THE STUDY OF ELDERLY PEOPLE LIVING ALONE: FINDINGS FROM KANCHANABURI PROJECT SOFIA AWEAR

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1 THE STUDY OF ELDERLY PEOPLE LIVING ALONE: FINDINGS FROM KANCHANABURI PROJECT SOFIA AWEAR A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS (POPULATION AND SOCIAL RESEARCH) FACULTY OF GRADUATE STUDIES MAHIDOL UNIVERSITY 2003 ISBN COPYRIGHT OF MAHIDOL UNIVERSITY

2 Thesis entitled THE STUDY OF ELDERLY PEOPLE LIVING ALONE: FINDINGS FROM KANCHANABURI PROJECT.. Ms.Sofia Awear Candidate.. Prof.Pramote Prasatkul, Ph.D. (Demography) Major-Advisor.. Assoc.Prof.Orapin Pitakmahaket, Ph.D. (Applied Population Research) Co-Advisor.. Assoc.Prof.Rassmidara Hoonsawat, Ph.D. Dean Faculty of Graduate Studies. Asst.Prof. Pimonpan Isarabhakdi, Ph.D.(Rural Sociology and Demography) Chair Master of Arts Programme in Population and Social Research Institute for Population and social Research

3 Thesis entitled THE STUDY OF ELDERLY PEOPLE LIVING ALONE: FINDINGS FROM KANCHANABURI PROJECT was submitted to the Faculty of Graduate Studies, Mahidol University for the degree of Master of Arts (Population and Social Research) on 12 September, Ms.Sofia Awear Candidate.. Prof.Pramote Prasatkul, Ph.D. (Demography) Chair.. Ms.Patama Vapattanawong, Ph.D. (Demography) Member.. Assoc.Prof.Orapin Pitakmahaket, Ph.D. (Applied Population Research) Member.. Assoc.Prof.Rassmidara Hoonsawat, Ph.D. Dean Faculty of Graduate Studies Mahidol University.. Assoc.Prof.Bencha Yodumnern-Attig, Ph.D. (Anthropology) Director Institute for Population and Social Research Mahidol University

4 ACKNOWLEDGEMENT I would like to express my most sincere gratitude to Professor Dr. Pramote Prasartkul, Professor Dr. Orapin Pitakmahaket, and Ajarn Dr. Patama Vapatanawong for their tremendous support, and encouragement. Most particularly, I d like to thank Hewlett-IPSR Graduate Scholarship, The Wellcome Trust- IPSR Graduate Scholarship, and Faculty of Graduate Studies, Mahidol University that enabled me to undertake this thesis. I also wish to extend my deepest gratitude and affection to my friends, P Leng, Tor, and Jeab for providing me with helpful material and great solutions on this thesis. I also would like to thank Mr. Ean Lee, Mum, P Jeab Waraporn, P Ying Wichuda, P Nok Tanaluk, and P Ae Prachatip, for their never ending support. Finally, I would like to thank my family for their tolerance in sharing my heart and mind for so long. Sofia Awear

5 Fac. of Grad. Studies, Mahidol Univ. Thesis / iv THE STUDY OF ELDERLY PEOPLE LIVING ALONE : FINDINGS FROM KANCHANABURI PROJECT SOFIA AWEAR PRPR/M M.A. (POPULATION AND SOCIAL RESEARCH) THESIS ADVISORS : PRAMOTE PRASARTKUL, Ph.D. (SOCIOLOGY, DEMOGRAPHY), ORAPIN PITAKMAHAKET, Ph.D. (APPLIED POPULATON RESEARCH) ABSTRACT The objective of this study is to investigate the pattern of aged people s living arrangement, focusing on the well being of the elderly who live without adult support and care. Part of the information on living arrangements is taken from the 2001 survey of the Kanchanaburi project. In-depth interviews were also used. This study finds that the elderly live alone because of their single status (having never married), widowhood, divorce, or the migration of their children. The elderly faced health, emotional, financial and housing problems; most of them need basic health and financial facilities, and emotional support, the sources of which are mostly from their children, relatives and communities. Those who are living alone are able to survive with the care of their children, kin and communities. This study shows that the traditional system of familial care for the elderly remains in Thai communities. KEY WORDS: LIVING ARRANGEMENT / ELDERLY/ KANCHANABURI PROJECT 61 P. ISBN

