Thailand Urged to Invest in Home-Based Care as Ageing Population Surges

Thailand faces a looming care workforce crisis as its population continues to age at one of the fastest rates in Southeast Asia. A new report by the International Labour Organization (ILO) projects that the country will require up to 250,000 additional paid care workers by 2037, including approximately 55,000 migrant workers, to meet the needs of its expanding elderly population.

Titled Care at home: Projecting Thailand's need for national and migrant labour for home-based care for older persons, the study provides a detailed analysis of the country's emerging care demands. It emphasizes the urgent need for public investment in the care economy and calls for the professionalization of care work — especially in light of Thailand's "ageing-in-place" policy, which promotes older persons living in their homes rather than in institutional care settings.

A Shifting Demographic and Family Landscape

Thailand became an "aged society" in 2022, with over 20% of its population aged 60 and above. By 2037, nearly 30% of the population will be over 60. Simultaneously, family structures are changing: declining birth rates, increasing urbanization, and more women in the formal workforce mean that traditional models of unpaid family caregiving are eroding.

As a result, demand for paid home-based care is expected to surge by at least 70% over the next 12 years, with the real figure potentially higher depending on regional disparities and economic conditions.

Migrant Workers: An Expanding Role

Thailand has historically relied on migrant labour from neighboring countries — particularly Myanmar, Cambodia, and Laos — for domestic and care work. The ILO report notes that migrant workers already make up a significant share of Thailand's informal care workforce, and this trend will continue as the Thai working-age population declines.

However, the current system lacks adequate regulation, leading to poor working conditions, low wages, and limited legal protections for migrant care workers. The report strongly advocates for regularized and fair migration pathways, ensuring that migrant caregivers are formally recognized, adequately trained, and protected under Thai labor laws.

Policy Gaps and Equity Concerns

The report highlights that many low- and middle-income families in Thailand cannot afford private care services. Without public investment, this creates a "care divide" where wealthier households have access to quality care while vulnerable communities are left without support.

"Thailand's ageing-at-home approach can only succeed if care work is recognized, protected and valued as skilled work," said Xiaoyan Qian, ILO Country Director for Thailand, Cambodia, and Lao PDR.

She added:

"By investing in decent work for care workers, both national and migrant, Thailand can build a sustainable, equitable care system that benefits families, communities and the national economy."

ILO Recommendations for a Sustainable Care Economy

The ILO study, part of the TRIANGLE in ASEAN programme (supported by Australia's Department of Foreign Affairs and Trade and Global Affairs Canada), offers a roadmap for Thailand to avert the coming crisis. Key recommendations include:

• Increase public funding for home-based and community care services to ensure affordability and accessibility.

• Implement and enforce the new Ministerial Regulation No. 15 on Domestic Work (2024), which sets standards for working hours, rest days, and occupational safety for domestic and care workers.

• Professionalize care work by upgrading care-related skills, providing certification and training pathways, and recognizing care work as a skilled profession.

• Expand community-based care systems, particularly in rural areas, to support decentralized and culturally appropriate care services.

• Strengthen health literacy and support family caregivers, including with training and resources.

• Adopt assistive technologies, including telehealth platforms and mobility aids, to reduce physical demands and enhance care coverage.

• Improve data collection and workforce planning to anticipate future needs and monitor progress.

According to ILO modelling, adopting these recommendations could significantly reduce the projected care worker shortage, potentially bringing the required additional workforce down to fewer than 100,000 — a far more manageable figure.

Care Work as a Pillar of Social and Economic Development

Globally, the ILO has been advocating for recognizing care work as a key part of economic development and gender equality. Its 2024 Resolution concerning decent work and the care economy underscores the importance of care jobs in achieving sustainable development goals (SDGs), particularly SDG 5 on gender equality, SDG 8 on decent work, and SDG 3 on good health and well-being.

The Thailand study aligns with this global agenda and is intended to support the country's National Strategy on Ageing, its labour migration policy framework, and future discussions on universal long-term care financing.

Looking Ahead: A Call to Action

Thailand's demographic transformation is irreversible — but the outcomes for families, older people, and care workers are not. Whether the country builds a just, inclusive care system depends on how it acts now.

"Without meaningful investment, we risk leaving the most vulnerable behind — both those in need of care and those providing it," said one expert at the launch of the report.

By taking a rights-based, inclusive, and forward-thinking approach to care, Thailand can turn a demographic challenge into an opportunity for employment, dignity, and resilience.