al007

Registering with British Embassy on death and release of body as applicable to those  English people with legally registered marriages, and thus Thai next of Kin

I had a long conversation with my Embassy The British Embassy after a chain of emails,  Yesterday

The information I obtained is different from some on Thai Visa

The told me the following

They do not have a register of British Nationals, living in Thailand, who have voluntarily registered and further it is not possible to register with them

They advised me for my body to be released from a hospital, on death; all my Thai wife has to do is produce copy of marriage certificate,( there is no requirement for the British embassy to be involved) she is then free to arrange the funeral or donation of the body according to the deceased wishes, The UK Embassy said their approval is not required, in any way so far as they are aware

They also said a will is a strong suggestion, I already have one in both Thai and English

They did also say in the event of any problem call the Embassy and help to resolve matters would be immediately forthcoming

I also have a file on what to do on death, with separate pages for each item, like will, page for each bank account, page for pension fund, page for stockbrokers, summary page of assets, page of those to be contacted, etc etc

1 minute ago, Pilotman said:

Thanks for that.  he is now on his was to Udon Thani from the village which is close to Non Sang. the local  facility is barely a cottage hospital or clinic and they are next to useless..Trouble is, in Udon last time, the doctor wanted to take a biopsy  and the brother in law said no, why i'm not sure.  He said on the phone to me that he was afraid of dying, and so refused, which is an odd thing to say in his circumstances.  I am 600kls away but I hope that on his return to the hospital today , he just does what the doctor wants and then gets some pain meds that actually do the trick, one way or the other.  

Do not forget the cancer hospital just south of Udon, maybe his local clinic if pushed will give him referral there

The people I have met there have been very caring and very helpful

I do not know how you explain this I am not afraid of dying just the pain bit

On 23/08/2017 at 4:08 PM, al007 said:

I have seen Thais dying here in many cases in great pain and it distresses and worries me greatly, I have said to families this is unnecessary let me get and pay for a doctor but generally had to back off

I said this over a week ago when I started this thread

Sheryl has just confirmed the Thai personality, is to suffer and not complain, and they treat doctors often like Gods, this thinking unfortunately makes it more difficult to assist

So there is an element of the pain that is of their own making, and regardless of my views we must respect the Thai Culture

Sometimes we will fail despite our efforts, we need to be firm and let them see our concern is because of love

3 hours ago, Pilotman said:

My wife's brother in law in Udon  is in the last stages of liver cancer and in pain.  The  hospitals can do nothing for him and even discharged him last week.  What a tragic situation for him and others in that state. 

So very sad

One observation are we certain we know all the facts, occasionally they get twisted

When you say UDON, do you mean UdonThani, and if so was it the cancer hospital, on the main road from the south going into town

I have had consultations at the cancer hospital  near Udon Thani and found a very large range of ability and care

If I had a family member in this situation I would visit the hospital and try and get the CEO, and initially try nice honest sweet talking

If that failed I would return with a solicitor, I would not give up easily

I find what you describe as horrendous, it is not a situation of can not prescribe pain killers it is simply WILL NOT

We also know the chief Executive of KhonKaen, I would go there also I would leave no stone unturned

It is very sad the pain this leaves the man in and also the pain and stress it causes the family

Hospitals have management levels above the hospital itself, I would be there as well

Personally I find what you describe as barbaric and totally unacceptable

I will at least pray, sometimes  maybe the last resort but it can also help. and I believe has helped me

If you need to talk please PM me, I will give you my phone number

Mcmillan in the UK have a help line and can be got on Skype, it is not only the cancer victim that needs help but the immediate family, these people will talk even if you are outside the UK, I have used them a lot on my own problems

10 hours ago, Sheryl said:

His insurer has not said or done anything.  And he is not currently in need of palliative care. So there is nothing to be negotiated

Incorrect and misleading statement may I gently suggest Sheryl

Now is the time to negotiate with the Insurer and clarify the position, that negotiation could result in clarification of the wording, or a change of cover for additional consideration

It would appear my English is not understood by Americans

In the English language in the UK to negotiate is not about solely payment of claims

On 31/08/2017 at 6:18 PM, connda said:

 I have insurance that will cover hospice care.  I'm not sure they will cover end-of-life care in a "better private hospital."   