6 Fac. of Grad. Studies, Mahidol Univ. Thesis / v การศ กษาผ ส งอาย ท อาศ ยอย โดยล าพ ง:ข อค นพบจากโครงการกาญจนบ ร (THE STUDY OF ELDERLY PEOPLE LIVING ALONE : FINDINGS FROM KANCHANABURI PROJECT) โซเฟ ย อาแว PRPR/M ศศ.ม. (ว จ ยประชากรและส งคม) คณะกรรมการควบค มว ทยาน พนธ : ปราโมทย ประสาทก ล, Ph.D. (SOCIOLOGY, DEMOGRAPHY), อรพ นทร พ ท กษ มหาเกต, Ph.D. (APPLIED POPULATON RESEARCH) บทค ดย อ การศ กษาคร งน ม ว ตถ ประสงค เพ อศ กษาร ปแบบการอย อาศ ยของผ ส งอาย และ สภาวะความเป นอย ของผ ส งอาย ท อาศ ยอย ตามล าพ งโดยไม ม ผ ใหญ ว ยแรงงานอาศ ยร วมอย ด วย การ ศ กษาคร งน ใช ว ธ การท งเช งปร มาณและค ณภาพ ข อม ลเช งปร มาณได จากโครงการ กาญจนบ ร ป พ.ศ 2544 การศ กษาเช งค ณภาพใช การส มภาษณ ระด บล กในประชากรส งอาย จ านวน 15 รายท อาศ ยอย เพ ยงล าพ งโดยไม ม ผ ใหญ ว ยแรงงานอาศ ยร วมอย ด วย การศ กษาน พบว าผ ส งอาย อาศ ยอย ตามล าพ งโดยไม ม ผ ใหญ ว ยแรงงานอาศ ยอย ด วย ม สาเหต จาก ไม ได แต งงาน ค สมรสเส ยช ว ตหร อหย าร าง ล กๆ ย ายถ นไปอาศ ยอย ต างพ นท หร อแต ง งานแยกครอบคร ว ป ญหาต างๆ ท ผ ส งอาย ท อาศ ยอย ตามล าพ งประสบน นส วนใหญ ม ป ญหาคล ายๆ ก น ค อ ป ญหาด านส ขภาพร างกาย จ ตใจ เศรษฐก จ และป ญหาด านท อย อาศ ย ด านความต องการของ ผ ส งอาย พบว าย งคงม ความต องการอย ในป จจ ยพ นฐานท งทางด านร างกาย ด านจ ตใจและด านการ เง น แหล งความช วยเหล อท ท าให ผ ส งอาย สามารถด าเน นช ว ตอย ได น นส วนใหญ มาจากบ ตรหลาน เคร อญาต และช มชน จากการศ กษา พบว าผ ส งอาย ในโครงการกาญจนบ ร ท แม จะอาศ ยอย โดยล าพ ง แต ก ไม ได ถ กทอดท งเสมอไป เน องด วยส งคมไทยย งม ล กหลาน เคร อญาต ท ย งคงให ความเคารพ และให ความช วยเหล อ อ กท งช มชนย งม ความเอ ออาทรเก อก ลก น ตลอดจนความกต ญ กตเวท ท บ ตรม ต อบ พการ น นส งผลให ผ ส งอาย ย งคงได ร บการด แลและได ร บการยกย องให อย ส งคมได ด วยด เสมอมา 61 หน า. ISBN

7 TABLE OF CONTENTS Page ACKNOWLEDGEMENT iii ABSTRACT (ENGLISH) iv ABSTRACT (THAI) v LIST OF TABLES viii LIST OF FIGURES ix CHAPTER I INTRODUCTION 1.1 Introduction Objective of the study Limitation of the study Definitions 5 II LITERATURE REVIEW 2.1 Definition of the elderly The measurement of living arrangement The changes in society that affected the living arrangement of the elderly Social status role, problems and needs of the elderly The support and care for the elderly Previous studies Conceptual framework 14 III METHODOLOGY 3.1 Information about Kanchanaburi Source of data 19

8 vii TABLE OF CONTENTS (Continue) CHAPTER Page IV RESULT 4.1 General characteristics of the elderly Living arrangement of the elderly Well-being of the elderly 29 V CONCLUSION AND SUGGESTION 5.1 Conclusions Suggestions 51 BIBLIOGRAPHY 53 APPENDIX 59 BIOGRAPHY 61

9 LIST OF TABLES Page Table 1 Table 2 Table 3 Number and percentage of household with elderly in Kanchanaburi project Number and percentage of the elderly in Kanchanaburi project 2001, categorized by living arrangement 23 Number and percentage of the elderly in Kanchanaburi project 2001, categorized by general characteristics of the elderly 24 Table 4 Living arrangement of the elderly, Kanchanaburi project 2000, classified by elderly s characteristics 27

10 LIST OF FIGURES Page Figure 1 Projection of aged population (60+), Figure 2 Conceptual framework of the source of support to the elderly 15 Figure 3 Population Pyramid of Kanchanaburi province 18 Figure 4 Map of Kanchanaburi province 18 Figure 5 Population Pyramid of Kanchanaburi project 22

11 Fac. of Grad. Studies, Mahidol Univ. M.A. (Population and Social Research) / 1 CHAPTER I INTRODUCTION 1.1 Introduction The life expectancy of the Thai population has become longer, while the proportion of the elderly has rapidly increased, its number being predicted to continue to increase in the future. This situation exists due to significant reduction of birth and death rates that had been high in the past. Simultaneously, the public health systems were better which brought about the increasing number and proportion of the elderly. This circumstance occurred in many developed and developing countries. The United Nations Organization expected that the world proportion of the aged, those are older than 60 years old, would increase by about 3 folds that is from 580 million in 1998 to 2,000 million in 2050 (United Nations, 1999: p.36). Similarly, Thailand achieved objective of decreasing its total fertility rate (TFR) or the average number of children that a female could have during her fertile. This rate decreased from 5.1 in 1973 (NSO, ) to lower that the replacement level at about 1.7 (Mahidol Population Gazette 2003). Simultaneously, Thai population had longer life expectancy. In 1973, the average life expectancy of Thais was 61 years (Republic Health Statistic) but currently it is 71 years (Mahidol Population Gazette 2003). The decrease in birth rate, combine with longer life expectancy, caused in the increase in the number of the elderly. Regarding, there were only 1.2 million elderly who were older than 60 years old, or 4.6% of total population in 1960, and there were 1.9 million or 5.0% of total population in The number increased to 2.5 million or 5.5% of total population in In 1990, this figure reached 4.0 million or 7.4% and by 2000, the number of senior citizens was 5.7 million or 9.7% of total number of Thai citizens (NSO, 1960). The Thailand

