Issues and Needs of Elderly in Community Facilities and Services: A Case Study of Urban Housing Projects in Bangkok, Thailand

Abstract

Thailand is projected to become a “super-aged” society in 2050, with more than 35 percent of the population aged 60 or above. The aging population represents enormous challenges in supporting the elderly’s needs in terms of living environment and well-being. Providing community facilities and services that foster healthy aging in urban residential areas ensures that older adults feel comfortable aging in their homes or communities. Therefore, this research study includes a comprehensive assessment of the needs of elderly people that used community facilities and services using a focus group interview, a site investigation, and a questionnaire survey in five urban housing projects in Bangkok. The study reveals that the need for community facilities and services, such as green spaces, safety facilities, and medical services, was prioritized by the majority of elderly respondents, especially those who were ambulant and active. Elderly people’s income and health status, the provision of community facilities and services for the elderly, and the usability and accessibility of community facilities were found to be key factors that affected elderly people’s satisfaction and participation in social activities. As reported in the literature, an elderly-friendly living environment should support social activities in the open spaces of residential areas. It is revealed by the study that green spaces, safety facilities, elderly clubs, medical and long-term care services, and social activity arrangement services were instrumental for elderly people’s social and health status; therefore, these should be considered by housing developers and facility managers.

1. Introduction

In 2015, the ASEAN countries became aging societies [1], while Thailand has been an aging society since 2010, with the elderly making up 12.9% of the total population. Thailand is also expected to double its elderly population by 2030, with the proportion of the elderly as high as 25.8% of the total population of 68.3 million [2]. As the number of elderly citizens constantly increases, the population structure of the country changing into an aging society brings both quantitative and qualitative problems for all ages.

In Thailand, the number of middle- and late-aged older people is increasing, reflecting an increasing burden of health expenditures, as many older people still do not have enough income [3]. If the elderly have unhealthy lifestyles and diets, and limited access to healthcare and to elderly-friendly living environments, the risk of non-communicable diseases (NCDs) can increase [3]. In the current situation, elderly household members are often taken care of by their adult children, relatives, or even community members, according to traditional and cultural norms. In urban and rural communities in Thailand, the senior population relies on age-related support activities and programs, such as community welfare funds, village elderly clubs and schools, and social assistance for the elderly with difficulties, which connect the elderly who are isolated to the rest of the community [4]. Furthermore, social welfare promotes the well-being of all people in Thai society, including the elderly [5].

Age-friendly housing and living environments are essential for the daily lives of the elderly living in urban areas. The management of the housing environment is the duty of the housing and facility management team and relates to two parts: individual needs and social needs [6]. The social interaction environment includes community facilities and services that are essential for the elderly. In urban housing, social interaction benefits the physical and psychological health of the elderly [7]. The proper setting for interacting with others encourages the elderly to participate in activities or talk to others. Thus, there should be more social spaces and open spaces in housing and the community to allow the elderly to participate in activities together and promote the well-being and active aging of the elderly.

The elderly living in Bangkok have to adapt to the environment, which has various impacts on health conditions, physical, mental, and social situations, well-being, feeling safe with respect to life, and property [8]. A caring environment in a capital city such as Bangkok may be at a disadvantage or not suitable for the lifestyle of the elderly compared with a loving environment in urban or rural areas. Thus, to create a caring environment for the elderly living in Bangkok, there is a need for the urgent development of social activity environments, social and health service systems, and economics.

Therefore, more research should be conducted on the issues and needs of the elderly in community facilities and services in urban housing projects in Bangkok, Thailand. This study aims to provide policy and planning implications for improving and developing community facilities and housing projects to accommodate the transition to an aging society in the coming years. The study design assesses the current status, issues, and needs of elderly people in housing and community facilities and services in urban housing in Bangkok. This study is divided into four sections. Firstly, we present the review and discussion of the literature on livable cities and communities for the elderly, focusing on elderly people’s housing, elderly people’s issues and needs in Thailand, social activity and environment, and urban housing management, especially for the elderly. Secondly, the research methodology, including the criteria to define the scope of the study area and population sampling, is presented. Thirdly, the results of the focus group, site investigation, and questionnaire survey are explained; lastly, the issues and needs assessment is addressed from health, environmental, social, and economic perspectives, highlighting the specific needs for support services and urban housing environments for the elderly’s social activities.

The objectives of the study are as follows:

(1)

To assess the current status of elderly people living in community facilities and of the services in urban housing in Bangkok;

(2)

To identify the comprehensive issues and needs from health, environmental, social, and economic perspectives, also considering support services;

(3)

To provide planning and practical implications for elderly-friendly urban housing that would support the elderly’s social activities and healthy aging.

2. Literature Review

Livable cities and communities refer to communities existing in both urban and rural areas with a good environment and quality of life. They consist of a caring society with a strong community and are characterized by convenience and a feeling of safety with respect to life and property; moreover, they have a stable economic system and present the unique culture and spirit of the city and society [9]. Many organizations have established indicators for livable cities and communities, such as Asia Week and the World Health Organization (WHO), with a strong emphasis on the health of cities. One of the cities mentioned in the livable city indicators is Bangkok, which can be measured according to four aspects: social, environmental, physical, and economic/administrative indicators [9].

Thailand’s transformation into an aging society and the rapidly growing trend of the elderly population has resulted in problems for the elderly’s living conditions, including the health, economic, and social issues that they face. As a result, the government has to take action regarding policies, design plans for the elderly, and collaborate with other agencies [10].

Housing for the elderly is essential to their way of life and the sense of security, as are architectural design, location, and the choice of building types. There is a wide variety of housing for the elderly that should be considered necessary and appropriate to the city’s social landscape. The issues or factors of accommodation for the elderly are rental rates, essential services, architectural design, renovation, operation and maintenance, access to other services, communities and family ties, choice of residence, and living environment [9].