Lets try and help connda get an answer we have talked all around this

A copy of the policy document is required

Name of insurer and domicile, if UK you would have access to the insurance ombudsman, very pro the policyholder

The countries laws that are applicable to the contract, i.e. UK law USA Law California Law Thailand Law

Read carefully all definitions esp re palliative and hospice care, and anything vaguely related to end of life

Read carefully all exclusions

Read financial levels of cove

read precasting clauses

Reread slowly the whole policy document

Meet with the agent who sold the policy

At this stage write to the insurance company for clarification, and keep the reply with the policy document

Now and not later is the time to clarify matters not when you are drugged on morphine

WE are already on PM contact and if you wish via that section I would willingly give you my opinion, if you send me a copy of the policy document but unless very simple still suggest you get a second opinion

Listening to Sheryl and Nancy, I feel injustice is maybe being done

You are two powerful ladies with a wealth of experience, so you say

Sheryl has reviewed an awful lot of policies, to quote the lady

The kind and charitable thing for you two ladies is to assist the poster wth these problems, get his authority and then negotiate on his behalf with the insurer

From what you both say it will be a piece of cake

You will then  have done a very charitable act and made the man very happy and relieved

I will also eat humble pie and say I was wrong, and give US$250 to a charity of your choice

Just a thought from a man maybe dying of cancer

2 hours ago, Sheryl said:

I have not seen an insurance policy that covers hospice services but would not cover it if given in a hospital.

Well I guess you now have

I would fully agree with the insurer

1 hour ago, NancyL said:

.  As Sheryl has said, it's important to seek treatment early and have a palliative care specialist who is your primary care physician.  

I only talk of my own personal experiences

With all my problems for me it is neither sensible nor appropriate for my primary care physician to be a palliative care specialist at this time

This week I have had long discussions with my primary oncologist, I actually have two, on the question of pain when dying

For me that man is my number one carer

He trained at John Hopkins, he is about 40, in his prime and not past his sell buy date

(A friend with prostate problems this week saw a urologist at a private hospital in BKK, and that man was past his sell by date and gave some very suspect opinions, age of consultant for me is critical)

My Oncologist agrees Thailand lags USA and UK in pain suppression but comments among the younger doctors things are changing a lot

He has categorically assured my wife and myself, he can and will arrange for pain mitigation whilst at home even though 500kms from BKK, and with a little manoeuvring this will be until the very end

HE HAS SAID DO NOT WORRY HE WILL TAKE CARE OF IT ALL

I trust him and my personal problem is being taken care of

At the moment I do not know if I have 6mths or 15 yrs to go, next week will clarify more

I am a very open person and will willingly discuss by PM even things we are prohibited from discussing here on open forum, my wish is to learn and help others and avoid controversy, and remain honest wth my opinions

1 hour ago, Sheryl said:

 

He specifically stated his policy does cover hospice care.

Hence Nancy's question.

 

Correct, I think maybe you miss my point, insurance companies pay out according to the contract

The contract says hospice not hospital

Of course it is worth challenging it but unlikely in my view as a retired professional who among many things had in the past responsibility for very large group medical schemes as well as PHI and disability insurance

Insurance companies  and the underwriters are not charities and often not nice people

At the time of taking out the policy if the question had been asked will you pay for hospice care in a hospital and there was a written answer confirming  then he probably ok

Even on this thread there is a difference in meaning maybe in English like the Queens English, being my language and American English

Palliative care in a hospital is not the same as a hospice, I can only talk for the UK where hospices are far cheaper than full blown hospitals

In post 32 Nancy quoted as follows

 So if your insurance will cover hospice care, why won't it cover end-of-life care in a private hospital?

Well there is a lot of misunderstanding around

Insurance companies are large businesses for the purpose of making money

They write to contract and all the small print

The less they pay out the more money they make

They will always take your money and only dispute at the time of claim

So to make the statement why won't they cover end of life in a hospital very obvious the policy does not include that

They only pay according to the contract they wrote, nat according to what you might like

In post 19 Nancy quoted

 Everyone, no matter how old, can obtain accident insurance.

