Thailand transitioned into an aging society in 2005 and is projected to become a “super-aged society” in the coming decades, progressing faster than both Asian and global averages. This demographic shift has placed significant pressure on the country to address the growing needs of older individuals, particularly in the area of aged care. Thailand’s current approach emphasizes “aging in place,” a model that seeks to reduce dependence on institutionalization by fostering collaboration among local governments, public agencies, the private sector, and families to deliver community-based care. Although promising, this strategy has only been implemented in recent decades and still requires further development. One major gap in this framework is the limited research examining the role of families, a central pillar of community-based care for older adults.
To better understand how community-based care can be developed to meet the diverse needs of Thai older adults with varying health conditions and socioeconomic backgrounds, this study provides an empirical description of family caregiving practices. It also explores the limitations and challenges families encounter in this role. The analysis draws on qualitative data collected between 2020 and 2023 as part of the Longitudinal Aging Study, which began in 2014. The study was conducted in the central municipal area of Nakhon Pathom Province, located west of Bangkok, using semi-structured interviews with 25 households that included older persons who were dependent to some extent, ranging from mild difficulties with daily activities to full bedridden status.
The findings reveal three recurring patterns in family caregiving dynamics. In many cases, adult children provided intermittent care while living nearby, while in others, older persons relied entirely on self-care. A notable number were cared for by the “young-old,” often referred to individuals aged around 60 to 69. Across these situations, families bore most of the responsibility for caregiving, with limited support from external community partners. Reflections from older adults and their family members underscored the difficulties they faced, particularly a lack of knowledge in managing complex health issues. Families expressed a need for more assistance to relieve their burden, yet the availability of community volunteers was limited, and those involved were often already stretched thin. Furthermore, housing environments were frequently ill-suited for older adults, contributing to falls and fractures—common causes of dependency and reduced mobility.
The study underscores the importance of strengthening support systems for families caring for older persons at home. Sustaining this model will require coordinated efforts from all sectors to ensure families are equipped with the knowledge, resources, and infrastructure necessary to maintain safe and effective home-based elder care.
View full abstract