province.
Ms Suban was troubled by several ailments, including diabetes, high blood pressure, gallstones and cataracts. The left side of her body became weak and she was eventually confined to her bed.
In 2016, the NHSO, in cooperation with the public health ministry, rolled out the "Long Term Care (LTC)" campaign, aimed at providing health care services for senior citizens who need to be taken care of by others.
Under the programme, caregivers will be sent to visit elderly patients regularly at their home to provide proper treatment and correct advice.
Ms Suban was registered in the programme in 2016. Since then she has been visited by caregivers twice a week. Physical therapists from Warinchamrab Hospital also come to her house to provide treatment.
She was trained to use elastic to stretch her arms and legs. The activity stimulated her recovery.
Ms Suban's caregiver, Ura Sila, 34, said at the beginning her patient was unable to turn over on the bed. A group of caregivers came up with an idea of weaving elastic into an exercise device which was used by Ms Suban to stretch her muscles.
"After two years, she began standing and trying to walk by herself. This is my great happiness," Ms Ura said. "This is a worthwhile return from our dedication."
"Today, it becomes the relationship. It seems we are taking care of our mother or a relative."
The LTC originated from the expectation that the ageing population would be rising rapidly in the future. The population of those in advanced ages rose from four million (6.8%) in 1994 to 10 million (14.9%) in 2014. This is forecast to jump to 20.5 million (32.1%) in 2040.
The public health ministry in 2015 estimated there were about 1.3 million elderly dependents, or 21% of 6.3 million people in advanced ages.
In 2016, the government earmarked 600 million baht to the NHSO to provide care for elderly dependents. The budget will be used to provide medical services, health promotion and illness prevention campaigns as well as rehabilitation programmes for the bedridden elderly.
The budget for the programme has risen to 1.2 billion baht this year, targeting about one million elderly dependents.
It is estimated elderly dependents use 5,000 baht in medical treatment per year.
Under the programme, centres to take care of the elderly were established in local communities with public health technical officers sent to manage the centres.
The managers would provide knowledge on how to take care of elderly patients. Caregivers are required to pass a 70-hour training programme for health care.
They are trained to check blood pressure and heart rate as well as learn basic physical therapy, how to clean wounds, and advise patients on eating nutritious meals.
There are about 20,000 caregivers across the country. They are paid between 4,000 and 4,500 baht a month. Each caregiver is projected to take care of six to 10 patients.
Caregiver Kulwadee Takdadhuaton, 27, in tambon Kung of Si Sa Ket's Sila Lat district, said she takes care of 10 senior citizens, including seven bedridden elderly patients.
She said she is glad to help take care of the elderly, who she said are like their senior relatives. She said she has to visit elderly patients twice a week.
One of her patients is 67-year-old Kamsing Katasila, who suffered a stroke.
Two years ago, the man was bedridden and relied on feeding tubes. But today, he can eat by himself and sit and started to talk again.
"Taking care of the patients, particularly the elderly, is not easy," Kulwadee said. "But after I have worked for some time, I feel this is a valuable and meaning task. To see the elderly get better makes me feel great."
The role of the caregivers also helps ease concerns among relatives of elderly patients on how to take care of their loved ones. Mr Kamsing's daughter, Boonpeng Katasila, 32, said she is happy that someone with knowledge helps take care of her father. She said she and family members didn't know how to help her father.
As health staff frequently visit her house and her father's health becomes better, Ms boonpeng said she is now confident to let her mother take care of her father.
Sakchai Kanjanawatana, the NHSO secretary-general, said the LTC covers only people with Universal Healthcare Coverage (UC) cards, widely known as the gold card scheme. It does not reach civil servants or those covered under the Social Security Fund.
Swiss expertise comes to rescue
The National Health Security Office (NHSO)'s Long Term Care (LTC) scheme, which sends caregivers to tend to ill senior citizens at their homes, was developed from a TimeBank project in Switzerland, according to NHSO deputy secretary-general Chuchai Sornchamni.
Dr Chuchai said the TimeBank project was initiated by a local administration office in St Gallen, a northern town in Switzerland, in 2008. It then spread to other cities in the country.
The project came from the prospect that the cost of the elderly living in nursing home is steep, he said.
Under the programme, volunteers visit senior citizens at home twice a week. They cook for them, clean their houses and take them for a walk, he said.
The time volunteers spend on the patients' houses would be recorded in their cards. When they need to seek help from other volunteers, they have to bring the cards to the offices to withdraw the time frame in which they could be tended to by others, Dr Chuchai said.