Aging in place (AIP) is a concept that refers to the houses in which the elderly and their community of neighbors live and has been proposed in elderly-friendly residential complexes and elderly-friendly cities to make everyday life comfortable for the elderly [11]. Housing is one of the relevant domains, and it is connected to AIP. The concept of housing refers to the fact that the housing conditions of older people are often linked to their quality of life and to whether they can age independently and actively in their community. Moreover, according to the elderly who live in Bangkok, they have lower energy and quality of life than the rural elderly and the other urban elderly. The improvement or development of the environment into a more caring and suitable one for the life of the elderly in the capital city should be pursued.

The study of the current situation of the elderly’s issues and needs in the urban area in Thailand can be categorized into four dimensions. Regarding the economic dimension, according to the 2011 elderly population survey, one-third of the elderly had incomes lower than the poverty line, and their children continued to be their primary source of income [9]. Nearly half of the elderly earned income from work, with only one in three elderly earning savings or holding property. More than four in five received subsistence allowances, and less than one in ten received government pensions [12]. In 2013, there were 3.5 million older people who worked, corresponding to 36% of the total elderly population. The elderly’s occupations were mostly informal or outside the system, and less than ten percent worked in the system [9].

Regarding the health dimension, in 2014, 40.5 percent of the elderly considered themselves to be moderately healthy, while 36.9 percent rated themselves as healthy, and 3.6 percent rated themselves as healthy [13]. The older the elderly were, the higher their risk for chronic diseases or congenital diseases caused by eating habits, exercise, deterioration of health, and genetics. Moreover, elderly people aged 60–79, 80–89, and over 90 years old, corresponding to 7.7%, 10.1%, and 16.3% of the total elderly population, respectively, did not receive treatment continuously. It was reported that in Asian society, elderly people are likely to be taken care of at home by informal caregivers, such as daughters, sons, relatives, or spouses, who represent the primary helpers of older people, rather than in a nursing home [14]. Moreover, a study suggested that informal caregivers need knowledge and experience to take care of the elderly and that caregiver services for the elderly in Thailand are essential because they reduce the occurrences of unnecessary hospitalization, complications, and depression [15].

To summarize the aspects that studies have found relevant to the health dimension, most elderly people considered themselves to be moderately healthy. Still, there was a higher risk of chronic disease or congenital disease caused by eating habits, exercise, deterioration of health, and genetics. Most elderly people did not receive treatment continuously, and most elderly caregivers were family members who lacked the knowledge and experience to care for the elderly.

Thailand’s household size is likely to become smaller over time. The number of elderly living alone was 7% in 2007, 8.6% in 2011, and 10.4% in 2014. In the residential areas of the elderly in 2014, the elderly in the municipality were 40.9% and in the non-municipal regions, 59.1% [9]. Social participation and activities refer to recreation, socialization, and cultural, educational, and spiritual activities. Social involvement in late life was found to positively influence the quality of life, psychological well-being, and health of the elderly [16]. Regarding social activities for the elderly, investigated via elderly clubs, it was found that there were 22,880 elderly club members in 2010 and 25,104 in 2013. Moreover, in 2011, the proportion of the elderly attending elderly clubs was nearly 70 percent, which increased from 2007 by more than 10 percent in all sectors [9].

Accordingly, the elderly now live alone more than in the past. Moreover, regarding the elderly’s social activities, the number of elderly clubs was reported to be high in Thailand, both in the urban and rural areas, and it was suggested that elderly clubs play significant roles in improving the quality of life for the elderly and being representative of the elderly population.

Regarding the environmental dimension, a living environment in terms of age-friendly housing is one that is not overcrowded, in which older people are comfortable, that is not located in areas prone to natural disasters, and in which older people feel safe [17]. However, a study on the environment of urban housing in Thailand found that one in four elderly people had experienced a fall; 75% of which were because of unsafe home environments. In total, 29.72% of the elderly were recorded to have experienced a fall, with 56.16% having been injured. The injuries were recorded to have occurred outside the home (55.17%) rather than at home (44.83%). The places where the elderly had been injured were the corridors outside the house and the bathrooms [9]. In terms of improving the facilities for the elderly, Ministerial Regulation 2005 provides facilities for the disabled and the elderly. However, if a building was built before 2005 or it is a government agency building, a state enterprise, or a private building that is open to the general public, it does not meet the criteria, and it is not under any obligation to provide facilities for the disabled and the elderly [18].

The environment plays an essential role in the well-being of the elderly. The current legislation and laws do not cover sufficient environmental conditions to enable the elderly to live comfortably and safely. The above-mentioned study reported that some elderly people had experienced a fall, and more than 75% had fallen because of unsafe home environments, while most of the elderly had been injured outside their house.

For the well-being of the elderly, there are also other issues and needs that affect the quality of their life. Regarding the educational dimension, some elderly people do not study or do not have the opportunity to gain knowledge for self-development to suit the changing age and society. Moreover, in terms of the psychological dimension, some older people are not given enough attention and care, which makes them feel lonely and may generate worries that they will be abandoned by their children and relatives, as well as worries about death. In addition, from the perspective of the family dimension, in the past, some elderly people lived with a large family or an extended family, creating a warm relationship between parents and children; however, nowadays, the elderly are alone. These are the essential issues that affect the well-being of the elderly who live in urban housing.

Moreover, policy-making regarding livable cities and communities, aging in place, housing for the elderly, and the improvement of the environment for the elderly who live in Bangkok should pay more attention to the social interaction environment, which is very important for the elderly. Proper environments should be provided for interacting with others and encouraging the elderly to participate in activities or even talk to others.