12 Sofia Awear Introduction / 2 Population Projection of the Office of National Education Commission, , projected that in the future the number and the proportion of the aged in Thailand will increase continually due to the longer life span of Thai population. In 2003, the number of the aged will increase to 6.4 million or 9.9% and in 2008, the number of the aged will increase to 7.5 million or 11.2%. This trend of increase will reach 10.5 million or 15.0% in (Figure 1) Percent Source: National Statistical Office, National Education Commission, 1999 Year Figure 1 Projection of aged population (60+), From the population projection, the number of the aged had increased continually in the background of the Thai socio-economic development. The socioeconomic changes caused the changes in living arrangement; the family pattern was transformed from an extended family to a nuclear family. This change in family pattern reduces the quality in suitable care for the aged. Currently, a nuclear family that consists members who are of same generation such as a single person, a couple of spouse because they do not have a child or their child is away from home for work is increasing. An interesting development is the increase in the elderly who live alone or

13 Fac. of Grad. Studies, Mahidol Univ. M.A. (Population and Social Research) / 3 with a spouse only, while there is a decrease of those living with children (Chayowan et al., 1960; Wongsit and Siriboon, 1998) Additionally, Pramote Prasartkul (2001) found that there was a pattern of increase in rural nuclear families. The aged people lived with their grandchildren because they were asked to take care of them by the parents. The parents provided financial support for their children s expenses. However, there were also some aged who were left without any connection to or support from their children. They had to foster their grandchildren themselves. Migration was another factor that effected the living arrangement. (Wongsit and Siriwan, 1998; Somkaoyai, 2001; Pantatik, 1993) In the past, a majority of the Thai population had agricultural occupation. Currently, agricultural occupation is no longer an attractive option due to the lack of farmland and unstable revenue while working in an urban area could provide better revenue. Many young people migrated to work in a big city, and left the aged to live alone or to look after the grandchildren. The rapid increase in the proportion and number of elderly had never occurred in Thai history (Karnchanawong, 1996). Changes in population structure and the other patterns in Thailand actually caused some problems that affected the elderly s lifestyle. These changes necessitate the support and care of an adult responsible for the old, such as home care, health care, bringing the aged to a doctor, and provision of warmth and emotional support. The elderly also experienced both physical and mental stress with reference to their status and role, for example, retirement and the resulting lack of revenue and loss of confidence, loneliness, anxiety, etc. The elderly might often have to face problems on their own, and while this affect them, the nation is inevitably affected as well. Lifestyle and the relationship between an elderly and his children were important to living conditions, physical and spiritual well-being and also the welfare of society. The number of the aged who lived alone with no supervision is an increasing trend. From the study of Madee Kanchanakijsakul (2002) on Consequences of

14 Sofia Awear Introduction / 4 Demographic Transition on Thai Elderly Living Arrangements; it was found that the number of aged who lived alone or lived with spouse only increased from 5.0% and 6.4% in 1971 to 6.0 % and 13.1% in 2001 respectively. On the other hand, an aged who lived with children or others who are not their own children had decreased from 76.5% and 12.1% in 1970 to 70.6% and 10.3% in 2000 respectively. It is the matter of interest to study how an elderly live alone without the supervision and support of an adult. Therefore, a study of this group of citizens has been carried out on the life style, needs and the problems they encounter. The study would be used as a criterion to plan an appropriate welfare policy for the aged. 1.2 Objectives of the Study To investigate the pattern of the elderly living arrangement, Kanchanaburi project To study the well being of the elderly who live without adult support and care. The study focused on causes of living alone, problems and needs, and the source of support. 1.3 Limitations of the Study In this research, the researcher determined that the scope of the research study cover the living arrangement of the elderly, one who is older than 60 years old, Kanchanaburi Project The study also included the elderly who lived alone without an attendant; these elderly are those who live alone, live with spouse only and live with children under 15 years of age. The study would figure out the cause of living alone, problems and needs, and the receiving of support.

15 Fac. of Grad. Studies, Mahidol Univ. M.A. (Population and Social Research) / Definition Elderly is defined a person aged people 60 years and over Living arrangement refers to the living style of the elderly (taking into consideration living with the other members in the same household) namely, the elderly who are living alone, living with spouse only, living with children under 15- years of age and living with adult Well-being of the elderly means the living condition of the elderly who live alone without a working-aged adult namely, the elderly who are living alone, living with spouse only, living with children under 15- years of age. The study focused on cause of living alone, problems and needs, and the receiving of support.

16 Sofia Awear Literature review / 6 CHAPTER II LITERATURE REVIEW This study involved the living arrangement of senior citizens. The researcher reviewed documents and related research that would be presented in consecutively as the following: 2.1 Definition of the Elderly In the study on the aged, there is some differences in the definition of the word elderly. An elderly is one whose age is 60 years or at the 5 th cycles (cycle of 12 years) (Cowgill, 1992) and a person who is experiencing the decline of physical ability, mental process, memory system, learning, characteristics, including the changes in social status and role (Pornsiripong, et al., 1991). Additionally, there are different definitions of elderly in the following: Uay Katesing (1986) categorized the elder into four types that were 1. Elder of age, the number of year lived. 2. Elder of body, according to the physical condition. 3. Elder of mind, old because of one s perception. 4. Elder, as perceived by society and from work experiences, duties, responsibilities, etc.