This is on the thread on palliative care, and if anyone believes this type of policy might payout for Palliative care, that is fake news and very mistaken

I believe its inclusion without warning could persuade people to spend money they do not really have and expect to be covered for palliative care, to be mislead

Of course if at the time you need palliative care and are knocked off the motor bike then hospital costs might be paid, but in reality at that stage of your life you are unlikely to be on the motor bike

Generally be very careful and read all the small print in depth before buying ANY insurance, and if in doubt ask the insurance company to clarify further in writing, in that case, the letter will be enforceable legally

Insurance companies are here for their benefit not ours, pay premiums for years, get old the insurance company then increases the premium to unaffordable levels, and when challenged say we did not withdraw cover, offered market rates and the insured chose not to renew, his problem not ours

Americans should at least understand this last bit , it happens in the USA all the time, Obama care was trying to change this, but in Thailand that would not help you

30 minutes ago, Sheryl said:

They do give morphine in the govt hospitals. And plenty of people die in them. But nurse:patient ratios are poor and the overall level of palliative care not up to what one would want..

You would need to be admitted only at the point where you could no longer take oral medication so stay would usually not be very long.

Fake new scare news

At the stage you are admitted and on IV pain suppression you know little of whats going on so nurse patient ratio etc irrelevant

Do not be sacred by so called experts

21 minutes ago, Sheryl said:

They do give morphine in the govt hospitals. And plenty of people die in them. But nurse:patient ratios are poor and the overall level of palliative care not up to what one would want...though certainly better than nothing. To day

 

End of life care is not as expensive as other things (e.g. surgery etc) in a private hospital.

 

As mentioned, oral morphine and fentanyl patches can be gotten outpatient. You would need to be admitted only at the point where you could no longer take oral medication so stay would usually not be very long.

I started this thread

there is a lot of misinformation that has  been posted, DT would call it fake news

i have confidential information from very good doctors that tell a different story, I will willingly share on a PM basis 

I am rather fed up with the politics of TV

Well we visited Honda HQ at Bang Na, very professional very attentive what had been so lacking in KhonKaen

They have promised to resolve matters in the very near future and whilst they are doing this provide a loan car

I am very optimistic all will be properly resolved

As always with good reputable companies it is often necessary to go high enough to see the company philosophy is followed and complied with

So far a happy customer

4 hours ago, MahasarakhamMitch said:

Ignoring the house and car, it has to be my Rolex .....a birthday present to me from me
 

And very nice to may you enjoy it

We make money well some of us do and we must not forget ourselves

I have an Australian friend in the mega rich category, and he can not understand why someone bought themselves a Rolex

Still travels on the cheapest flights

So sad to have a lot of money and neither give it away or enjoy it

Remember if we do not spend our money our kids will for certain once they get their hands on it

1 minute ago, madmax2 said:

I did that with ford, it did not fix our problem, ford representative blamed the dealer and the dealer blamed ford, separately of course because i could not speak to both representatives together  this went on for 2 years

Only way to fix the problem was to sell the ford and buy a toyota and at long last have trouble free motoring

I know I had four new Toyotas and never a problem, not one in ten yrs

 I have a couple of different cancers and I wanted to make my wife's  life easier

This is also Thailand

I have already told the KhonKaen dealer I may just burn the car at their premises with press present, also have to be careful this is Thailand and do not want to wind up in jail (Joke not stupid, mad yes, some say do not get mad get even)

Thats why we all need to talk

CUISINE ART

Peanuts killed the motor in the first two days

Imported equipment had got rid of box so warranty no good my fault

I need t repair can any one tell me where to get a spare motor

55 minutes ago, JoeW said:

recommend you go and visit Honda's head office at Bangna (next to the BTS). 

 

Thanks got full address from warranty book

Appreciated, Greatly!!

Are we all not falling into the trap of aiding abetting and enabling, the whole question of coming to Thailand, in these circumstances, is shall I say illogical

Maybe we should all go quiet and withdraw

just some observations

God Bless there is a lot of pain around on this

18 minutes ago, JoeW said:

Having worked with Japanese people for almost a decade now, what you SHOULD not do is drive all the way to Ayuthaya and go complain there. First of all you won't get passed security and do you really believe driving to the assembly plant will do you any good?

 

If you want to go and complain to the Marketing Manager then I recommend you go and visit Honda's head office at Bangna (next to the BTS). 

Of course barging in their, screaming and demanding the problem gets resolved is not going to help you (it wouldn't help you in Europe either). 

My advice:

 

1. Make an appointment at the Bangna dealer. Set the date and time.

2. Explain them the issues which you have in detail on the phone and inform them that your dealer in KK cannot resolve the issues.