Regarding the elderly’s social activities and environment, a case study of high-rise housing in Indonesia and Japan showed that individual activities and community activities organized by community organizations were essential for the elderly. They could create a healthy, happy, and self-reliant living environment for the elderly [19]. As examples of community activities, the study reported that the Indonesian elderly played sports, gathered, and prayed together. At the same time, the Japanese elderly performed simple gymnastics, attended karaoke and games, made origami, played music, and supervised the elderly’s conditions in community wellness centers. Therefore, common spaces and community spaces created social interactions between the elderly and all generations, and improved the quality of life of the elderly living in high-rise housing.

In Thailand, elderly clubs play significant roles in improving the quality of life of the elderly and being representative of the elderly. Data from the 2014 survey showed that the proportion of elderly clubs and elderly club members was higher in urban and rural areas [9]. For elderly people who lived in general urban housing complexes in Bangkok, areas in the neighborhood, such as the area around their houses, gardens, outdoor and indoor exercise areas, and the walking or jogging tracks, represented excellent opportunities for them to participate in social activities.

Meanwhile, the urban elderly who lived in low-income housing, such as flats and apartments, used their neighborhood areas for activities arranged in the following order of priority: they used the space inside their rooms for primary activities; the hallways or corridors to chat with friends, sit down for lunch, or work; and spaces between the buildings for leisure activities with their family or neighbors [20].

Moreover, in terms of housing management, urban housing management, especially for the elderly, differs from general residential project development. Operators, management teams, juristic persons, or housing committees must provide long-term care for customers, such as the elderly. The urban housing projects must combine design, construction, and services accordingly. The designs of houses, rooms, common areas, and community facilities need to be safe for the elderly. Caregiver services and medical treatment should be provided according to the health statuses of the elderly. In addition, services and recreational activities should be appropriate and complete to meet the needs of the elderly.

According to the literature review, the elderly’s issues and needs, which affect the quality of their lives in general, have been addressed by previous research studies, but the elderly’s issues and needs have not been analyzed in terms of community facilities and services for the elderly who live in urban housing, which would be important for improving the elderly’s quality of life and for developing community areas.

3. Materials and Methods

This study aims to assess the current status of and identify issues and needs of the elderly in community facilities and services in urban housing in Bangkok from health, environmental, social, and economic perspectives, while also considering support services. The steps of the study are shown below.

(1)

The focus group methodology was used to identify the issues and needs of the elderly in urban housing. The participants were selected with social, economic, and cultural characteristics, similar experiences, and their relationships with the elderly. There were ten participants: two social workers, two nurses, two community representatives, a universal design expert, a Universal Design Center (UDC) member of staff, and two elderly people. Participants were asked questions in four parts:

(1.1)

The participant’s background—name, age, status, occupation/position, company/institute/organization, and job description and how it relates to the elderly;

(1.2)

Issues and problems of elderly people in urban housing—the current situation of the elderly in urban housing, the important issues and problems of the elderly, and the solution to the elderly’s problems;

(1.3)

The elderly’s issues with age-friendly environments, such as outdoor spaces and buildings, transportation, and housing;

(1.4)

Suggestions.

The process of the focus group was as follows:

Step 1: The moderator introduced themselves, the note-taker, and the staff;

Step 2: The moderator described the objective of the research and focus groups;

Step 3: The moderator described the process steps of the focus groups.

A typological analysis was conducted on the focus group’s qualitative data;

(2)

A questionnaire survey methodology was used to assess the current living status of elderly people and identify the comprehensive issues and needs assessment of community facilities and services in urban housing in Bangkok from health, environmental, social, and economic perspectives, while also considering support services. The steps of the study were as follows:

(2.1)

Setting of criteria to define the scope of study

There were four criteria to define the scope of the study areas:

(a)

The districts of Bangkok;

(b)

The type of housing and urban housing in Bangkok and elderly housing in Thailand;

(c)

The building life cycle of facility management theory and the period of the development of the housing projects or the age of the housing projects;

(d)

The price of urban housing in Bangkok.

Firstly, the population of Bangkok has been reported to be aging faster than in Thailand’s other provinces [21]. From the list of 50 districts in Bangkok divided into three areas, this study defined the scope of the study areas of housing projects as including all three sections of Bangkok—inner, middle, and outer areas.

Secondly, the scope of the study of the type of housing and urban housing in Bangkok [22,23,24] and elderly housing in Thailand [20,23,25] was defined as detached houses, townhouses (including twin houses), and condominiums.

Thirdly, the study of the building life cycle of facility management theory [26] and the period of the development of the housing projects revealed that the scope of this study had to include the age of the housing projects divided into two categories: (1) traditional houses or old projects, the construction of which was completed before 1999, and (2) current or new projects, the construction of which was completed in or after 1999.

Lastly, the price of housing, which is one of the factors for the elderly living in urban housing [9], was the last criterium to define the scope of urban housing. According to the above three criteria and the real estate index report [24], which defined the scope of the study, it was found that there were 3026 housing projects in Bangkok.

The prices of condominiums, detached houses, and townhouses in each area were as follows:

• Inner area
  • Condominiums:

    -

    There were 1093 condominium projects with an average of THB 10,800,000 (USD 0.32 M) per unit or THB 132,308 (USD 3.95 K) per sqm;

    -

    The range of prices was from THB 1,900,000 to 75,000,000 (USD 0.06 M to 2.24 M) per unit or THB 75,000 to 500,000 (USD 2.24 K to 14.91 K) per sqm.

  • Detached and townhouses:

    -

    There were 36 housing projects with a price average of THB 31,290,000 (USD 0.93 M) per unit;

    -

    The range of prices was from THB 5,390,000 to 203,125,000 (USD 0.16 M to 6.06 M) per unit.

• Middle area
  • Condominiums:

    -

    There were 1018 condominium projects in the middle area with an average price of THB 11,000,000 (USD 0.33 M) per unit or THB 133,298 (USD 3.98 K) per sqm;

    -

    The range of prices was from THB 800,000 to 35,000,000 (from USD 0.02 M to 1.04 M) per unit or from THB 9000 to 340,000 (from USD 0.27 K to 10.14 K) per sqm.

