What’s the Truth about Alzheimer’s Care in Thailand?
I recently asked Nancy Lindley, who has guided several families through the process of obtaining intensive care for their Alzheimer’s relatives here. This was her response:
I have walked several expats here through the process of terminal care for an elder in Thailand. Be warned that this is not easy. Custodial care at home is OK (I’ve known several resident expats who have done exactly what you’re proposing. Sometimes it works out OK, often it doesn’t) but anything medical runs into the following problems:
- Cost: at age 65+ it’s impossible to get insurance.
- Thailand is 50 years behind current, best practices in palliative care.
- If someone is hospitalized they may have difficulty getting their wishes honored regarding life support and so forth and will definitely have difficulty getting hospice level care at home. The people I have assisted all had to do it themselves. It was not easy and they could not obtain the preferred drugs. Of course on the other hand are the incalculable benefits of someone being with their caring family rather than in an institution.
Cover these four bases before you make the move to Thailand:
- Self insure for major medical costs by setting aside 2–5 million baht (preferably closer to 5). Even if they don’t need any extraordinary measures (see below) there are plenty of events that can cause pain and bad quality of life that are treatable but costly.
- Have a frank discussion with them regarding her wishes in terms of heroic measures/end of life care and if appropriate have her draw up a Thai living will. Get Thai legal assistance because only Thai wills are recognized in Thailand.
- Shop around for a GP who understands the “living will” concept and is prepared to honor it. This may take some doing; it’s a new idea in Thailand.
- Avoid having them hospitalized as much as possible and get them discharged as quickly as possible if hospitalization is unavoidable. Even with a living will, you may have trouble getting wishes honored by a hospital. Additionally, the hospital’s Thai speaking environment will be confusing and traumatic for them.
The Basics of Home Alzheimer’s Care in Thailand
It’s Important that you
- Have a good relationship with your loved one,
- Both agree that it’s a good idea to come to Thailand, and
- Have a good Thai connection who is
- well-respected locally: Not necessarily the actual caregiver, but who can
- train, and
- manage your caregivers.
- comfortable getting around the village and
- able to tell you where to go for help.
4. Have a good local hospital with
- some English-speaking doctors and nurses and
- a doctor who will make house calls
- a good Thai co-ordinator can line up tradesmen.
- Equipment like hoists, walk-in tubs, etc (imported and very expensive).
Thais usually use muscle power in caring for the elderly. If a patient is large, potential caregivers will be reluctant to get involved.
People think you can hire “some little Thai girl” for the same wages as a 7-11 clerk to do this job. Sorry, that just isn’t the case, not if you want to have peace of mind that the caregiver is going to show up to work on time, we able to communicate with your loved one and be sensitive to her needs. The average 7-11 clerk type of carer is going to sit around and watch Thai soap operas while your loved one lies in bed all day, without being turned to prevent bedsores, offered water, or given any food beyond what the caregiver fixed herself for lunch.
Here in Chiang Mai we call on a core of ladies we call upon for end-of-life care who typically earn 1000 baht for a 12 hr shift. That’s 60,000 baht or $2,000/month, for 2 caregivers, and you still have to cover their days off. Here’s a letter I received from a local expat about their experience with intensive care. It will give you some perspective on our local conditions:
Four years ago my Thai wife and I relocated to Bangkok from the US with our handicapped son (now 12 years old). He is confined to a wheelchair, has a trach and feeding tube, cannot talk, and requires 24 hour attention. The home health care services in the US are quite poor and unreliable, and we have found it much easier here to find and train local people to take care of our son. During the day (7am-7pm) we have a local woman taking care of him — she had no prior healthcare experience and my wife trained her in how to do everything necessary with our son. At night (7pm-7am) we have a group of local nurses and nurse’s aides who rotate in taking care of him. We bought a hoist from Modernform Health & Care, which also sells other medical equipment like hospital beds, wheelchairs, etc. Their website is www.modernformhealthcare.co.th, and phone is 02-722-8033-5. We also bought a Toyota van and installed a wheelchair lift through Siam Nissin, whose website is www.siamnissin.com, telephone 02-454-1340.
Since Lanna Care is busy serving local expats the all-volunteer staff does not have time to respond to enquiries about Alzheimer’s care in Thailand, please use the Contact form on this page to ask any questions about Alzheimer’s – or other intensive care – in Thailand and we’ll do our best to respond. Until then, watch this video about Alzheimer’s care in Thailand. It’s in German but it’s better to ignore the narration and concentrate on the body language: a much more important factor in elder care at Heartwood Seniors..
Alzheimers Care in Bangkok
Gemma Purnell is Bangkok’s leading authority on all expat matters. I asked her to advise Russell, a client, and here’s what she wrote:
Your information was passed to me by Godfree Roberts regarding bringing your 90 year old Mother to Thailand.
I will skip over the visa and travel requirements, I expect as a resident of Bangkok that you are aware of these. She would be eligible for a retirement visa providing that she can show 800,000 baht in a Thai bank account or 65,000 THB in monthly income.
You will be able to sign a power of attorney to deal with her affairs including her bank account and her visa, although this is not straight forward and would require a lawyer it can be done.
The best and most economical international health care can be found at Phyathai 2 hospital in Bangkok where the head of the Platinum Suite is well known for her caring approach with elderly foreign patients and speaks English to almost native speaker level.
This would be a sound option for ongoing and inpatient medical care.
For outpatient care in the home, I would recommend hiring a Philippina nurse who I should be able to help you source. However ensuring that the candidates suit your particular needs before hiring them will be your own responsibility.
Philippinas are generally more well versed in western care than Thais and often have a better command of the English language. They will also be more economical to hire and I would expect an experienced live in Philipina nurse to cost you no more 20,000 – 25,000 baht per month.
You may be able to hire a Thai nurse, however finding someone with the suitable language skills, experience in geriatric care and willingness to work outside the benefits of the Thai system would be more difficult.
I hope that I have provided the information that you were looking for and if you have any further questions please don’t hesitate to contact me back at this email address.
More reading on Alzheimers care in Thailand
- Some Tips for Filing a VA Disability Claim | VAntage Point – But you will need a VA doctor to attest that the condition is service connected or falls under US code 38.1117 and I can say because I have been working on mine since 1992 that they care less what a real doctor has to say. My current ….. As we have an increasingly aging Vet community (if they are that fortunate) that are more likely than not to have service connected dementias and/or Alzheimers; this is very much of a concern to us–the entire Veteran family. Again …
- The War My Parents Never Wanted | VAntage Point – The Alzheimer’s; losing our home; watching my mom struggle without her husband. . .but he just shrugged. I realized reassurance wasn’t what mattered. I leaned over, kissed my dad … Family is healing, and you being around helps make sure he will get good care, that is a proven thing. Love him, and do not blame yourself for decisions you made. I am glad …. May 18, 2011 at 9:09 pm. Oh my god, where did this guy come from? Hey, hope Thailand is treating you well!
- Ohio Department of Aging | Information – When Phyllis was diagnosed with Alzheimer’s disease in 2007, John became her caregiver until she died in 2013. Still singing, this “Happy Dabbler,” as he refers to himself, is a wonderful … She works with Adult Protective Services, the Youngstown Rescue Mission, Help Hotline Crisis Center, Area Agency on Aging 11, Inc. and home care providers to fill the gaps between available services in the community. She is one of the founding members of the Mahoning Adult Protection …