3. Visit the dealer and see if they can resolve the issue.

Thank you sir some good and sound observations

I am but a simple retired  succesful professional man

My reputation was as a global trouble shooter who never failed, yes I upset too many but that is life

All I want is my car to work properly, and technicians not to make the problem worse, they are pulling unrelated wires from every where then not fitting all the parts back properly, we have a box of bits. 

This is at the newest and largest honda dealer ship in  Thailand at KhonKaen, where they have 200/330 vehicles in stock. they are now saying to lend a car they have to bring one from Bangkok, and then bring technician from bangkok all makes little sense

My electrics and locking and alarm system are not working properly, it is probably only a question of changing one control box with a choice of three

Not even let the technicians drive from  Bangkok to KhonKaen lend me his car, fix mine and return

The Honda service here neither meets the European or American standards, it is a question of getting to the right level, when there is a reasonable chance that the general honda philosophy of looking after the customer will take over

I was involved long time ago with Honda dealerships in the UK and this was not the way they worked then

A little more specific information on where the Banga location is would be appreciated like gps location

I am not alone at being unhappy and in the good company of McLaren, who I also know and are local to where I used to live!

15 hours ago, NancyL said:

 

  I've known of people dying on short plane trips within Thailand to CM trying to get to McKean.  Airplane cabins aren't pressurized at sea level.  Air ambulances are different.

 

 

Nancy I am not your normal run of the mill old man, I am not scared in anyway of dying

What I do not want is longterm painful illness that is also difficult for family

(deletion by Moderator)

However the chances of dying painfully are still low despite two cancers, prostrate and colorectal, I am 72, my father, grandfather, and great-grandfather all died at 70, I was confident that would not happen to me because statistically the odds of four male members of a family all dying a the same age were very safe and in my favor

So far no family member on quite a large spread family has died in pain, many gone with simple quick heart attack, and with a DNR in place the odd of going on the operating table also increase

I still drive, twenty years ago I needed glasses today I do ok without

I have however given up driving when drinking my sober lady does that

I do not and will not drive motorbikes, I am considering a bicycle to help loose weight, but again dangerous, and yes I have accident insurance

Most people do die quietly and peacefully and not in hospitals, I only have to watch the villages round us people going all the time, roads shut parties and funerals

Then in the same villages many weddings, and in Issan I have worked out the average child is born seven months after getting pregnant, happened in the case of a cousin, I said at the wedding she looks pregnant, and was assured no, the child was born 7 months later, must be to do with the crabs in the papaya salad

I can think of one way to end it all quickly and that would be for my very Thai, very Issan wife to find me with another woman, but that would be guaranteed very painful and very messy, so that is ruled out

2 hours ago, Sheryl said:

Embassy approval is required to release the body to anyone/anyplace. The purpose is to ensure next of kin are notified. Where there is a Thai spouse, as soon as they verify this fact they will give the OK.

 

If the UK Embassy has an expat registration system, avail of it and clearly list your wife. This registry is the first thing they will check.

Thank you, I believe I plan better tan most but am not registered with UK embassy here, nor is my wife

Unlike many the UK government and pension people have my thai address

I will register myself and wife with UK embassy, also give them a copy of my will, they probably will ignore the will but can try

Also going to get wife a new UK visa just in case we ever wanted to go there, but can not see that with sensible alternative

As for Nancies comments on when to go I already meet her criteria, sheets changed every two days and back generally scrubbed in the shower, I am a lucky man

I an planning hopefully many more years but lets stay informed

We worry about these things but drove from KhonKaen to BKK today, saw so many accidents with the bad weather

As always one thing guaranteed living is terminal, I do not buy lottery tickets because when I ask for the guarantee told do not get one  

Checked into nice hotel, told the room was exclusive, I asked surely the beds and sheets at their prices included, they were but have in the past had to pay extra for sheets

22 minutes ago, NancyL said:

The cost of care at McKean really depends upon the services required.  In general, a private room (which is what is recommended for end-of-life) with meals, nursing care, perhaps wound care, etc, is about 60,000 baht/month.  I've know cases that were as high as 100,000 baht per month when the patient had several bad bedsores that required daily dressing changes, with morphine and expensive medical supplies.  In some cases, where money is an issue, an end-of-life patient can be placed in a ward room, with several other patients, but then it's difficult for the family, although very possible for just one family members to spend good quality time with the person.  Then the cost could be about 30,000 baht/month.  The wards at McKean are much more spacious, quiet and have aircon they use when really hot vs. wards at a gov't hospital.  