  • Detached houses and townhouses:

    -

    There were 410 housing projects in the middle area with an average price of THB 9940.000 (USD 0.29 M) per unit;

    -

    The range of prices was from THB 2,200,000 to 240,000,000 (from USD 0.06 M to 7.16 M) per unit.

• Outer area
  • Condominiums:

    -

    There were 97 condominium projects with an average price of THB 9,880,000 (USD 0.29 M) per unit or THB 124,584 (USD 3.72 K) per sqm;

    -

    The range of prices was from THB 900,000 to 12,000,000 (from USD 0.03 M to 0.36 M) per unit or from THB 9000 to 297,000 (from USD 0.27 K to 8.86 K) per sqm.

  • Detached houses and townhouses::

    -

    There were 372 housing projects with an average price of THB 5,840,000 (USD 0.17 M) per unit;

    -

    The range of prices was from THB 1,750,000 to 120,000,0000 (from USD 0.05 M to 3.58 M) per unit.

From the process of defining the criteria for finding the population of the study, 18 housing projects emerged, as shown in Figure 1. Thus, we set more criteria to select the sample projects.

(2.2)

Setting of criteria to define population and sampling

(a)

The land development projects were divided into three sizes: small, medium, and large [27]. The eligible detached house and townhouse projects were:

• Detached houses, townhouses, or twin houses located in Bangkok;
• Projects including traditional houses or old projects (construction completed before 1999) and new projects (construction completed in or after 1999);
• Sizes of housing projects—medium- and large-sized projects;
• Projects with residents or co-owners of more than 50% of total residential units.

(b)

According to the height, condominium projects were divided into low-rise and high-rise buildings [28]. The eligible condominium projects were:

• Condominiums located in Bangkok;
• Projects—new projects;
• Height of projects—both low-rise and high-rise projects;
• Projects with residents or co-owners of more than 50% of total residential units.

From the 18 housing projects that were the population of this study, we chose five different housing projects as a sample size with purposive sampling that could be included according to the above criteria. All housing projects had residents who were not only elderly people. This study collected data from older people who lived with family members and neighbors of other ages. The locations of these samples are shown in Figure 2, and the details of all housing projects are as follows:

• A is the new condominium project located in Din Daeng District in the inner area;
• B is the new condominium project located in Don Mueang District in the outer area;
• C is the old detached house project located in Lak Si District in the outer area;
• D is the new townhouse project located in Lat Phrao District in the middle area;
• E is the old townhouse project located in Sai Mai District in the middle area.

Moreover, this study collected data via questionnaires administered to the elderly people who lived in the five housing projects, selected by accidental sampling.

(3)

We created research tools, such as questionnaire forms for the elderly, to understand the comprehensive issues and needs assessment of community facilities and services in urban housing in Bangkok from health, environmental, social, and economic perspectives, while also considering support services, shown as Appendix A.

(3.1)

The questionnaire emphasized five issues as follows:

• The elderly people’s backgrounds, including age, education, living situation, family members, and reasons for living in housing;
• Health issues, including self-help ability, serious illness, medical or routine treatments, injuries or accidents, and consequences from injuries;
• Economic issues, including elderly people’s incomes, source of income, and expenses;
• Social issues, including duration and type of social activities, and preferences for social activities;
• Environmental issues, including social and community facilities and services, as well as accessibility and usability of facilities and services;
• Suggestions.

(3.2)

This study used quota sampling and collected 20–25 questionnaires per project. The researchers created 110 questionnaires for the elderly people who lived in the five housing complex projects. For each project, the researchers used non-probability with purposive sampling to set the criteria for selecting elderly people. The criteria were as follows:

• The elderly person lived in one of the selected housing projects;
• The elderly person regularly used community facilities;
• The elderly person walked or stayed around the common area when the researcher went to perform a field survey;
• The elderly person seemed to like to talk or cooperate with the researcher.

(3.3)

The description of the sample is as follows:

• Most respondents, 29.09%, were elderly people in the age range 60–64 years, and 60.97% were elderly women;
• A total of 31.85% of respondents had graduated with a Bachelor’s degree. In the new condominiums and in the townhouses, 73.68% of the elderly had graduated with a Bachelor’s degree or had a higher education level. In comparison, 70.18% of the elderly who had graduated from high school or had a lower education level lived in the old detached houses and in the townhouses;
• A total of 41.86% of respondents lived with children and spouses and lived in all types of housing complexes. Moreover, the average number of family members was four;
• The average time of the elderly people living in the current housing complex was 13.9 years. Most of the elderly people had moved from an old house in Bangkok or rural areas. The elderly who had moved from previous places in other districts of Bangkok lived in the new housing projects (both in the townhouses or detached houses and condominiums) and lived with children or took care of their children and grandchildren.

(3.4)

The questionnaire forms were evaluated by three experts in social studies, urban planning, and universal design. Considering the experts’ comments, the questionnaire had to be revised for the number of pages, and the questions and technical terms had to be re-checked. Moreover, this study performed a pilot test with ten elderly people who lived in an urban housing project comprising detached houses and townhouses and elderly people from the Department of Older Persons. After that, the researchers performed the field survey, and collected and analyzed the data, after which a discussion of the results was conducted, and conclusions were drawn.

(4)

The collected data were divided into elderly people’s issues extracted from the literature review, the current issues and needs of the elderly in community facilities and services in urban housing in Bangkok extracted from the focus groups and questionnaires, the relationship between the social and environmental dimensions, and the urban housing environment’s effect on the elderly’s social activities.

(5)

A content analysis was mainly used for the document review of the literature and the data from each housing project, along with a typological analysis and a theoretical model. Finally, these two methods were used to analyze the collected data and compare them with the theory and concepts.

4. Results

The study results are summarized in the following subsections.

