CIRCLES OF CARE FOR DEATH PREPARATION AMONG PEOPLE WITHOUT CLOSE NETWORKS IN THAI SOCIETY

Abstract

This qualitative study 1. examines characteristics of circles of care for death preparation in Thai society; and 2. analyze gaps and propose development guidelines for people without close networks suitable for Thailand. Data was gathered by in-depth interview with 20 organization representatives involved in death preparation in state and quasi-state; academic and medical; civil society; and private sectors. Data was analyzed by the framework method with circles of care as initial framework.

Because death preparation depends on entrusting personal wishes to a recipient who is usually in the inner circle, people without close networks lack a caregiver and recipient of advance wishes from the outset. Each outer circle accommodates them only partially and conditionally; the community circle provides planning devices but cannot itself store and enact the requests; the service circle admits only those already in the system; and the policy circle has only started building an electronic advance-directive registry (e-Living Will) with limited reach. Two further elements in Thailand include a commercial market circle filtered by purchasing power, and a religious-institution axis serving as backup in some areas. Those who are without networks or means lapse into a gap of all circles simultaneously. Therefore, a national mechanism should compile advance wishes, proactive case-finding, and preparedness options independent of purchasing power. In conclusion, the difficulty of death preparation among people without close networks in Thai society does not arise from a lack of organizations, networks, or services, but from each circle of care operating on its own, without a central policy to connect the existing institutional social capital so that the circles reinforce one another.