Working towards the golden years

Thirteen years have passed since Thailand officially entered the “ageing” society and 16 since it adopted the Second National Plan for Older Persons, 2002-2021 and while the intentions were good, a mere 28.6 per cent of the goals set out have actually been implemented and progress continues to be painfully slow on other objectives listed in the strategy.
Now help is on the horizon. Instead of letting the government go it alone, the Pfizer Thailand Foundation has stepped in with a three-year project titled “Pfizer Healthy Ageing Society”.
“We considered many projects but decided on this one in light of the lack of progress on the national plan and the fact that the focus is on seniors who are going to retire very soon or have already retired. Besides, most of the projects focus on healthcare while we think that financial preparation is also crucial. The Pfizer Healthy Ageing Society therefore focuses on physical health, mental health and savings,” says Siriwan Chuenchomsakun, a trustee and secretary to Pfizer Thailand Foundation.
Without preparation for life in their golden years, Thailand’s elderly cannot be guaranteed a comfortable existence. It’s expected that by 2021, more than 20 per cent of Thailand’s population will be over the age of 60 making Thailand what is known as a “complete ageing” society. By 2023 will be a “super aged” society, meaning that the elderly will make up more than 28 per cent of the total population.
Pfizer Thailand Foundation is working with Kenan Institute Asia and the project, now in its second year, and following 12 months of implementation in Bangkok, has turned its attention to building a healthy elderly population in Ubon Ratchathani Province
The project brings together a panel of the country’s leading health academics and practitioners to provide a deeper understanding of healthy living and behavioural change that will lead to good physical health, strong mental health and adequate savings. 
The Bt17 million budget is funded by the foundation and is used to create workshops and activities to build on the health, society and economic data collected from target populations. It then uses that information to develop a holistic healthcare approach for pre-seniors (aged 45-59), selecting them from the public healthcare and school systems by giving them the knowledge they need to prepare for old age.
“They not only have time to prepare but we hope that each of them will pass on the knowledge to their communities and students,” says Supaporn Mahaphontrakoon, project manager, Kenan Institute Asia.
The society’s recent pre-senior workshop in Ubon Ratchathani Province saw 120 change agents from public health offices, community healthcare volunteers, community development academics, and community thought leaders participating, exchanging holistic health and financial knowledge vital to bring about behavioural shifts towards wellbeing and healthy ageing. The activity plays a vital role in helping to imbue a deep understanding in the community and prepare Thailand to become a truly healthy ageing society.

It is just one of several workshop and activities, with topics ranging from “get to know about healthy ageing and preparations for ageing”, “lovely home”, “how eating can prevent NCDs”, “ease mind, balance body”, “anti-amnesia medicine” and “financial literacy’.
The Bangkok leg of the project tackled the Khlong Toei and Bang Khunthien areas where relationships between potential change agents and the community were already strong.
Both locations created around 120 change agents and each of them will pass on their knowledge to around five people. “In fact, what we learned is that they can spread the knowledge to 30 individuals,” Supaporn says. 
After the training, the change agent distributes healthy ageing practices to their groups, from teachers to students or from public health officers to their patients and their communities. In Bangkok, the project also provided nine grants of Bt50,000 for proposals initiated by the change agent to implement in their community so that they can pass on their knowledge through the activities.
“What we found is that each project is mainly in healthcare and in a conventional format. So we gave some advice to allow them to start by addressing problems or issues already faced in the community and which therefore will have more impact.”
 Ubon Ratchathani was chosen because it is home to a high number of elderly and has strong and active community relationships between public health officials and older people. 
Kesorn Prachoomdaeng, 55, is a public health technical officer who works in the town’s municipal hospital and focuses on preventive care. She’s responsible for three villages and decided to join the project to learn more about wellness in the elderly. “I am going to be an old person soon, so I want to prepare for it,” she says. 
Meanwhile Pimporn Uthaphu, 40, also a public health technical officer but from Warin Chamrab, says she had never really thought about the need to adapt the home to cater to elderly, such as replacing the squat toilet, which is still in common use upcountry, providing easy to use faucets and adapting stairs to avoid falls. 

Kesorn and Pimporn also benefited from learning about the mental health of the elderly as both have parents living with them. 
 “What we heard during the training is exactly what is happening at our homes and that has given us a better understanding of an old person’s mentality,” says Kesron, adding that her mother who has just finished chemotherapy for cancer wants to go back to working in the rice field. Pimporn’s father has all the symptoms of alcoholism but still drinks everyday.
As civil servants with a pension, they admit that the knowledge about savings doesn’t really concern them. Yet according to the project’s baseline KAP (Knowledge Attitude and Practice) survey conducted by Kenan, financial literacy is a forgotten issue on the elderly agenda. While many do understand the importance of saving, they find it impossible to manage their finances. A whopping 65 per cent in Bangkok and 93 per cent in Ubon have household debts.
Suvipha Chaladki, the consultant from Kenan responsible for the project’s financial components, says that despite huge debts, it is not only possible but vital to have savings.
“If you are in debt and don’t have any savings, then what do you do when you have, say, a medical emergency? You end up having to borrow money and that increases your debt,” she says.
Dr Kittima Sriwatanakul, senior project manager, Pfizer Thailand Foundation, adds that even though the project aims to raise consciousness for soon-to-be seniors, it would be impossible to implement it countrywide. 
“So we have to build the change agents as the key persons to pass on the knowledge. It’s a big issue so we want to create a model which the government sector can work from and expand.” 
The major problem, she adds, is to convince people to change their attitude. 
“We all have the knowledge and know how to do it but we can’t do it. So we have to change our attitude then do it repeatedly until it becomes a habit. Changing the behaviour is the toughest part, as people will only do that if they face a crisis. But getting old is not a crisis and if we ignore the preparations until we are actually old, then it’s too late.” 
Siriwan Arunthippaitoon, senior expert with the Ministry of Social Development and Human Security’s Department of Older Persons and adviser to the project, says the first phase of the project was successfully implemented thanks to the cooperation between the government and private sectors, and civil society. 
“Today the project is entering a second phase built on strong national and community networks,” she says.