4.1. Economic Issues

In the focus group, most participants mentioned that most elderly people received money from their children. However, if it was not enough, elderly people had to go out to work to earn more income, while the elderly income guarantee system, i.e., an allowance for the elderly, from which the elderly people in the study received THB 600–1000 per month, was not enough for their expenses. It was found that there were some policies and plans to develop professional skills for the elderly to increase the income and subsistence allowance for the elderly. Moreover, some communities had community savings cooperatives for the elderly and other members.

From Figure 3, the data obtained from the questionnaire revealed that 81% of elderly people in urban housing did not work, and they received support for their living expenses. Most elderly people, a total of 57 people (51.81%), received money from their children, while 25 people (22.75%) received money from their pension allowance. The top five reasons for elderly people’s spending were food, daily stuff, daily expenses, merit-making, and paying utility bills.

Regarding elderly people’s monthly income, 31.82% of the elderly people in the study earned no more than THB 5000 (USD 148.83), especially those residing in old housing projects. When calculating such income from a monthly to a daily basis, it was found that most of the respondents had an income of THB 166 per day, which is lower than the minimum wage rate in Thailand and below the poverty line. However, when looking at the income per household, it was higher than the income of elderly people. Most seniors lived with children who could help with their monthly expenses if their current salary or income was insufficient.

Therefore, most of the elderly people who lived in urban housing received money from their children. If they received enough money, covering their daily expenses for food and everyday stuff, the economy was not the most important aspect for the elderly people in the study.

4.2. Health Issues

Most participants from the focus group mentioned that most elderly people lived alone during the daytime. Some of the elderly people who lived independently (independently living (IL) elderly people) or aged actively could go outside and participate in social activities, while some of the elderly people who depended on assistance or equipment had to live alone during the daytime. In the current community and urban housing situation, some caregivers in long-term care programs visited and took care of the elderly who were homebound or bed-bound or who had no one to look after them. However, the number of staff was not enough to meet the needs of the elderly.

From the questionnaires, 84.63% of the elderly people could walk. All of the elderly living in condominiums could walk, while some of the elderly who lived in housing projects could walk but required accessories and wheelchairs and needed assistance. According to the literature review, the elderly’s serious illnesses can be divided into eight categories, as shown in Figure 4. In our study, a total of 76.79% of the elderly people had high blood pressure and high cholesterol, and 23.66% of the elderly people had to have a check-up at a hospital every 1–2 months for their serious illness.

Moreover, 22.75% of the elderly people had experienced a fall or had had an accident in the past year, including falling when using community facilities and falling in their house or room, and some elderly people had had symptoms or consequences from falls and accidents.

4.3. Social Issues

The focus group found that most elderly people in urban housing lived with their family but lived alone in the daytime, and some elderly people had to take care of their grandchildren. IL or actively aging elderly people could go outside and participate in activities, while AL elderly people stayed at home. There were community areas for the elderly, such as an elderly club, a health club, and a dancing club, where elderly people could play games, dance, exercise, and participate in religious activities. Some of the elderly people in the study were found to usually leave their house for merit-making on various occasions rather than gathering for practice, and some elderly people usually went out to talk and exchange their ideas and life stories. Moreover, in some urban housing projects, some activities had active elderly people gather to visit the bed-bound elderly, which is an activity that encourages patients to go out into the community and society again.

The results of the questionnaires suggest that social issues are essential for the elderly living in Thailand’s urban housing. The elderly people in the study left their house to participate in their social activities around two times per day and stayed outside their house/room for around 3.15 h. There were 93 elderly people, 84.55%, who participated in activities with their family members and neighbors, while some elderly people carried out outdoor activities alone. Most elderly people performed social activities in their housing complexes, such as walking, sitting, meeting, or talking with others.

Regarding elderly people’s social participation in housing, most of them, 70.98%, enjoyed meeting people or participating in social activities, while 29.02% did not enjoy that. The elderly who enjoyed participating in social activities did so in housing complexes, such as houses, gardens, neighbors’ houses, and lakes.

Figure 5 shows where elderly people carried out their activities outside their house. The top four social activities of the elderly people in this study were as follows:

• Walking (55 people)—34 people, which is the highest number, walked around their houses, and 17 people walked around the park or garden;
• Meeting or talking with other people (46 people);
• Sitting (41 people)—14 and 9 people enjoyed sitting in a park or garden and in the area around the house, respectively;
• Exercising and jogging (38 people)—15 and 14 people enjoyed performing exercises and jogging around their houses and parks or gardens, respectively, while only 4 people, 10%, enjoyed exercising in fitness centers.

Elderly clubs play essential roles in improving the elderly’s quality of life, and they are representative of the elderly. The literature review found that there are elderly clubs in the community accounting for 10% of each sector in Thailand, while from the questionnaires, it was found there were elderly clubs in two urban housing projects, which were old housing projects, accounting for 40%.

In terms of social participation, there were not many community areas and elderly clubs for the elderly, which is a matter that affected the elderly because these activities promote more social participation in the elderly’s social life in housing quarters and in the community. Some elderly people were willing to participate with others at the elderly club and community area if they could go outside or there was someone to help and assist them. Most of the elderly in urban housing went outside and participated in social activities every day with their family members and neighbors at community facilities in their housing complexes. Thus, social issues are important issues that affect the needs of the elderly who live in urban housing in terms of participating in social activities in community facilities.

4.4. Environmental Issues

According to the data from the focus group, most of the elderly may not be aware of environmental issues as much as they should be. In this study, elderly people had lived in the same house for many years without renovating their home and surroundings to suit their changing lifestyles, while some had modified it; however, they were simple adjustments that did not use any universal design principles.

Most urban housing projects provided community facilities for everyone, but they were not made especially for the elderly or people with disabilities, so most elderly people did not have the opportunity to use them. Most people who lived in urban housing, including elderly people, traveled on foot or by bicycle from place to place in the neighborhood. Most of the facilities related to the travel chain were not safe enough for the elderly, such as pedestrian paths, crosswalks, and bike lanes.

