New measures for a new age
Local communities are at the forefront of efforts to prepare for a greying society
As Thailand's population ages, the key concern rests with how senior citizens will be properly taken care of as many of them live alone and lack activities to keep them fit.
Elderly people show they have a sound mind and a sound body after participating in a programme to restore their strength and mental health arranged by the Donkaew tambon administrative organisation (TAO) in Chiang Mai's Mae Rim district.
But the elderly in tambon Donkaew of Chiang Mai's Mae Rim district are feeling at ease as their tambon administrative organisation (TAO) took the issue seriously and put together a programme that helps restore some vitality and make life easier for the elderly.
"Tambon Donkaew presents a model for practising how to care for the elderly and the disabled, which keeps them upbeat and in good spirits," said Noppadol Na Chiang Mai, chairman of the TAO.
"We have a group of healthy senior citizens who are ready to assist other elderly people in need of help."
Volunteers and experts assist the elderly residents in getting into their exercise routines, either individually or in group.
The TAO also has a facility where the elderly can borrow the equipment they need to help make life easier in their golden years, such as wheelchairs, walkers and beds.
Some items have been donated from people who no longer need them. The TAO also borrowed some equipment from the Rajanagarindra Institute of Child Development without charge.
The TAO also campaigns to promote healthy food for the elderly, some of whom are encouraged to grow backyard vegetables for their own consumption while their diets must not be too oily, sweet or salty.
Local vendors who regularly sell food to the elderly are also asked to go easy on the salt and sugar when making dishes.
Ubol Yawainawichai, chief administrator of the Donkaew TAO, said in the past the Donkaew community nursed a lot of sick, elderly and disabled, including those bed-ridden, who had little access to state healthcare services. They stayed at home alone fending for themselves, she said.
But the community began drawing in volunteers to care for the older people in their homes.
"We have put this caring project into practice and hope to pass it to the next generation. It's ingrained in us and it's something we are proud to call the 'Donkaew DNA'," said Ms Ubol, describing how caring for one another runs deep in community residents' veins.
People in all quarters in the community are welcome to take part in the scheme.
The community also started a scheme called "One household, one CPR" to cater to to the older population. CPR stands for cardiopulmonary resuscitation.
If someone's heart stops beating for four minutes or longer, they are declared medically dead. Surveys found that it took about six minutes to bring patients from the southern area of the TAO to the community hospital, and eight minutes from the northern part.
An elderly woman walks with greater ease using a walker on loan from the Donkaew TAO. photos by Penchan Charoensuthipan and the National Health Security Office
It is therefore essential that residents, including elderly people, are trained to perform CPR as this could mean the difference between life or death if one of their neighbours requires emergency help, Ms Ubol said. CPR training classes are held at local schools.
The TAO has advised families suffering from acute illnesses that one member should be well-versed in CPR. A training manikin is taken to households so families can practise, she said.
Ms Ubol said the TAO has asked locals to share stories about the illnesses their families contracted to spread knowledge about them, as this could lead to more effective treatments.
For example, in one case, two local residents died after manifesting the same symptoms, including weakened muscles. They were confined to bed until their last days.
The community assumed that both had died of chemicals from pesticide sprayed in the farms, she said, adding this led to requests for farmers to undergo blood tests.
The tests confirmed that 50 people had toxic chemicals in their blood. The findings, Ms Ubol said, triggered a public relations drive in the community to phase out chemical use in farms, which subsequently produced pesticide-safe crops.
Ampan Sunthonchaiboon, a 77-year-old resident of tambon Donkaew, said she gets around with greater ease thanks to an electric wheelchair she borrowed from the TAO's assistant scheme. She now manages to cover longer distances outside, something she didn't think possible before.
"Credit is also due to the doctors and nurses at the Donkaew community hospital who check on the health of community residents," Ms Ampan said.
Looking after one's physical health is not enough, though.
Every Thursday morning, Ms Ampan turns up at the Homsuk School where she attends sessions reserved exclusively for the elderly, such as chanting prayers, meditations and mild exercises.
On Fridays, she makes a trip down to a physical therapy centre for the elderly and the disabled. It is here that she stretches out, which helps build up her stamina and gives her a little of that precious agility, under the supervision of a skilled therapist.
The National Health Security Office (NHSO) is the core agency lending financial support for the Local Administrative Associations (LOAs) to conduct health improvement projects for the elderly.
The NHSO concentrates on getting across long-term care, known as (LTC), to the elderly who need it the most, according to Dr Karoon Kuntiranont, deputy secretary-general of the agency. It forms a prompt and effective response to the government, which has prepared policies suited for transitioning the country to an ageing society.
Dr Karoon said in fiscal 2019, the government earmarked a budget worth 916.8 million baht to be spent by the NHSO in delivering the LTC to elderly people. The administration targets 152,800 LTC people.
Of the budget, 150 million baht will be injected into the local service units nationwide tasked with caring for the elderly. Each unit receives around 100,000 baht a month to look after the elderly in their catchment areas.
Meanwhile, 741 million baht goes into the local health security funds managed by LOAs, he said.
Back in tambon Donkaew, the Community Caregiver Centre is up and running. It dispatches medical practitioners and caregivers to assist people in their homes.
Panitta Sudduangkaew, 59, a manager at the centre, said the population of the tambon is about 15,000 and around 10% are 60 or older.
About 170 of the elderly and disabled are in frail health. They need close attention and regular visits by caregivers. About 20 are bed-ridden.
Ms Panitta said about 100 senior citizens make it a point to come to the spiritual-boosting and low-intensity exercise classes at the Homsuk School. About a dozen are over 80.
She said she felt privileged to be running the centre in her home community.
"They are like relatives to me. They need all the healthcare services and assistance that can be made available," she said.
She said the elderly find the company of one another pleasurable as they go about their routines in the class, with nurses on hand to observe their health condition.
Some elderly people have been advised to attend physical therapy sessions to regain their strength, she said, noting most of the senior citizens are languishing from weak muscles.