Thailand – Resources to support community and institutional Long-Term Care responses to COVID-19

LTCcovid Country Profile – Printable Version

1.00. Brief overview of the Long-Term Care system

Families provide most of the care given to older persons, at home and without payment. Home-based care provided by trained volunteers or paid caregivers is growing, and helps to support informal care-support systems (source: Country Diagnostic Study on Long-Term Care in Thailand | Asian Development Bank (adb.org).

Update for: Thailand Last updated: January 6th, 2022

1.01. Population size and ageing context

The Thai population was 69,625,582 in 2019, life expectancy at birth was 73.12 years for men and 80.62 years for women in 2019. The number of older persons is expected to increase from 11.3 million (16.7% of the Thai population) in 2017 to 22.9 million (33% of the Thai population) by 2040 (source: Country Diagnostic Study on Long-Term Care in Thailand (adb.org)).

Update for: Thailand Last updated: September 8th, 2021

1.03. Long-term care financing arrangements and coverage

Total public spending on health-related LTC was 1.7 billion in 2012. The Ministry of Public Health is the major source of finance (1.6 billion). Spending by nongovernment organizations (NGOs) on health-related LTC was 70.3 million. Finance from family members is a major source of funding for LTC in Thailand. Government revenue is a source of finance for the Community-Based Long-Term Care Program, under the National Health Security Office (NHSO). But out-of-pocket payments are the main source of funding for LTC in private residential facilities.

References:

Asian Development Bank (2020) Country Diagnostic Study on Long-Term Care in Thailand. ADB.

Update for: Thailand Last updated: December 17th, 2021

1.05. Quality and regulation in Long-term care

Update for: Thailand Last updated: February 21st, 2022

1.08. Care home infrastructure

Residential nursing care and specialist care are less available than community care, but they are growing as well. Most residential care services for dependent older persons are found in private nursing homes and private hospitals, although some residential homes and homes for poor older persons are financed by the government and charitable organizations. The Ministry of Social Development and Human Security manages public homes called “Social Welfare Development Centers for Older Persons,” which aim to provide shelter, but also a degree of care for residents if they develop care support needs. Services at residential care facilities range from basic to complex care, including accommodations, help with personal hygiene, assistance with ADL and moving about, care that requires nursing skills, rehabilitation, day care, respite care, and hospice care (source: Country Diagnostic Study on Long-Term Care in Thailand (adb.org).

A survey of care home residents living at two government long-term care centres during August 2020 to October 2020 found that most residents (82.5%) lived in shared rooms (government financed rooms) and the median length of stay was 5 years (Srifuengfung et al., 2021).

References:

Srifuengfung, M., Thana-Udom, K., Ratta-Apha, W., Chulakadabba, S., Sanguanpanich, N., & Viravan, N. (2021). Impact of the COVID-19 pandemic on older adults living in long-term care centers in Thailand, and risk factors for post-traumatic stress, depression, and anxiety. Journal of Affective Disorders, 295, 353–365. https://dx.doi.org/10.1016/j.jad.2021.08.044

Update for: Thailand Last updated: January 14th, 2022

1.09. Community-based care infrastructure

For many years, Thailand has explored models of home- and community-based care, with an emphasis on services provided at home, initiatives over the years including training volunteers to provide care services in the community (e.g. home visits, assistance with meals, assistance with taking medicine etc); and various integrated community-based care projects. The Community-Based Long-Term Care Program, under the National Health Security Office (NHSO), started in 2016 and had provided care to some 193,000 older persons by 2018; there are plans to expand it throughout the country (source: Country Diagnostic Study on Long-Term Care in Thailand (adb.org).

Update for: Thailand Last updated: February 1st, 2022

1.10. Workforce conditions: pay, employment conditions, qualification levels, shortages

In general, care for older persons in Thailand is provided by informal caregivers. After informal caregivers, volunteers are the next most important group providing LTC, Volunteers are usually officially trained in the basics of caring for older persons. Although they work without pay, those who volunteer for government projects receive transport allowances. The roughly 1 million village health volunteers (VHVs) in
Thailand play an important role in the country’s care system, but they do not have any specific responsibility or training for LTC.