All participants mentioned a relationship between environmental and social issues for the elderly in urban housing. The elderly gathered to participate in activities and found space or community facilities in their housing complexes to participate in such activities together. Thus, the role of the environment should be to support social activities in urban housing.

From the questionnaires, it was found the average frequency of using social and community facilities was around five days per week, and the range was from one to seven days, which means from once a week to every day. The top three community facilities in housing, which the elderly people mentioned, as shown in Figure 6, were gardens with playgrounds, streets, and restaurants or coffee shops in their housing buildings. Most of the elderly people in the study, 69.16%, used the community facilities in their housing buildings. In comparison, 30.84% of the elderly people did not use community facilities because they did not want to, could not leave their house for an activity, or did not find it easy to access them. Most IL elderly people used community facilities almost every day. Most elderly people mentioned public parks, playgrounds, and multipurpose plazas for exercise, and social and religious activities. Moreover, they also mentioned elderly clubs and facilities when discussing the travel chain, including streets for pedestrians.

The elderly people in the study mentioned problems of community facilities in urban housing, such as unsafe environments, inappropriate spaces, and a lack of social interaction spaces for the elderly. The elderly people in the study needed more playgrounds, swimming pools, and areas that encourage the elderly to interact more. They needed more safety facilities related to the travel chain, e.g., streets for pedestrians, in their housing complexes. Moreover, 31.85% of the elderly people needed more facilities, while 34.28% of them mentioned elderly facilities, such as ramps, walkways with rails, medical rooms, and elderly clubs.

Moreover, 34 people, 30.84% of the elderly people, did not use community facilities. The elderly people in this study did not use community facilities because of the following reasons, ranked from first–third: they did not want to leave their house, they could not leave their home, and the facilities were not easy to use. Some elderly people did not use the fitness facilities because there was no trainer and they could not use equipment in fitness centers. Some elderly people had no friends with whom to carry out an activity, so they only used the street for walking and exercising by themselves. Moreover, some of them could not go out to participate in some activities because of working hours, and some thought it would have been a waste of their time.

Therefore, the environment is an important issue that affects the well-being of the elderly. In our study, some elderly people were not aware of the environment around their house as much as they should have been. In urban housing, it was noticed that most people, including elderly people, traveled on foot or by bicycle from place to place. Most of the facilities related to the travel chain were not safe enough for the elderly. Most elderly people used community facilities around five days per week.

4.5. Support-Service-Related Issues

According to the focus group, the participants mentioned support services in two categories: general services, such as security, cleaning, gardening, operation, and maintenance; and elderly services, such as food delivery services performed by housing staff, the cleaning of the elderly’s house or room, and health services. Regarding health and medical services, there should be more medical staff from long-term care programs to visit and check up on the elderly who are bed-bound or at the ends of their lives; furthermore, there should be health subsidies for taking care of the elderly who depend on assistance or equipment. In particular, there should be more support for those that have to live alone during the daytime.

In the same way, from the questionnaire, most elderly people emphasized the basic facility services, as shown in Figure 7. There were 110 people, and 106 mentioned security services and gardening services as ranking first and second. The elderly people in the study mentioned operation and maintenance, cleaning services in the common areas, and garbage collection, ranking third–fifth. At the same time, elderly people did not mention the cleaning of the elderly’s houses.

There were 22 elderly people who needed more services, such as a CCTV system, traffic and parking management, medical services, such as medical treatment and medical check-up services, and massage services. Moreover, the elderly needed more food delivery or catering services and social interaction services, such as the arrangement of social events for the community to get to know each other better, social activities in the daytime, and elderly clubs. Moreover, some elderly people mentioned that there should be more activities that promote interactions in their housing complexes.

In addition to general services, the elderly mentioned the need of more food delivery services, the cleaning of the elderly’s houses, medical and health services, traffic and parking management, and social interaction services, which shows the problems in the elderly’s daily living today.

5. Discussions

Based on the research results and compared with the results obtained from the literature review, the Discussion section aims to perform a comprehensive overview of the issues and needs assessment from health, environmental, social, and economic perspectives, also considering support services and the urban housing environment for the elderly’s social activities.

5.1. The Comprehensive Issues and Needs Assessment from Health, Environmental, Social, and Economic Perspectives, While Also Considering Support Services

The elderly’s subjective well-being is their satisfaction with life as a whole based on a personal standard [29]. Elderly people with better health, higher incomes, and better mobility have higher psychological well-being. A residence improves the safety, comfort, and self-worth of a person, which results in a higher level of psychological well-being [30]. From the perspective of health issues, in 2011, most elderly people assessed their health as very good and good (38.40% and 4.30% of respondents, respectively), while 15.90% evaluated their health as bad–very bad [3]. In the same way, the results from the focus group and the questionnaire show that most elderly people assessed their health as very good and healthy. From the questionnaire, 84.63% of the elderly were able to walk, while 15.37% of the elderly had difficulty with ADLs.

The health status of the elderly is reflected in the serious illnesses that affect the elderly. In 2011, the top five chronic health problems were high blood pressure, high cholesterol, diabetes, gout, rheumatoid, heart, and paralysis [3]. From this study, most elderly people in urban housing had high blood pressure, high cholesterol, and diabetes. Moreover, some elderly people had to have a check-up at a hospital every 1–2 months for their serious illnesses.

Regarding injuries and accidents, which show the security level of the elderly’s living environment, from the literature review, most elderly people who were reported to have gotten injured had experienced a fall because of an unsafe home environment, and the injuries occurred outside their house rather than inside. Most of the elderly, 60%, had experienced a fall and had had an accident in a housing complex or had been injured and had fallen in community facilities, as reported in the questionnaire responses. The elderly may face risks if they are not provided with proper facilities to assist with activities of daily living (ADLs). The management of facilities for the elderly should not only provide accommodation but also minimize risks to their safety [31]. Thus, if there are appropriate facilities and medical services, the elderly in urban housing can have better health and quality of life.

