A growing body of evidence underscores the immense emotional, physical, and spiritual strain shouldered by caregivers—often family members—tasked with looking after loved ones with chronic illnesses such as Alzheimer’s, cancer, stroke, or Parkinson’s disease. Recent personal stories and new data shared in a July 2025 report by faith columnist Terry Pluto bring renewed attention to both the widespread challenges and silent heroics within caregiving communities, with lessons and warnings that resonate deeply in Thailand.
Caregiving is often a journey of uncertainty. As captured by the story of a man caring for his wife with early-onset Alzheimer’s, the experience is dominated by persistent questions: “When will this end?” and “How will it end?” The reality is that many caregivers embark on this path with scant certainty about the eventual duration or outcome. The narrative goes beyond Alzheimer’s, anchoring broader experiences among those providing long-term support for loved ones with a variety of life-altering conditions. According to the Family Caregiver Alliance, cited in Pluto’s column, the average length of caregiving service in the US is estimated at 4.3 years, with nearly one in five cases stretching a decade or more—a testament to the extended, relentless demands caretakers often face (cleveland.com).
This article’s relevance for Thailand is profound. The nation’s demographic shift towards an ageing population is straining families—and the health system—far more than in previous generations. As of 2024, Thailand has an estimated 13 million people over 60, according to the Ministry of Social Development and Human Security. Changing family structures and internal migration trends have resulted in more elderly parents living separately from young relatives or left behind in rural communities (Bangkok Post). In both the US and Thailand, it is women, frequently middle-aged and balancing paid work with family, who are statistically most likely to serve as unpaid caregivers. Yet, the latest research confirms that men are increasingly stepping into these roles—especially as the age profile of caregivers rises. The average US caregiver is cited as a 46-year-old woman, but a significant percentage of caregivers are men and elderly people themselves.
The physical consequences of long-term caregiving are well documented. Caregivers often neglect their own health and can be pushed to exhaustion or even serious injury. Pluto recounts cases where caregivers suffered debilitating injuries while helping their loved ones, including broken hips and knees. Research from Thailand’s Department of Mental Health similarly reports elevated rates of depression, sleep disorders, and musculoskeletal problems among caregivers of patients with dementia and stroke (dmh.go.th). Notably, a recent study published in the Southeast Asian Journal of Tropical Medicine and Public Health showed that 48% of Thai informal caregivers for Alzheimer’s patients reported moderate to severe stress, linked strongly to lack of community support and respite services.
Yet, the psychological burden can be even more intense. Pluto’s article highlights the ordeal of “second-guessers”—family members or acquaintances who criticize caregiving decisions yet rarely take responsibility themselves. Guilt, isolation, and self-doubt can be constant companions, especially as illnesses progress and relationships change. Joe Tait, a well-known figure referenced in the column, spent years caring for his wife with Alzheimer’s, eventually suffering his own health crises and enduring the heartbreaking reality that his wife no longer recognized him. Such emotional trauma is mirrored in Thailand, where Buddhist values of filial piety and gratitude (“bunkhun”) can bring additional pressure, even as official supports lag behind community needs (International Journal of Geriatric Psychiatry).
The advances in medical science seldom bring swift or miraculous solutions. As articulated by a support group leader quoted in Pluto’s column, “People who are dealing with this on a daily basis get their hopes up when some ‘magical’ experimental drug shows up in the marketplace. Then, after a few months, we learn it doesn’t work.” The cycle of hope and disappointment—whether in drug trials or homeopathic remedies—is a global phenomenon. In Thailand, families may likewise turn to alternative therapies, herbal remedies, or spiritual healing, sometimes encouraged by aggressive online marketing despite a lack of robust clinical evidence.
So how are caregivers supported, and where do gaps remain? In the United States, organizations like the Family Caregiver Alliance provide hotlines, legal resources, and mental health guidance (caregiver.org). Thailand offers some public and non-profit support, including home health visits from village health volunteers, counselling at public hospitals, and community networks facilitated by temples. Still, coverage is patchy and urban-centric, and informal care—typically unpaid—is still viewed as an extension of family duty, not as labor deserving of structured respite or compensation (World Health Organization). The COVID-19 pandemic further exposed the vulnerability of Thailand’s older adults and the strains placed upon traditional caregiver arrangements, with periods of isolation and economic hardship fueling a mental health crisis among both patients and their supporters.
What practical advice—and hope—emerges from Pluto’s work and related research? First, experts emphasize the necessity for caregivers to care for themselves: to accept support from community, to share responsibilities with willing relatives, and, crucially, to recognize the limits of their own strength. The article recounts how limiting visiting hours, delegating paperwork, and seeking peer support were vital steps taken by both the US commentators and their counterparts in other societies. As a retired Thai geriatrician explained in a 2023 interview with Thai PBS, “Exhausted caregivers help nobody. Allowing short breaks, even to visit the market or temple, can make a tremendous difference.” Social connection—whether through church, temple, or online support groups—helps buffer the sense of isolation that caregiving often brings.
Second, public policy is increasingly moving towards recognizing and supporting the unpaid caregiving workforce. In Thailand, there is growing advocacy for the introduction of a national respite care voucher and strengthened legal protections for caregivers, similar to schemes piloted in Japan and Singapore (Nikkei Asia). There is also a cultural shift towards more open conversations about aging, memory loss, and end-of-life care—a departure from the traditional “kreng jai” (fear of imposing) that has historically kept many Thai families from seeking outside help.
Looking ahead, increasing public awareness is essential to change both attitudes and behaviour. In the US, Pluto’s campaign seeks real-life tips and practical wisdom directly from caregivers themselves, building a living resource. Thailand can mirror this by facilitating more peer-to-peer learning platforms, broadcast and online, and by incorporating real-life caregiver voices into public health messaging.
In the end, the latest research reminds us that the “bravery” of caregiving is not only found in moments of crisis but in the daily endurance, compassion, and, often, spiritual resilience of ordinary people—wives, husbands, daughters, sons, and friends—performing extraordinary acts of devotion. For Thai families, the takeaway is that accepting help, prioritizing one’s own wellness, and asking for institutional support are steps to be celebrated, not stigmatized.
For any Thai reader currently caring for a relative, here are practical recommendations:
- Don’t try to do everything yourself: Divide duties among family members if possible, and reach out to local health volunteers or NGOs.
- Make use of health ministry hotlines and local hospital social workers for medical information and support.
- Take regular “mental breaks” through short walks, religious activities, or social groups.
- Document financial and medical records systematically to reduce later stress and empower shared decision-making.
- Seek peer support—consider local or online “caregiver circles” for advice and encouragement.
As Thailand’s population continues to age, caregiving will touch more lives. Proactive learning, policy adjustment, and, most importantly, caring for the caregivers themselves, will be critical in building a healthier and more resilient society.
Sources: cleveland.com, Family Caregiver Alliance, Ministry of Social Development and Human Security, Bangkok Post, Department of Mental Health Thailand, International Journal of Geriatric Psychiatry, WHO, Nikkei Asia