BANGKOK – If you were to ask the people of Bangkok what problems they most earnestly want the city to solve, most respondents would point to nagging issues like traffic congestion, flash floods and the need to preserve more green space.
But what about concerns linked to the capital’s fast-ageing society? Few people pay much attention to them or think they apply to them.
Despite the lukewarm interest, a fast-greying society is a huge concern as it means more people will be leaving the workforce with fewer replacing them to help prop up their social welfare and other costs.
The question is how long will these people be able to survive, and what can state agencies do to ensure they enjoy a decent life?
The Bangkok Post spoke recently with Thaweesak Lertprapan, a deputy Bangkok governor in charge of promoting a more healthy society, to find out what the Bangkok Metropolitan Administration (BMA) plans to do to keep its elderly citizens happy and healthy.
How does City Hall view the problems associated with an ageing society?
First of all, I have to say that we already are an aging society, especially in Bangkok. And from the experience of other capital cities that are now dealing with a greying society, a larger city tends to have a more serious version of those problems.
One reason is that we have changed from being a society dominated by extended families to one that is more isolated and built around the nuclear family. Rising living costs make it harder for many people to cope with the additional costs of raising a child, which is believed to be a factor in the steady drop in the birthrate in the capital since 2012.
Bangkok recorded about 800,000 births in 2012, 780,000 in 2013, 770,000 in 2014, 730,000 in 2015 and 704,000 in 2016.
Meanwhile, the elderly demographic continues to rise because people are tending to live longer thanks to scientific developments, a better diet, and more health-conscious habits.
But one of the main problems facing old people remains access to health care, which is too low. Many elderly people have become bedridden patients and their children do not have enough money to cover the costs of transporting them between home and hospital often. It is sad but true to say that some don’t even have children to care for them.
Imagine if the birth rate continues to fall and people live longer and longer. That would soon make the elderly demographic the predominant one nationwide. At present, 16% of Bangkok’s registered 10 million people are aged 60 or over — and this doesn’t even take into account the unregistered population, which is believed to be 50% as big.
It’s estimated that in the next eight years, three in 10 people will be ranked as elderly, which totally fits the definition of a fully fledged ageing society.
So, how is the city preparing to deal with that?
One project that is already under way is aimed at making life more convenient for elderly people when they visit hospitals under the BMA’s supervision. They are given priority in booking appointments by phone ahead of their visit. There are currently nine such hospitals where elderly patients are guaranteed they will not have to wait for more than an hour to see a doctor.
Normally patients have to arrive very early in the morning and wait hours for their turn, so this should help a lot in terms of saving them time. It should also make the hospitals less crowded due to the more efficient management of patients.
We also have a plan to expand five hospitals and build two new ones in the districts of Klong Sam Wa and Bangna. They are expected to be completed early next year.
Another project dubbed “caregiver” sees nursing volunteers visit bedridden patients who have returned home from hospital. It has 1,800 volunteers and expects to recruit another 1,200 by year’s end.
Information about the patients obtained by the volunteers is compiled on a digital database at the BMA’s Homeward Referral Centre, which falls under the auspices of the BMA’s Health Department. This includes details on the state of their health and the hospitals where they have received long-term treatment. Relatives of bedridden patients can also request help from the volunteers.
Over the past year of implementing this project the centre has stored information on about 9,000 people for use in improving its service. The BMA aims to keep expanding its hospital network and increasing the capacity of its home-based care project to serve bedridden patients.
This is part of a broader effort to cut the number of those who are receiving treatment and care at hospitals where beds are limited. Bangkok hospitals have a combined capacity of 35,000 inpatients but BMA hospitals can only accommodate 2,000.
The project also helps families cut the costs of caring for such patients, which is estimated at between 1,000 baht and 2,000 baht a day.
Any other measures to help elderly people in general?
The BMA has opened centres to promote healthy living to people of all ages in a project that is effectively “rebranding” the BMA’s youth and sports centres as health-promotion facilities.
They used to carry the word “youth” in their name, leading people to think they were intended only for young people. This could have made the elderly reluctant to visit them to exercise or engage in other recreational activities. So the BMA decided to change the name to attract people of all ages.
Apart from the changed name, more activities and services will be added so they can cater to a wider range of visitors on a multi-purpose basis, offering entertainment, exercise and other recreational activities.
Future services may include health screenings and a wide range of occupational training programmes such as foreign language courses. Basically, all kinds of activities can be created to attract the elderly to come visit. At least they can come to meet people and make new friends. All of the services are free but guaranteed to be high quality.
The BMA intends to open such centres in all 50 districts by year’s end. It will also extend their service hours so they open two hours earlier in the morning, running from 6am to 8pm. This means students and day workers can all drop by at some point.