Social issues are essential for the elderly who live in Thailand’s urban housing. Regarding the elderly’s social participation in urban housing, in this study, most elderly people enjoyed meeting people or participating in social activities in housing complexes. The elderly people in this study usually left their house to participate in a social activity around two times per day and stayed outside 3.15 h per day. Most elderly people participated in an activity with their family members and neighbors, while there were some elderly people who carried out outdoor activities alone. According to the literature review, most elderly people go out of their house to regularly participate in activities in the morning with their family members, neighbors, or alone [2].

The study of the elderly’s social activities shows the type of social participation in housing complexes. From the literature review, studies found that there were many clubs, events, and activities in housing buildings for the elderly. The number of elderly members who participated in social activities in elderly clubs increased from 68.9% in 2011 to 69.6% in 2014 [2]. Moreover, two types of elderly people’s activities in community facilities were reported: activities in community centers, such as exercise, arts, and crafts, and activities in senior centers, such as dancing and playing games [32]. Moreover, quality public spaces in urban areas are a significant opportunity to encourage the elderly to interact socially. Formal and informal public spaces can provide a variety of atmospheres to motivate a range of social interactions [33]. From the focus group, the participants mentioned examples of community facilities in urban housing that offered elderly social activities, such as elderly clubs, health clubs, and dancing clubs, where the elderly could play games, dance, exercise, and participate in religious activities. From the questionnaire, most elderly people participated in social activities at community facilities in their housing complex, such as walking, sitting, meeting, or talking with other people.

Environmental factors, such as dwelling conditions, can adversely affect the well-being of older persons. They can also act as stressors and become factors contributing to one’s psychological well-being [34]. Not only living in better conditions, but also moving to a better living environment can increase the elderly’s levels of happiness and life satisfaction. In Thailand’s urban housing, the environment types are community facilities, infrastructure facilities, common areas, amenities and decorations, and the housing environment [35]. Moreover, IDL elderly people in housing and unemployed were reported to use community facilities every day and used them in the daytime around four hours per day [14]. Similar to the above-mentioned literature study, this study revealed that the average frequency of using social and community facilities was five days per week. The top three community facilities that elderly people mentioned were gardens with playgrounds, streets, and restaurants or coffee shops in their housing complexes. Moreover, the elderly also mentioned elderly clubs and facilities when discussing the travel chain, e.g., streets for pedestrians.

From this study, most elderly people, 69.16%, used the community facilities in their housing complexes. In comparison, 30.84% of the elderly did not use community facilities because they did not want to use them, could not leave their house for an activity, or did not find it easy to access them.

Moreover, from the literature review, unsafe and insecure environments, a lack of social interaction spaces, and communal or shared amenity spaces in urban housing in Bangkok were reported. Similarly, in this study, the elderly mentioned hazardous environments; for example, they mentioned unsafe facilities related to the travel chain, e.g., streets, streets for pedestrians, and footpaths, in housing complexes. Moreover, they also needed more playgrounds, swimming pools, and areas that encourage the elderly to have more social interactions.

Lastly, in Thailand’s housing, support services can be categorized into standard services and residential services, such as basic facility services and community activities [35]. From the results, most elderly people mentioned and emphasized basic facility services, such as security services, gardening, operation and maintenance, and cleaning. The elderly people in our study also mentioned pest control, maintenance of A/C system services, CCTV systems, traffic and parking management, medical services, food delivery services, and catering services. Moreover, social activity services, such as the arrangement of social events and activities for the elderly in housing, were mentioned by some elderly people.

5.2. The Urban Housing Environment for the Elderly’s Social Activities

In this subsection, we discuss the results compared across housing types as well as the results obtained from both the focus group and questionnaires, and we compare them with what emerged from the literature review to define the urban housing environment for the elderly’s social activities.

From the perspective of the environmental issue, the five analyzed housing projects had general community facilities and general services. Social and community facilities, such as elderly clubs, were among the urban housing environments that encouraged the elderly to take part in social activities. There were two elderly clubs, accounting for 40%, in the old urban detached house and townhouse projects analyzed in the study. However, when comparing the participation ratio of the activities, it was found that the old urban detached house project had a lot of older people who wanted to participate in the activities. In comparison, the old urban townhouse project had fewer people who wanted to join the events. According to the survey, among the problems that affected the elderly’s club participation were the sizes and conditions of the places. Therefore, the social and community facilities should be in good condition to support the participation of the elderly in social activities. Moreover, 34.28% of the elderly people in this study mentioned elderly facilities, such as ramps and walkways with rails, medical rooms, and elderly clubs.

Green spaces, the level of noise of the environment, the elderly’s feelings of safety, and the accessibility of the environment are also significant in the elderly’s social lives [36,37]. According to the study, there were green spaces in all five urban housing projects, and 99.09% of the elderly mentioned parks, gardens, and playgrounds, where they enjoy participating in social activities. Most elderly people living in condominium projects preferred outdoor areas, such as exercise areas and green spaces, which encouraged them to participate in more social activities. Moreover, the elderly in the detached house and townhouse projects also mentioned the aesthetics and the quality of green space related to the maintenance conditions and gardening services.

The noise level in the environment impacts the elderly’s ability to interact with others [37,38]. From the study, there were no older people directly addressing the issue of the acoustic environment. However, some of the elderly who lived in the condominium projects mentioned noise-polluting vehicles, such as motorcycles and cars, which pertains to traffic and parking management.

