Unseen Guardians: The Silent Struggle of Thailand's Women Informal Caregivers

Bangkok, 8 March 2024 – Every morning, as Ms. Wannee, a 63-year-old part-time nurse, greets the day, her routine unfolds with quiet dedication and deep affection. Living only with her 93-year-old mother, her life has transitioned from a busy nursing career to providing compassionate care for her beloved mother. Despite having siblings who are also capable of assisting, the mantle of primary caregiver has naturally fallen to her, the unmarried daughter with a nursing background. Their daily life is interwoven with moments of togetherness, from the simple act of cooking for her mother to sharing stories and ensuring her mother's comfort. On International Women's Day, we celebrate the quiet strength and resilience of Thailand's informal women caregivers, like Ms Wannee, who embody the spirit of dedication in an ageing society.  

Family members, especially women—the informal, unpaid carers—are the main carers of older persons in Thailand. They reduce the pressure on the country’s health and social care systems for older persons by taking on long-term care responsibilities. These women, the unsung heroes, play a pivotal role in easing the load on our healthcare systems by providing tireless support to their older persons loved ones. Despite their invaluable contribution to a growing number of older persons, these caregivers often operate without substantial formal support. While the government recognizes the importance of healthy ageing, the key role of these dedicated caregivers in society also needs to be acknowledged. Thailand, home to approximately 13 million older persons, is at a crossroads, highlighting the urgency for long-term care policies that champion and include the welfare of these caregivers.

Ms. Wannee's commitment to her mother is a personal choice fuelled by love and a sense of familial responsibility. The government’s modest stipend of 1,000 baht, intended for older persons aged above 90, is a small acknowledgement of her role, but it's the emotional fulfilment and the opportunity to repay her mother’s past care that truly motivates her. Importantly, this allowance is respectfully used by her mother for personal pleasures, such as offerings to monks, buying snacks, or purchasing lottery tickets, rather than being spent by Ms. Wannee herself. "It’s not about any financial aspect," she notes. "It’s about being there for someone who once did the same for you." Her reflections on what her life might have been like without her caregiving responsibilities reveal a complex mix of emotions. "There might have been more personal freedom, perhaps more opportunities for career advancement and social interactions. But ensuring my mother's well-being brings a different kind of satisfaction," she shares.

There are social and cultural factors that contribute to women taking on the majority of caregiving roles. These include traditional gender expectations and the perception of care work as an extension of women's domestic responsibilities. The World Health Organization (WHO) has pointed out the significant health burdens shouldered by informal caregivers, emphasizing the physical, emotional, and financial strains associated with this role. Ms. Wannee's narrative vividly illustrates the personal sacrifices entangled with caregiving, especially when much of the work goes relatively unnoticed.

To address the plight of informal caregivers, Ms. Wannee calls for greater support, advocating for initiatives like peer support groups and respite care services. “I believe investing in women who, like myself, are informal caregivers for older or other needy persons is important. If we have support systems such as peer support groups and volunteers or staff who can provide appropriate respite care, we can more freely and fully pursue some of the activities that we want to do. I believe I would see improvements in my physical and mental health and have more opportunities to participate in social activities with others. Ultimately, I think that taking care of older persons in the family is not the sole responsibility of women in the household, but everyone in the family and society should also help.”

Ms. Wannee hopes for a future where support for caregivers extends beyond token gestures, envisioning a community that offers stronger networks of support, including peer groups and respite care services. Such measures would not only acknowledge the invaluable work of caregivers but also provide them with much-needed relief and recognition.

Echoing the call for action, Dr. Jos Vandelaer, WHO Representative to Thailand, emphasizes, "The dedication of unpaid informal caregivers is often overlooked as being one of the key service pillars of our healthcare system... It is essential that we come together as a society to address gender stereotyping of informal carers, provide the necessary support to address their needs, and give the clear recognition that these women deserve."

This International Women’s Day, let's honour Thailand's women's informal caregivers with more than words. Let's commit to real change, ensuring they receive the recognition, support, and appreciation they rightly deserve. Let's shine a light on these unseen guardians who bring warmth and care to our older people's lives every day.

Original article published on WHO