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October 12, 2017

Japanese-style long-term care system introduced in graying Thailand, also influencing neighboring countries

photoCare managers (long-term care support specialists) sent from Japan with elderly Thai people

Japan is known for the rapid pace at which its population aged. Actually, however, population aging continues in all the countries of Southeast Asia, as well, with no exceptions. In Thailand, population aging is outpacing what happened in Japan, and the government there is hurrying to build a long-term care system for the elderly.

JICA has been providing support for elderly Thai people for more than 10 years, and a project that ended in August developed long-term care services that suit the situation in Thailand. The project was found to have been highly effective: Many elderly people who received long-term care services responded that they improved their physical function, and the Thai government incorporated the results of the project into its long-term care policies.

Providing individualized care that combines health and welfare services

photoCare managers conduct an interview about a patient’s current situation to create a care plan

In 2000, Japan introduced a long-term care system that provides long-term care services using the support of the entire society. At the center of this system are care managers (long-term care support specialists) who check on the situation of each elderly person and create a care plan that combines various health and welfare services to match his needs. This process is known as "care management."

In 2013, Thailand began the Project on Long-Term Care Service Development for the Frail Elderly and Other Vulnerable People (LTOP) in an effort to use a similar system to Japan's. The project set three goals it is working to achieve in six regions:
1. Developing a model for the provision of elderly long-term care services
2. Developing a program to train long-term care workers
3. Making policy recommendations

In Thailand, care of elderly people has been carried out by individual hospitals, health care centers and local governments, with almost no coordination among them, resulting in inadequate provision of efficient services to the elderly.

photoChecking an elderly person's ability to move around

So, the project is training nurses at hospitals who have handled local nursing care to be case managers with the goal of introducing care management like that in Japan. Health care workers at local governments have also gotten involved, and the country has managed to introduce such a system. In addition, care centers and care visits to the homes of the elderly have begun, making it possible to provide more extensive and warm care than in the past.

There is data showing that through these initiatives, 65 percent of the people served by the program in the target regions have seen improvements in indicators of daily movements including eating, changing clothes, moving, going to the bathroom, straightening their posture and bathing.

Using Japanese experience and expertise, the project also has made proposals to the government regarding creating a structure to make the long-term care service model sustainable and securing financial resources.

The long-term care services model expands from Thailand to other countries

photoA care center

In June, a seminar was held in Bangkok to share the results of the project with neighboring countries. 22 people from 10 countries including Malaysia and Vietnam participated and learned about Thailand's long-term care services model and its effects.

Based on the results so far, a new project emphasizing strengthening coordination between medical care and long-term care will begin in October. In Thailand, a fair number of elderly people who have a stroke or a fracture are quickly discharged from the hospital without making a functional recovery, and as a result they become bed-ridden. The project will look for ways, including rehabilitation, of avoiding people becoming dependent on a caregiver. Because Japan experienced population aging slightly earlier than Southeast Asia, JICA has experience and expertise in this area, and it will continue supporting the creation of long-term care service models that match the current situation of each country.


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