17 Fac. of Grad. Studies, Mahidol Univ. M.A. (Population and Social Research) /7 Phon Saengsingkiew (1972) yielded three criteria in order to specify an elderly as the following: 1. Chronological age. It specified that one who is older than 65 years is a senior citizen. 2. Working ability. It specified that one who retired from work is an elderly. The criteria were changeable and different from country to country, sex, and occupation. For example, in USA, the retirement age was specified according to the occupation as the following: in industrial sector, the retirement age is 65 years, official government officer retirement age 70, and a doctor at the age of 63 years. 3. The development and declining state. The criteria regarded that a human experiences two processes: development and declining processes. In infants and youth, there are development processes more than declining processes, but in an elder, there are declining processes more than development processes. Barilo and Smith (referred in Yodpeth, 1991) presented the elder as the following: 1. Raditional. It specified an elder according to one s age or retirement age. The age that is used to specify is different in each country. In Thailand, most of the elderly retire after 60 years of age. 2. Body function. It specified an elder according to physical form or physiology, with a different declining state of physical form. In an elder, each organ would function less but cases are also different from person to person. 3. Mental function. It specified an elder according to the declining abilities to create, memorize, learn and the general state of mind. In an elder, the states of discouragment and amnesia were often found. However, it did not mean that every elder had to have these states of mind. 4. Self-concept. It specified an elder according to the concept that the elder viewed himself. Usually, an elder would view himself as I am an elder, very old age, a perception that affect this physiology and lifestyle. The elder s selfconcept, thus, influences his well-being. 5. Occupation. It specified an elder according to the ability to work. The criteria came from the concept of the decline in physical form and mind. Most

18 Sofia Awear Literature review / 8 people then specified that the elder is of the age when leisure is needed, and should therefore stop working. 6. Coping with stress and illness. It specified an elder according to the conditions of both physical form and mind. An elder often suffers from illness because of the decline in physical form and also often faced social problems that caused emotional stress. From the definition of the elderly presented above, the word elderly could be concluded as meaning one who experiences the decline in physical form, intelligence, memory, apprehension, mind, thinking, characteristics, and transformation of social status and role. In this study, the age specification is used to specify whether he is an elderly. An elderly is defined as one who is older than 60 years of age. 2.2 The Measurement of Living Arrangement The study of living arrangement actually used the private household to assess the living arrangement of most of the elderly (Knodel and Debavalya, 1992; Kim and Choe, 1992). The meaning of private household according to the population and household census (1992) was a household that included a person living alone or two or more persons, related or unrelated, residing in the same household and making common provision for food or other essentials of living. Some studies have considered institutionalization as a type of living arrangement as well (Mattiko and Petchurai, 1999; Mutchler and Burr, 1991). The number of household members and the relationship between the elderly and the other members in a household was an index used to study the living arrangement (Knodel, Chayowan and Siriboon, 1992). Other studies specified the types of living arrangement of a senior citizen by dividing household into an extended

19 Fac. of Grad. Studies, Mahidol Univ. M.A. (Population and Social Research) /9 family or nuclear family, and the members age group in a household (Yodpetch, 2001; Martin and Culter, 1983). The objectives of this research are to study the living arrangement including the well-being, of the elderly who live alone with no attendant. Therefore, the living arrangement of the elderly would be grouped according to relationship between a senior citizen and the other members in a household. 2.3 The Changes in Society that Affected the Living Arrangement of the Elderly In former years, Thai elderly traditionally lived with their descendants but the study showed that this practice gradually changed, with the number of elderly living alone or with spouses only increasing (Karnchanakijsakul, 2002). The same finding of the elderly s living arrangement in societies of the Philippines revealed that most of them live with grand children under 15 years of age and they are satisfied with the situation. Some of them have ideas that grand children are their responsibility (Domingo and Casterline, 1992). During the past three decade, Thailand has been undergoing socio-economic traansformations, and the effects on the elderly s way of life are as follow: Firstly, with improved medical and health service, the living conditions have become better, and they live longer lives than before. Consequently, the need for a better health care system is necessary, and must be supported by the society. Secondly, communities are being urbanized and industrialized. The consequences of this are that people from the rural areas have migrated to modern towns or cities to seek better jobs. The elderly are being left to live alone. Thirapong Somkaoyai (2001) found that those who live in households that have migrants are

20 Sofia Awear Literature review / 10 more likely to live alone. Also, the study of Livelihood of Lone Elderly Woman (2000) disclosed that elderly female from 60 years upward have to live alone because their husbands have died and their descendants have migrated to obtain better jobs. This result in the elderly being less attended to and taken care of. At the same time, communities that have been industrialized demand increased labour force, absorbing more women into it. When descendants can make more income, the elderly also receive better assistance, such as, the facile machines for the elderly. However, elderly who are cared for and attended to by their descendants are on decrease. (Mason, 1992). The higher education, economic and social statuses of women are affecting the elderly too, women in the industrialized communities have to assume more roles in the family; whether to take care of children and elderly or to works outside the home to support the family. The elderly also bear impact from this situations, i.e, neglect and isolation (Savuaniya, 1997; Chayowan, 2001). The change in the population structure, economy, and societies in Thailand have transformed the housing and family structure gradually. Most families set a limit on the number of offsprings to have; more people work in industrialized than agricultural fields, towns are urbanized; people are more westernized and modernized; villagers migrate to developed towns or cities for better jobs and education. Moreover, newly married couples choose to make their own families without interference from their parent. As mentioned above, the co-residence of the elderly and their descendants shall decrease in the future. 2.4 Social Status, Role, Problem and Needs of the Elderly Social status and roles of the elderly From the study of Siriwun Siriboon (1992) entitled The Fact and Attitude of Families Support of Thai Adult it was found that in Thai traditional way of living, sons or daughters cared for and served their fathers and mothers until death