The social life of the elderly is associated with the accessibility of their environment. Transport is a primary indicator of accessibility that can play an essential role in the social lives of the elderly [39]. Moreover, the availability of services located within a five minute walk of the elderly’s residence is essential for the elderly’s social activities [36]. From the focus group and questionnaires, one of the reasons why the elderly did not enjoy participating in social activities and did not use community facilities was the accessibility of the community facilities. Moreover, most elderly people traveled on foot or by bicycle from place to place in the housing complex and the neighborhood. Most of the community facilities in the old detached house and townhouse projects related to the travel chain were not safe enough for the elderly. These problems hindered the access to community facilities and support services and elderly people’s participation in various activities, including social activities.

In addition, safety, as a feature of the physical environment, also contributes to the social life of the elderly. In general, people restrict their activities due to feeling unsafe, and the feeling of not being safe leads to limited social interactions and less social involvement in the community [40]. In the same way, from our study, it emerged that 22.75% of the elderly people had experienced a fall and had had an accident when using community facilities and in their house or room. Some elderly people mentioned the lack of safety in travel-chain facilities and the need for safer elderly facilities, such as ramps and walkways with rails. All elderly people preferred security services among the support services they needed in their housing complexes. In total, 20% of elderly people needed more CCTV systems in hidden spots. Moreover, the appropriate provision of suitable facilities (e.g., elderly clubs), and services (e.g., medical and long-term care services and the arrangement of social activities for the elderly) would allow the elderly to have better health and social lives in urban housing.

In the context of elderly community facilities and services in other countries, there is a relationship between residential satisfaction and psychological well-being. Regarding the elderly’s issues and needs, it was reported that the urban elderly in Columbus, Ohio, who lived having health, money, and mobility, had high psychological well-being and the resources to ensure they had a favorable residence—one in which they felt safe [30]. In another study, the social interactions of urban older women living in Beijing, China, were related to their physical and psychological situations. Moreover, public spaces positively impacted their psychological well-being and social participation [33]. A study of the elderly’s well-being in Hongkong found that the environmental dwelling conditions mainly indirectly affected older persons’ psychological well-being; hence, they probably influenced the elderly’s opportunities for successful aging [34]. In the same way, from our study, it emerged that urban elderly people who were healthy and with good incomes also participated in social interaction activities in community facilities and housing, improving their well-being. Moreover, social interaction environments, such as gardens, playgrounds, and elderly clubs, were found to be essential for the elderly living in urban housing.

6. Conclusions and Recommendations

Social interactions benefit the physical and psychological health of the elderly. Community facilities and services, such as social interaction environments, are essential for the elderly living in urban housing communities. This study aims to assess the current status of the elderly living in urban housing in Bangkok; identify their issues and needs from health, environmental, social, and economic perspectives, while also considering support services; and define an elderly-friendly living environment that would facilitate the elderly to partake in social activities in the community.

The study reveals the current status of the elderly in urban housing. Most elderly people were young elderly people and female. Most of them lived with their children, spouses, wives, or partner, and the average number of family members was four, which was found to be higher in the old housing projects. Most elderly people who moved from outside Bangkok and rural areas had gone to live with their children and took care of their grandchildren. Most elderly people who lived in the old housing projects had graduated from high school or had a lower education level, while most of those who lived in the new housing projects had graduated with Bachelor’s degrees. Moreover, most elderly people who were still working lived in the condominiums and participated in fewer social activities in common areas than others who lived in the old housing.

Regarding the issues and needs of the elderly, most elderly people assessed their health as very good and healthy, but still needed health facilities and services, such as medical and long-term care services, for a healthier and better quality of life. The elderly people who did not work were unemployed or retired and were dependent on their children; they had more free time and participated in more social activities than others. Social issues were important issues that affected the needs of the elderly people who lived in urban housing in terms of participating in their social activities in community facilities. Most elderly people were welcome to participate in social activities and leave their house to participate in daily social activities with their family members and neighbors in community facilities. Some elderly people did not want to participate in any social activity because of their attitude and health, as well as the usability and accessibility of community facilities, especially the elderly people who lived in the old housing.

The urban housing environments were community facilities, infrastructure facilities, and common areas. There was a relationship between environmental and social issues for the elderly people living in urban housing. The role of the environment should be to support social activities, but there were unsafe and insecure environments in urban housing in this study. The support services mentioned by elderly people were the basic facility services, medical services, and services related to their safety and social activities, which reflected current needs and problems, especially in old housing. Thus, the unsafety of the facilities and the lack of support services could be improved through housing operations, maintenance, and management.

An elderly-friendly living environment that facilitates the elderly’s social activities in urban housing should increase the amount, aesthetics, and quality of green spaces and the accessibility of community facilities. There were green areas in all five urban housing complexes in the study, while most elderly people who lived in condominiums preferred more green outdoor areas, such as parks and exercise areas. The accessibility, usability, and safety of using community facilities affected the living conditions of the elderly people in this study. From the study, it was found that the accessibility of community facilities was one of the reasons why elderly people did not enjoy participating in social activities and did not use community facilities. Most of the community facilities in old housing related to the travel chain were not safe enough for the elderly. Elderly people expressed the need for safer and more elderly facilities, such as ramps and walkways with rails. Moreover, providing elderly clubs, medical and long-term care services, and social activity arrangements for the elderly would allow the elderly to have better health and social lives in urban housing.

The study shows that the old housing projects needed more improvements and management of common areas than the others, especially regarding unsafe facilities. There were elderly people who did not work but had free time to participate in various activities in community facilities. Moreover, the elderly people who lived in the old housing needed more access to community facilities and services.

This study has limitations in terms of collecting data from the elderly. Some elderly people were unable to answer the questionnaire themselves and had to rely on an assistant to read the questions. The findings of this study should be considered by housing developers and facility managers when developing urban housing environments, such as green spaces, safety facilities, elderly clubs, medical and long-term care services, and social activity arrangement services for the elderly to accommodate the transition to an aging society. Moreover, further studies in this area could increase the population and sample size to provide more comprehensive data for applying the results to policy-making and city planning aimed at improving senior citizens’ well-being.