Bright ideas in the Grey Zone

AS HE wheels his 77-year-old aunt away from Bangkok’s first day centre for the elderly, Nakhon Thianprasert reflects on the familial duties that oblige him to juggle night-shift work and care for his ageing relative.

It is an increasingly common predicament in rapidly greying Thailand, where a demographic shift is straining social mores and threatening upheaval for the economy. 

“She raised me when I was little, so now I’ll take care of her when she’s old – it’s our culture,” says Nakhon, who’s 35. 

It’s common for Thais to take care of their ageing parents – the duty is drummed into them at an early age. But it’s getting tougher with the population of Thais over 65 expected to surge from seven million to 17 million over the next three decades, shrinking the workforce and burdening the welfare and medical systems.

While other Asian countries with elderly populations, such as Japan and Singapore, have the money to plan for welfare, middle-income Thailand is getting old before it gets rich.

The warm climate and abundant luxury retirement homes makes it a top destination for Western retirees, but the concept is taboo locally. 

Nakhon’s community in northeast Bangkok is working towards a compromise solution. Using donations, they run a small centre where children can drop off their parents during the day while they go to work or run errands.

Earlier this year the middle-class neighbourhood flipped an unused building into a brightly painted room equipped with a few beds, several rows of plastic chairs and simple exercise equipment.

Nurses and volunteers offer activities like sewing, painting and singing, plus a much-needed opportunity to socialise.

“It’s much better than staying home, where I just watch TV and do nothing,” says Nakhon’s aunt, Boonrod Khamhomkul, who suffers from diabetes and is unable to walk on her own.

The centre’s head nurse, Larita Chobpradith, goes door to door to around the neighbourhood to check on older residents and introduce them to the daycare concept. “Elderly people who have health problems don’t need to be bed-bound any more,” she says. “This way their relatives can also do their own thing and they won’t be stressed.”

Thailand’s rapid economic development, coupled with a successful contraceptive campaign in the 1970s, set the country on the path to ageing – a demographic transition that has taken some other developed countries up to 100 years.

But Thailand has only had a few decades to prepare for that shift. Some 20 million Thais – a quarter of the population – have no retirement savings and can only count on a paltry state pension.

While the Kingdom does have universal healthcare, many elderly people, especially in rural areas, struggle for access to it, says Sutayut Osornprasop, author of a recent World Bank report on ageing in Thailand.

He says more state support for community care programmes would help ensure that everyone gets the needed care. “In communities that are interested in elderly issues, we see very good results,” he says. “We need to think about the approach of community-based healthcare.”

A shrinking work force also threatens to weigh down the country’s already slumping economy. Neighbouring nations like Myanmar and Cambodia, whose populations are relatively young, are positioned to become increasingly appealing options to foreign investors looking for cheap labour.

One solution, says Kirida Bhaopichitr, a researcher at a Thai think-tank, is to shift the country’s economy away from agriculture towards services, giving elderly people opportunities to remain in the workforce. “As Thailand ages, the service sector could be a future engine of growth,” she says.

The country is also considering raising the retirement age and creating tax incentives for businesses to hire older workers.

Community leader Tanapol Petchmali, 64, was behind the first elderly daycare centre, but says more changes are needed.

“One day while I was working, I walked out here and saw an old woman carrying a bag and crying,” he says. The grandmother had been kicked out of her home and had nowhere to go.

“That was the starting moment that made me feel that, if we kept letting this happen in society, it would be trouble for sure.”