21 Fac. of Grad. Studies, Mahidol Univ. M.A. (Population and Social Research) /11 and vice versa. The elderly need to be cared for and looked after well by their descendants Napaporn Chayowan (1992). Generally, the elderly will be centre of related- family members. Sometime they are leaders and make decisions on the family s affairs. With the change of Thai families structure in some parts the elderly were less respected than before. Previous studies found that in urban environment, those who are able to make more money are admired; the effect of this is the departure of elderly s relatives to urban centres, leaving the elderly to live alone (Sithitrai and Sawaengdee, 1987; Bunyanupong et al., 1991) Problems and needs of the elderly Generally, the elderly are concerned about their physical and metal conditions. They are worried about their changing bodies, loneliness, inability to make income, becoming burden, and dejection (Thongvichien and Silapasuwun, 1989). The study of the elderly in Chiengmai found that the elderly are worried about their health, financial problems or suffered from diseases and each one has at least one disease that must be constantly treated. Moreover, the elderly feel anxious about their descendants more than themselves (Bunyanupong et al., 1991). The study of Livelihood of Lone Elderly Woman by Kusuma Prachumchana (2000) found that those who live alone for more than 5 years will face more physical and mental problems than who do not. They took care of themselves visiting to the hospitals etc.. For mental health, she found that those aged years old are in normal health, those aged are fearful, lonely, and sad and those aged 80 and over are anxious, and indiffereent. Adul Viriyavechakul (1997) has made a study and found that the elderly in the central part of Thailand have the following basic needs: were physical healths, free medicine and to cared for till the end of their lives. Most of the elderly also need financial assistance for their living from the government. The study shows

22 Sofia Awear Literature review / 12 that problem relationships within the family have a seriously negative impact on the elderly s well-being, thus concluding that family relationships should be given important affection for the sake of the elderly. 2.5 The Support and Care for the Elderly The study in Chiengmai found that they are still well-respected, visited and obeyed by their offsprings and neighbors. For the elderly who live alone without an adult, they remain in contact with their descendant and neigbours (Bunyanupong, et al., 1990). The study of the social support for the elderly in the northern region, found that when the elderly become sick, they are visited and care for by close offsprings, and gets receive financial help from offsprings who working away from home. They also obtain social welfare benefit from governmental and private organizations. The relationships between relatives appeared to maintained in a healthy state (Yodpetch et al., 1998). The elderly receive living expenses of 300 baht a month from the government, and free medical care from the Ministry of Public Health (National Statistical Office 2000) 2.6 Previous Studies From the previous studies, there were more females than males living alone or living with children under 15 years old of age. More males than females live with spouse. This is because of the difference in social status (Chayowan and John Knodel, 1992; Chayowan and Knodel, 1996; Casterline et al., 1995; National Statistical Office, 2001; Jitapankul et al.,1997).

23 Fac. of Grad. Studies, Mahidol Univ. M.A. (Population and Social Research) /13 The older they are, the more they live alone (The National statistical Office, 1998; Chayowan and Knodel, 1999; Casterline et al, 1995;Ju and Cheung, 1988). The causes of the elderly living alone depended on: the marital status, place of residence, educational level and financial factors. Those who live alone mostly are widowed (the National statistical Office, 2001; Prachunchana, 2000), while married elderly hardly live alone (Chayowan et al.,1990). A few of the wealthy elderly live alone. The study of Kusuma Prachumchana (2000) entitled Livelihood of Lone Elderly Woman found that those who live alone confront the problems of daily expenses, mostly with no support from offsprings. The study by Thirawon Panthathik (1993) found that those who own properties less than 100,000 baht, family members would emigrate for jobs over seas/in Bangkok or provinces nearly. Any family who possesses more than 100,000 baht, members will migrate to work in the provinces nearby. Thirapong Somkaoyai (2001) study Elderly Living Arrangement in the Rural Villages of Nangrong District showed that those who own more estate tended to live with their children. The same result of Malini Wongsit and Siriwun Siriboon (1998) entitled Family and The Elderly in Ayudthaya province stated that those who possess more land and house live with their children more than those who do not. This is because of their household members could work as agriculture in the land provided. The different living arrangements in the Philippines, Singapore, Taiwan and Thailand found that those elderly who obtained higher education trend to live alone, however, those in this category who live with spouse are less than those whit lower education (Casterlin et al; 1991). The elderly living in the metropolitan areas will reside alone or with married partners, but stay with descendants more than those in the rural areas, as the cities which are the centers of business, education, and other enjoyable activities

24 Sofia Awear Literature review / 14 (Bunyanupong et al., 1990; Casterline et al, 1991; Chayowan and Knodel, 1999; Andrew et al, 1986). From the previous studies concerned with the elderly, their way of living has been changing from the past. The most likely reasons for this are as follows: Thai communities have been gradually developing from agricultural to industrialized ones, with a subsequent industrialized labor force, migrating to towns and cities for jobs. The living arrangement of the elderly varies depending on the differences of sex, age, marital status, education, place of residence, financial status and so on. Even though previous studies found that most of the elderly stayed with their offsprings those who live alone with couples will increase in numbers. Efforts and policies to improve the elderly s social welfare and to meet their needs will be more effective by understanding hoe they adapt themselves to their problems and circumstances without the support and care of their descendents. 2.7 Conceptual Framework Although the elderly are living alone, they are not isolated and neglected. They are continuously supported financially by their descendants working in another part of country, while their offsprings living nearby will look after them. They also have good relationship with relatives who settled nearby, and with the neighbors, as well. Furthermore, they receive social welfare and special services from the concerned sections of the government.

