Thailand is becoming an "elderly" society due to significant growth of its population aged over 60 and a worrying decline in the birth rate.

The portents of an "elderly explosion" in Thai society have been observed and confirmed by demographers at Mahidol University's Institute for Population and Social Research (IPSR), which sounded a warning recently at a United Nations Population Fund (UNFPA) conference in Bangkok.

"The proportion of the elderly in Thailand's demographic structure is growing significantly," said IPSR demographer Professor Pramote Prasartkul.

The number of people aged 60 and over in Thailand will almost double in the next 20 years, from about six million currently about to 11.6 million, he said.

"Normally, the proportion of the elderly was about 5 per cent of the total population. It rose to 10 per cent six years ago, in 2000, and will reach 20 per cent in 2020, just 14 years from now."

At that point, two out of every 10 Thais will be aged 60 and over, making up a larger proportion of the population than children under 15, something that has never happened before in Thailand, he said.

"The size of our population should not be more than 65 million, but the proportion of the elderly will get larger and larger, with fewer children. This is the result of our past success in birth control," Pramote said.

Between 1963 and 1983 the number of births in Thailand each year was more than one million, known academically as a "million-birth cohort". This led to the launch of birth-control policies that were widely praised by the international community for their excellent implementation. Thailand's annual birth rate has never reached the one million mark since 1983 and is still on the decline. But this success has had a larger impact than originally foreseen.

"The million-birth cohort is like a big wave in population structure and development. Children born during those 20 years are now of working age, between 23 and 43 years old, and a large proportion will be aged over 60 in the next 20 years or so," Pramote explained.

"At that point today's children, who are fewer in number, will be of working age and will have to shoulder the burden of a larger number of elderly," he predicted.

The worry for Thailand is how to cope with the burden that this greying population will inevitably place on all sectors of the country, the demographer said.

"They will be of retirement age and no longer work, but will still need to meet the cost of living and larger medical bills," Pramote said.

Compounding this problem is another trend in the Thai population - the increase in the number of people living alone as a result of changes in the family structure over past decades, he said.

Pramote said IPSR researchers were worried by three factors in particular.

First, the age of first marriage has gone up. The average age of men marrying for the first time rose from 22.1 years in 1960 to 24 years in 2000, while among women the rise over the same period was from 25 years to 27.3 years, he said.

Second, the researchers found that the proportion of unmarried women had risen from 22.8 per cent of the total population in 1960 to 31.8 per cent in 2000.

Third, the number of children born per woman has dropped dramatically, from an average of 6.3 in 1964 to two in 1996 and 1.7 in 2004.

"That means that the birth rate is now less than the replacement rate: one father and one mother have less than two children," he said.

The IPSR research team also noted four trends among the elderly. The number of women is larger than the number of men and growing. More of the elderly are living alone. The number of those living with people other than their immediate families is growing. And the number of those living only with their spouse is decreasing.

"Everything in our forecast makes us worry. Thailand needs a policy to prepare society for the age of the elderly," Pramote said.

"Even though this trend is the same as in other countries, especially developed countries, the phenomenon is happening in a much shorter time in Thailand. This means we have less time to prepare our people for this rapid change," he said.

There is no better place to examine the implications of an ageing population that Ban Bangkhae in the capital's Phasi Charoen district, Thailand's oldest home for the aged.

"From what we are experiencing here, the number of elderly people is getting larger and so is the magnitude of their problems," said Umaphorn Phongjit, who has worked at Ban Bangkhae for 11 years.

The three main problems the elderly face are health, finances and the lack of care-givers, she explained.

"About 75 per cent of them face 'elderly' chronic diseases like diabetes, high blood pressure and back pain that need continuous treatment and care," she said.

"A large number have financial problems because they did not put aside enough savings during their working years, especially those who were farmers and labourers," Umaphorn said.

Because of the magnitude of these problems, she said, institutions like Ban Bangkhae cannot be the answer, especially in the long term.

The policy on care for the elderly is changing as a result, and homes like Ban Bangkhae and others around the country no longer encourage people to spend their last years at such facilities. Instead, the elderly are now being sent back into the community.

"Many people continue sending their elderly relatives to us due to the misunderstanding that we can cope and will take better care of their relatives than they can as they have don't have the time. Many of these are refused," Umaphorn said.

"We will accept only those who really need us: those who really have no family, those who have memory problems and those who need medical treatment," she said.

Under the new approach, Ban Bangkhae and other such facilities will work as consultants to communities and provide financial support to community projects to promote activities for the elderly involving their families and the public.

"Instead of seeing them as useless people waiting for death, the new approach is to see them as valued people whose life experiences and expertise in particular fields are useful to the community. So we will promote community activities to bridge the age gap and make the elderly a valued resource," she said.

This approach is also being applied to residents of Ban Bangkhae today, Umaphorn said. They are being sent to nearby schools to teach students about their particular expertise and the results have been better than expected, she said.

Currently, Thailand has eight state-run homes for the elderly, including Ban Bangkhae, in eight provinces. Another 15 similar institutions are run by local administrative organisations and another 35 are privately owned. Altogether, they cover 24 provinces.

Wallop Ploythabthim, permanent secretary of the Ministry of Social Development and Human Security, said the problem of an ageing population has been recognised and several policies have been initiated to address it. One such policy is to encourage families to take good care of their elderly as a part of Thai culture. Another is offering financial incentives such as tax deductions if they do.

ISPR's Pramote warned that the explosion in the number of elderly would affect everyone.

"The best way to prepare our society for the coming wave of elderly is to educate everyone on the issue and show them how to prepare themselves as individuals. Without enough understanding of the problem, the consequences will be larger than expected," he said.

Kamol Sukin

The Nation