 

The private rooms at McKean are really very much like the private rooms at the upscale private hospitals in CM, OK but without the designer bath products and 24 hours room service for food like they have at Bangkok Hospital.  But still the private rooms at McKean have aircon, flat screen TV, refrigerator, hot water pot, microwave, nice big clean bathroom, big sofa for family member, enough room where they'll bring in a bed for a family member, etc.  They're a very good deal at 60,000 baht/month for end-of-life.

 

You asked about getting "qualified medical people" for someone who can't afford such a facility.  Ah, here's the problem.  You can't obtain round-the-clock qualified people for home care for 60,000 baht/month, especially if your home isn't properly set up with the correct equipment.  

 

I've seen men who were abandoned by their Thai lovers and even wives during their final weeks because they just couldn't handle the care anymore.  They call the Embassy/Consulate and say "come get him" (it doesn't work that way, of course).  Or they try to soldier on, keeping him as comfortable as possible on a plastic sheet on the floor, so they can drag him into the hong naam several times during the day to wash off the mess that is coming out of many parts of his body.  Sorry if this is graphic, but is is how some people die when they don't have money.  They die in ways worse than any Thai person would have to.  

 

Think about this when you order your third beer of the night or decide to buy the next, latest greatest electronic gadget.  Just about everyone I know, even on a very low income, is able to set aside 5000 or 10,000 baht per month toward a health savings account.  Everyone, no matter how old, can obtain accident insurance.  There is no excuse for living pension check-to-pension check and still being here in Thailand.  If that's your status, you shouldn't be here.  You may be setting yourself up for a very unhappy ending.

 

 

Valuable information, personally I could cope with those costs even at the top end

It is on my list to visit, in the short term with the longer term view

Question then becomes how do you know when to go 

And maybe ambulance from KhonKaen to chiang mai, ( choice travel in ambulance alone, send wife in the car, very heavily sedated, ambulance does not make it normal horrific driving, D O A, problem resolved, excuse my bad humour, but OK for me)

I have a terrible mind and then think life very cheap here, pay someone to shoot me 10,000 again done, my outside box thinking, then into box and cremated, better than some of the scenarios you describe

You make a very valid comment on accident insurance, I can see no way that would work or an insurance would pay for palliative

 care on that type of policy, have I missed something if it would an absolutely must have

Yes I agree if nursed at home we have discussed, two full time nurses, the full time home help already in place and the gardening lady as well as the wife, works out more than 100,000 per month, a lot more, in fact nearer double with drugs and some doctors etc

Unfortunately  as you say, there are many here who should not be, and if they are from the UK and die in the way you describe they are even bigger fools than we think and have no plan, and they can avoid this

5 hours ago, Sheryl said:

Foreigners cannot be (legally) cremated or buried without clearance from their Embassy.

We need to retain humour even on important and depressing topics such as this

Lets remember also what we find  humour in the UK may offend others and this is for those with UK humour and over 18

So I live in Issan, I am in suspended animation, about to go into the fire, and exclaim in a foreign language, to those who have already drunk too much of my booze, "Stop this is not Legal" the last I remember was the man said give me another of his excellent whiskies I thought he stirred, that whiskey is doing me no good

Door shut case closed until they come to rake the bones for souvenirs a few days later

God Bless keep Smiling

7 hours ago, impulse said:

 

 

One other question of a very general nature, Does Thailand have medical people who help with those who still want to stay at home, or can't afford the cost of such a facility?  If so, where would one look for them in their area?

 

We already have a list of many nurses working part time at local hospitals, for this eventuality

Many hospitals employ part time nurses, when still in good health visit local hospitals and spread the word and you will be amazed how many possibles you find, all qualified nurses, maybe not in pallaitive care but definite possibles

It is also necessary to create a small network of helpful local doctors, and maybe vets ! ! who may be more experienced in what is required

My father gone 30plus yrs ago , an eminent dental surgeon, had a patient come in one day with a lot of pain, she said she had been to her doctor, he said why not your vet, she was offended, but as my father explained Vets on some things like teeth and euthanasia, are often better qualified than doctors, who do not generally deal with these topics

It is also sometimes challenging to understand we do not leave our horse or dog in pain, but if it is a loved spouse we do nothing

I note florida executed a man last week by injection, but we are not allowed free choice

A terrorist commits an awful crime and he is often immediately taken out of his obvious mental pain and discomfort

Just some personal observations