25 Fac. of Grad. Studies, Mahidol Univ. M.A. (Population and Social Research) /15 In conclusion, those who are involved in providing assistance to the elderly are advised to consider 4 sources to contribute toward their well-being during the last part of their lives: - support from their descendants, - support from their relatives, - support from the community, and - support from government (See Figure 2) Children Relatives The elderly who live alone Communities Government Figure 2 Conceptual framework of the source of support to the elderly

26 Sofia Awear Research methodology /16 CHAPTER III RESEARCH METHODOLOGY The study of the elderly living alone uses both qualitative and quantitative research methods. 3.1 Information about Kanchanaburi Size and location Kanchanaburi is a large province located in the western part of Thailand. It is 129 k.m. from Bangkok. The domain of Kanchanaburi is: North: border with Tak, U-Thai-Thani, Supanburi and Myanmar. East: border with Supanburi, Nakornpratom and Rajchaburi. South: border with Rajaburi. West: border with Myanmar Geography and weather The northern and western parts of the province are forest and mountainous area. The northeastern and some part of the north are dry land. The southeastern part and the center are fertile area. Due to the vast area of the province, the weather is different. In the plains, the weather is similar to the other Central Provinces. In the forest and mountain areas, the weather is different: during summer, the temperature is very high, and very low during the winter season.

27 Fac. Of Grad. Studies, Mahidol Univ. M.A. (Population and Social Research) / Local administration and development Kanchanaburi has 13 Amphurs, 98 Tumbons and 865 villages. The 13 Amphurs are the following; Muang, Thongphaphume, Tha-Muang, Thamaka, Saiyok, Boe ploy, Phanomtwuan, Lao Khan, Srisawas, Sangkalburi, Danmakhamthae, Nong Phaur, Hua Ka Jow. The local administration consisted of a District Administration, a Muang Municipality, and 26 Tumbons Municipalities and 95 Administration. Statistic of the department of Local Administration, Ministry of interior at the end of 2000, showed that there were 786,001 residents in Kanchanaburi. There were 398,639 males and 387,362 females. Kanchanaburi s residents who lived outside municipal areas made up 93.3% while 6.7% of them resided in the municipal areas. The population density was / km. 2 (NSO, 2001) From the Kanchanaburi Census, 2000, the age structure consisted of three age groups, which identify the population as below labour force age (below age 15), those in the working age (15-59), and finally those above the working ages (60 and above). Figure 3 shows that most of the populations in Kanchanaburi Province were of working age, followed by below labour force age, and aged people respectively. When we divided the numbers into two groups, Kanchanaburi province had the median age of 28 years old, meaning that most of them were of the working age group, and soon becoming of the 60 and above age group. The sex ratio is defined as the number of males per 100 females. Overall, there were more females than males (94 per 100).

28 Sofia Awear Research methodology /18 Male Age Female Source: Kanchanaburi Census, 2000, National Statistical Office. Figure 3 Population pyramid of Kanchanaburi Province, 2000 Percent Tak Sangkalburi Utaitani Thongphaphume District Supanburi Srisawas District Nong Phaur Boe Ploy District Saiyok Lao Khan District Hua Ka Jow District Phanomtwuan District Myanmar Danmakhamthae District Maung District Tha Muang District Rachaburi Figure 4 Map of Kanchanaburi Province Thamaka District Nakornpathom

29 Fac. Of Grad. Studies, Mahidol Univ. M.A. (Population and Social Research) / Source of Data The data for this study is taken from the Kanchanaburi project, This is a research project of the Institute for Population and Social Research, Mahidol University (with support from The Wellcome trust of the United Kingdom). The project started in January 2000 with the scheduled duration for five years. Its objectives are to study the population change in the studied areas, due to economic, social, and environmental influence, including the effects of government and nongovernment projects on the communities. Furthermore, a database on population, economic, and social aspects of Kanchanaburi province has been established. Operational research techniques were implemented to determine their quality of life. The Kanchanaburi project comprises a study area of 100 villages/census blocks selected from five strata; urban/semi-urban, rice, plantation, upland, and mixed economy. There are 20 villages/census blocks in each stratum. Three sets of data collection instruments, community, household, and individual, were used in the field site communities. The method used for data collection was structured interviews, and entailed the use of three sets of questionnaires: for the village, household and individual. The village questionnaire consisted of six parts: general village data, agriculture, occupation, infrastructure and transportation, environmental, and health. The household data questionnaire consisted of four sections: basic data on the household s occupants, household characteristics, land use and agricultural products, and mortality. The individual questionnaire was used for respondents aged 15 and over. It consisted of five sections: personal data, migration, fertility, health, and community development. In the study area, 12,657 households were listed, with a population of 46,029 (22,197 males and 23,832 females). This research project involves 4,619 individuals from 3,516 households, who were older than 60 years of age. For this current thesis, descriptive statistics were used to analyze the living arrangement of the elderly, categorized by sex, age (60-69, 70-79, 80 and over),