The two main government programs that utilize volunteer caregivers are: 1) the Home Care Volunteers for the Elderly (HCVE); 2) the Community-Based Long-Term Care Program, under the National Health Security Office (NHSO), which uses volunteer caregivers in
about 75% of the participating districts and paid caregivers in the other 25%. The HCVE volunteers are trained for 3 days, for a total of 18 hours, in basic personal care of older persons, the role of the volunteer, welfare and social services for older persons, and health promotion for older persons. The caregivers involved in the Community- Based Long-Term Care Program receive 70 hours of training whether they are
volunteers or paid caregivers.

Professional care personnel encompasses professionals who work in the health and social professions, including doctors, nurses, physiotherapists, occupational therapists, and other health personnel who receive payment for the provision of care services.

Nonprofessional care personnel encompasses people who actually provide private care for older persons, especially at home and in the community. They do not necessarily have formal training, but use past experience in caring for their own family members or their own knowledge and skills to provide care for others. This group includes care assistants, trained paid caregivers, untrained paid care givers, domestic workers (source: Country Diagnostic Study on Long-Term Care in Thailand (adb.org).

Update for: Thailand Last updated: January 6th, 2022

2.04. Impacts of the pandemic on access to care for people who use Long-Term Care

A study in Thailand investigated how the COVID-19 pandemic has affected 200 older adults without dementia living at two government long-term care centres during August 2020 to October 2020. Residents reported impact on health due to having difficulties in seeing doctors and one third of residents said that their medication was insufficient.

References:

Update for: Thailand Last updated: January 14th, 2022 Contributors: Adelina Comas-Herrera |

2.05. Impacts of the pandemic on the health and wellbeing of people who use Long-Term Care

A study in Thailand investigated how the COVID-19 pandemic has affected 200 older adults without dementia living at two government long-term care centres. The prevalence of and risk factors for post-traumatic stress, depression, and anxiety were investigated during August 2020 to October 2020.

Most older people reported a moderate or severe impact of the pandemic. The most impacted area was financial due to decreased support form outside the centre. Seventy percent of respondents reported no or mild psychological stress linked to the pandemic. A minority had post-traumatic stress, depression, or anxiety. Having respiratory tract infection symptoms and receiving news via social media was independently associated with these symptoms. Residents also reported impact on health due to having difficulties in seeing doctors and experiencing financial impacts.

References:

Update for: Thailand Last updated: January 14th, 2022 Contributors: William Byrd |

2.06. Other impacts of the pandemic on people who use Long-Term Care

A study in Thailand investigated how the COVID-19 pandemic has affected 200 older adults without dementia living at two government long-term care centres during August 2020 to October 2020. The study found that residents in these care homes experienced negative impacts on their finances, this is because the income of most older care home residents in government care homes is from donations and this is often linked to organised activities or visits that did not take place because of infection risk reduction measures.

The residents also reported loss of freedom as they were no longer able to freely go in and out of the centre. The residents also reported more disagreements and worse relationships with family members, and with other residents and staff.

References:

Update for: Thailand Last updated: January 14th, 2022

3.00. Overview of the pandemic response in the Long-Term Care system

Following the declaration of a nationwide curfew in Thailand on 25 March 2020, in April 2020, the Department of Older Persons issued a manual of control and prevention of COVID-19 for all government care homes to ensure social distancing, which has been in place at least until February 2021.

The manual of control and prevention of COVID-19 in care homes includes the following measures (Srifuengfung et al., 2021):

Activities are to be organised in open spaces that are at least 2 metres apart

Beds and personal items must be at least 1 to 2 metres apart

There must be a one-way entry and exit system

Residents must maintain physical distancing as always be at least 1-2 metres apart, they must have their body temperature measured every day, their cutlery must be separate, was their hands regularly and wear a face mask, refrain from going in and out of the centre.

Visitors and people from outside organisations are not permitted to visit or organise activities.

References:

Update for: Thailand Last updated: January 14th, 2022

3.01. Brief summary of the overall pandemic response (not specific to Long-Term Care)

Thailand experienced the first wave of COVID-19 during March and April 2020, prompting the government to declare a nationwide emergency curfew on the 25th March 2020. Even if the government relaxed the measures after the first COVID-19 outbreak was declared to be under control in May 2020, most Thai people have continued to practice social distancing (Srifuengfung et al., 2021).

References:

Update for: Thailand Last updated: January 14th, 2022