Nursing homes, palliative care??

[wamberal]

My father-in-law was admitted to hospital a week or so ago, his family assumed that he was at death's door.  He is certainly pretty well done for, from all accounts, but he has rallied a bit in hospital, is accepting tube feeding, shows few signs of knowing what is going on, but is alive.

 

 

My family has been told to take him home.

 

 

I would like to explore what other options there are, it is a huge burden on my two unmarried sisters-in-law, who are also expected to care for their mother who is not far behind him, and one of fhem also runs a small business.  My wife and I, who live in Australia, provide generous financial help, of course.  My wife is currently in Thailand.

 

What options are available?  It seems to me that some kind of palliative care, maybe a move into a nursing home, maybe we could employ nurses to help at home?


The old chap refused to consider going into a nursing home, and also would not allow any nurses or similar outside help, but from what I can gather, he is too far gone to put up any resistance now.  

 

He has been a wonderful father and husband, we all want him to have as much dignity and also as much peace as he can in his dying days.  But I am also keen to look at ways to reduce the awful burden that falls on my two sisters-in-law.

[metisdead]

Moving to the Health forum for knowledgeable information. 

[Sheryl]

In Thailand such care is usually provided at home, by family. There is virtually nothing by way of government help or services for this type of thing.

 

There are some nursing homes, but no central listing of them and they are all privately run, and of widely varying quality. . However I am sure the family could locate one through word of mouth  - whether they would find that idea acceptable, and whether it is affordable, is another matter. One also has to consider whether there are any such facilities near where the family live as it is a bad idea to have someone in them family able to visit often enough to ensure they are receiving proper care.

 

It might be more practical  to hire help in the  home. This too has to be arranged  privately and I'm sure the family here would know how to go about finding someone.

 

Palliative care is extremely weak in Thailand and there are no home hospice type programs such as in the West.

[wamberal]

Thanks for your post, Sheryl.  The family - my family - have not done any research as far as I know.  They have been totally exhausted by the demands on their time and their emotional and physical energy looking after the father for the last few years, and of course, the mother too, although she is at least able to toilet herself!!!

 

 

It was an act of desperation for my sister-in-law to call an ambulance and take him to the nearest hospital.  He had refused point blank to have any help in the home, and he had also refused point blank to consider any help or facility outside the family home.

 

 

The whole family assumed that he would pass away, my wife flew up, another of his daughters is flying from the US (a trip which she can ill afford, both in terms of the fare, but more importantly, the risk to her employment), but he rallied, is now tube fed, which is supposed to happen every two hours, and of course also needs other intensive nursing.

 

 

i do understand that it is up to the family to look after him, but I know that they are really struggling.  That is why I am looking for other options.

 

 

For the record, I do understand a fair bit about Thai culture and traditions, I worked at one of the power utilities for several years in the eighties.  I also worked in Hong Kong for a number of years, so also understand a lot about Chinese culture and traditions as well.

 

 

 

[Halfaboy]

Do a search on 'assisted living Thailand'. Maybe there is something that suits you.

[wpcoe]

@wamberal, in what part of Thailand is he?  Drop a note here with their location and maybe someone from that area will be inspired to chirp up.  I vaguely remember a discussion a while ago that there were palliative care nursing homes in the Chiang Mai area.

[Rent A Nurse Thailand]

Dear Wamberal ,

 

In case you are still in need of a nurse, please kindly feel free to contact us anytime by email : [email protected]. 

 

Jarinya Wongkraisron - General manager

Patient application form.pdf

Edited December 22, 2017 by Rent A Nurse Thailand
i want to add more text and files

[Sheryl]

Yes, do indicate what part of Thailand you are in. Since there is no central listing of nursing homes the only way to find them us by word of mouth.

 

Assisted living (of which there are few in Thailand) is not appropriate for this patient who would require full scale nursing home. Basically, nursing home and live in help are the options.

 

The place referred to in Chiang Mai would be  McKean Hospital. Excellent facility but costly. http://www.mckean.or.th/service/bougainvillea-en/

 

The family might also want to consider whether to continue to accept life prolonging measures like tube feeding if he is really in a vegetative state with no realistic hope of improvement.

[wamberal]

The family home is in Ekachai 119.

 

 

Thanks again for all the responses.

 

 

I have offered to pay for whatever options they can find, cost is not an issue.  

 

 

I have done a few years of voluntary work in nursing homes here in Australia, and had some limited training, so I have some understanding of the issues.

 

 

 

Edited December 22, 2017 by wamberal

[Sheryl]

33 minutes ago, wamberal said:

The family home is in Ekachai 119.

 

 

Thanks again for all the responses.

 

 

I have offered to pay for whatever options they can find, cost is not an issue.  

 

 

I have done a few years of voluntary work in nursing homes here in Australia, and had some limited training, so I have some understanding of the issues.

 

 

 

What Province? Is that Samut Sakhon??

 

In Bangkok, this place has a good reputation  http://www.goldenyears.co.th/en/

 

Google shows a few places in Samut Sakhon but I have no info on them and the sites are all in Thai.

 

 

[wamberal]

Thanks again, Sheryl.  I had already mentioned Golden Years to my wife, together with a few others that I found on google.

 

 

They think of themselves as living in  Bangkok.  The second daughter has a small jewellery business there.  My wife is the eldest.

[Sheryl]

If Bangkok is convenient and you can afford it, Golden Years is a good choice, in fact the best I know of in the Bangkok area.  It costs more than the many smaller nursing homes, which people  just open up as small businesses, often out of their homes, with no health professionals associated with them.

 

Hiring in staff at home is also an option. A nurses aide would be ideal and word of mouth at nearby hospitals will usually produce ones looking for extra work.

 

The other point to consider is whether to continue measures like tube feeding if he is really in a vegetative state with no realistic hope of recovery. That is certainly adding to the workload and if his condition is as bad as it sounds and no prognosis for improvement the utility is questionable. Thai doctors will automatically prescribe life prolonging care no matter what the prognosis but the family does not have to consent/agree.

[wamberal]

A further development, yesterday the news was that he has not been discharged.  His condition has worsened, apparently, so perhaps nature will take its inevitable course.

 

Thanks again, Sheryl.  I hope the old chap has a peaceful end, he has lived a good life, a wonderful husband and father.

 

If I had been thinking a bit more clearly I would have insisted that he be taken to somewhere like Bangkok Christian Hospital, rather than the nearest public hospital.   No disrespect to the public system, it sounds as though they are doing an adequate job, but I would have liked to make things as comfortable and pleasant for him as possible.

 

It sounds to me as though it is too late for a nursing home.

[Sheryl]

You can request/pay for a private room at the government hospital.

 

Palluative care is actually not much (if at all) better in private hospitals.

 

You can also pay for private duty nursing in govt hospital which would reduce the burden on the family.

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

 

 

 

[wamberal]

Thanks again, Sheryl.

[JSixpack]

Might be nice to have an idea of the costs of the various options/places.