30 Sofia Awear Research methodology /20 education (uneducated, primary school, higher than primary school), marital status (single, married, widowed, divorced, separated), annual income (no income, lower than 10,000 baht, 10,001-50,000 baht, 50, ,000 baht, more than 100,001 baht), place of residence (urban, rural). The result was presented in number and percentage of elderly characteristics and their living arrangement. The in-depth interview method was employed to gain qualitative information, focusing on the well being of the elderly who have been residing in household without adult support and care. The study shows the causes of the elderly living alone, problems and needs, and the source of support. The sample was selected from some quantitative data of the elderly who live alone without attendants in Saiyoke and Thamaka District, Karnchanaburi province. These elderly consisted of 6 persons who lived alone, 6 persons who lived with spouse, and 3 persons who lived with children under 15 years of age, They were categorized into 3 groups: aged years old, years old and 80 years and above. Of the total 15 persons, 5 were male, and 10 were female; 8 persons were married, 1 single and 6 were either divorced, widowed, or separated. Among them, 9 were uneducated and 6 had primary education. This study was carefully analyzed by content analysis. Data collection started from January to March The researcher went to meet the 15 interviewees above, expounded the objectives of this study to them, and established a rapport with them for making the interviews. Furthermore, their neighbors or relatives were also questioned in order to make the data more reliable.

31 Fac. Of Grad. Studies, Mahidol Univ. M.A.(Population and Social Research) /21 CHAPTER IV RESULTS The results of this study are divided into 3 parts: Part 1: Presented general characteristics of the elderly in the Kanchanaburi Project 2001 who were examined carefully for their sex, age, marital status, education, annual income, place of residence, and living arrangement. Part 2: Presented the elderly s living arrangement, with focus on 4 different groups, namely, the elderly who lived alone, lived with spouse only, lived with children under 15 years of age, and lived with adult. Part 3: Presented the well being of the elderly, focussing on those who lived alone without attendant, are reveal the cause of their living alone, problems and needs and the receiving of support. 4.1 General Characteristics of the Elderly, Kanchanaburi Project 2001 The population pyramid of the Kanchanaburi project (see Figure 5) showed the sex ratios or the number of males per 100 females. There were 94 per 100, meaning that in Kanchanaburi project, there were more females than males. When the population of the elderly for this project was taken into consideration, it was found that the ratio of males per 100 females were 85 per 100. The age structure is formed by three age groups, which identify the population as below labour force age (below age 15), those in the working age (15-59), and finally those above the working age (60 and above). Figure 5 shows that the majority

32 Sofia Awear Results /22 of the populations in Kanchanaburi project were of working age followed by below labour force age, and those above the working ages aged people respectively. When we divided the population into two groups, the median age of 29 years old was arrived at. Most of them, therefore, were still of the working age group, and advancing toward 60 years of age and above. In considering old dependency ratios or the number of working aged group per aged group, the subjects of the Kanchanaburi project bore a dependency burden of the aged, with 100 persons in the labour force ages to every 16 person aged 60 and above. Male Male ' Age Female Female Source: Kanchanaburi Project, 2001, Mahidol University Figure 5 Population pyramid of Karnchanaburi project, 2001 The Kanchanaburi project consisted of 12,657 households, 72.2% out of them were not contained elderly people while only 27.8% contained the elderly in the household. Accordingly, only 6.9% of the Kanchanaburi s household contained the elderly who lived alone without attendant (see Table 1). However, this small number of elderly people warrant a profound concern because they were changing physically, mentally and socially. They should be scrutinized for the purpose of discovering how they survive without adult support in to day s world of great complexity.

33 Fac. Of Grad. Studies, Mahidol Univ. M.A.(Population and Social Research) /23 Table 1 Number and percentage of household with elderly in Kanchanaburi Project, 2001 Types of household Number Percent All households in the project a) Households with no elderly b) Households with elderly - elderly who were living with children - elderly who were living alone - elderly who were living spouse - elderly who were living adults 12,657 9,141 3, , The population of Kanchanaburi project, 2001 consisted of 46,029 persons, with 12,657 households. About three fourth of the 4,619 elderly lived with adults. 10.9% of them lived with their spouse. 5.9% lived alone and 5.1% lived with children under 15 years of age. Compared with the study of the whole Thai population in 2000, it was found that the 6.0% of elderly lived alone, and 13.1% lived with spouse (Karnchanakijsakul, 2002 ). Table 2 Number and percentage of the elderly in Kanchanaburi Project, 2001 categorized by living arrangement Living Arrangement Number Percent Live with children under 15 years of age Live alone Live with spouse only Live with adult 3, Total 4,

34 Sofia Awear Results /24 This study found that there were more female than male in the Kanchanaburi project and their average age were 69 years old. More than half of them aged years old, while those aged 80 years above make up only 10.8%. Married elderly consisted of 60.5% while only 3.0% were unmarried. More than half of them had primary education and only 5.9% had higher than primary school. Their annual incomes were 16,405 Baht or 1,367 Baht monthly, and most of them lived in the countryside (see Table 3). Table 3 Number and percentage of the elderly in Kanchanaburi Project, 2001 categorized by general characteristics of the elderly General characteristics Number Percent Sex Male 2, Female 2, Age , , and above Mean 69.3 Median 68 Mode 60 Min 60 Max 111 S.D 7.6 Marital Satatus Single Married 2, Widowed 1, Divorced Separated Education Uneducated 1, Primary school 2, Higher than primary

35 Fac. Of Grad. Studies, Mahidol Univ. M.A.(Population and Social Research) /25 Table 3 Number and percentage of the elderly in Kanchanaburi Project, 2001 categorized by general characteristics of the elderly (Continue) General characteristics Number Percent Annual income No income 3, ,000 Baht ,001-50,000 Baht , ,000 Baht More than 100,001 Baht Mean 16,405 Median 0 Mode 0 Min 0 Max 9,000,000 S.D Place of Residence Urban Rural 3, Total 4, Living Arrangement of the elderly: Kanchanaburi Project, 2001 Table 4 shows that the majority of elderly lived with adults, and there were more females than males living alone or living with children under 15 years old. In contrast, more males than females lived with spouse only. This matches with the study of Napaporn Chayowan and John Knodel (1996) titled Survey Report of the Elderly in Thailand, National Statistical Office (2001) on the topic Thai Elderly, Casterline, JB et al.(1991) titled Differences in The Living Arrangement of the Elderly in Four Asia Countries: The interplay of Constraints and Preference, and Jitapunkul, et al. (1997) on Aging in Thailand which found that there were more female than male elderly who lived alone. On the other hand, male elderly preferred living with their spouse. This is because of the difference in life expectancy and the difference in social status which offer men more opportunities to remarry than female.

36 Sofia Awear Results /26 As they age, the elderly usually lived alone when they get older. From the study it was found that only 5.5% in the aged group lived alone. It increased to 6.3% and 7.6% for the aged group and 80 years old upwards, respectively. This study was in accordance with the study of National Statistical Office (1998) titled Statistics of Aging, Napaporn Chayowan and John Knodel (1999) titled Living Arrangement and Family Support of Thai Elderly, and Ju, and Cheung, (1988) on the topics The Elderly in Singapore which clarified that the older they become the more of them live alone. With reference to education preference, the survey showed that a majority of the elderly received only primary school education or were uneducated, because years ago people took less interest in education. Therefore, the highest education they received were primary levels. In the case of marital status, it was found that the elderly who were married were living alone represented the small number (1.2%). This finding was similar to the study of Kusuma Prachumchana (2000) titled Livelihood of Lone Elderly Woman which showed that the married elderly scarcely live alone. As to the income of the elderly, we found that those who received 100,000 Baht per annum would be alone less than those whose earnings were below 10,000 baht (that is 11.7% and15.7% respectively). This matches with the study of Kusuma Prachumchana (2000), Livelihood of Lone Elderly Woman which found that most of the elderly who live alone have no regular nor sufficient income, as well as the study of Thirawun Phanthatic (1993) titled Consequences of Migration to the Aging in the Rural area showing that in the case of an elderly who owned properties worth less than 100,000 Baht, it was more likely that household members worked in Bangkok / its periphery or overseas. As for the members in the household of an elderly who owned properties worth more than 100,000 Baht, they would work only in their own provinces or provinces nearby. From the study of Thirapong Somkaoyai (2001) entitled Elderly Living Arrangement in the Rural Villages of Nangrong District it disclosed that an elderly who owned more estates tended to live with their

37 Fac. Of Grad. Studies, Mahidol Univ. M.A.(Population and Social Research) /27 children because their household members could work in the land provided; more so than those who owned less estates. Similarly, the study case of the elderly in Bangkok and Ayuthaya province proved likewise (Wongsit and Siriboon, 1998). However, this study showed that an elderly who earned 10, ,000 Baht were less likely to live alone less than those who earned more than 100,000 Baht yearly. Earnings, Thus, seem not to affect the way they lived. However, the data on how they derived their income need to be verified and scrutinized in more detail. The study, therefore, could not conclude that earnings are irrelevant to the living arrangement of the elderly. This study finds that there are less elderly living in urban areas who are like to stay alone that those in the rural areas. The result of this study is similar to the study of The Elderly in Chiangmai by Krueksak Bunyanupong et al. and the study of Andrews et al. (1986) entitled Aging in the Western Pacific a Four countries, Study in Manila. which found that there were less elderly living in the city who lived alone or with their spouse, than those living in the suburb. This appears to be the result of urbanization especially in the capital, where business, activities and other attractions draw members away from their families in the countryside seek opportunities and a more comfortable life. Table 4 Living arrangement of the elderly, Kanchanaburi Project 2000, classified by elderly s characteristics Characteristics Alone With Spouse Living arrangement With children With adult Total Percent (No.) Sex Male (2,125) Female (2,494) Age (2,713) (1,406) 80 and above (500)

38 Sofia Awear Results /28 Table 4 Living arrangement of the elderly, Kanchanaburi Project 2000, classified by elderly s characteristics (Continue) Characteristics Alone With Spouse Living arrangement With children With adult Total Percent(Number) Education Uneducated (1,695) Primary school (2,652) 5.1 Higher than primary (272) 7.7 Marital Satatus Single (140) Married (2,793) Widowed (1,477) Divorced (18) Separated (191) Annual income No income (3,544) 10,000 baht (293) 10,001-50,000 Baht (553) 50, ,000 Baht (126) More than 100,001 Baht (103) Place of Residence Urban (688) Rural (3,931)