Too old for Thailand?

[Dick Crank]

I'm getting a bit older now. Not as mobile as I once was. This situations not going to get better as time goes on.

 

I'm thinking of returning to Thailand  (I lived there seven years when I was younger). I'm in an affluent country now in a comfortable situation, but am single and bored.

 

anyone towards their 70's have any suggestions or stories on how they get along with mobility and daily living in a country that can be challenging physically as you get older?

 

or am I just dreaming and yearning for youth again and need to accept where I am and have the support structure in place? If I leave now it won't be easy to return again to my current situation here.

[simoh1490]

I'm 68 and I've lived here for 16 years, I'm now starting to have mobility problems resulting from spinal damage and am looking ahead to my future, clearly, Thailand is not the place to be if you're wheelchair bound. As a consequence, I'm now looking to transition out over time spending less and less time here beginning this year.  There isn't much here by way of wheelchair friendly environments, the UK is much better but is far from perfect - given a choice between the two locations and being mobile versus static AND bored versus not so bored, I have to choose being mobile but perhaps slightly bored in the UK, boredom is, however, something a person can influence and control, much more so than mobility.. 

[poanoi]

i'm 50 and i'm in so much pain i am pretty much stuck in my hotel,

i wish i was in an elderly home back home

so i wouldnt have to get up on my feet ever again,

but alas, its too painful to go back,

and i cant find a trustworthy source of nembutal

[colinneil]

OP if you have mobility problem Thailand is not the place for you.

AS simon1490 said Thailand is not the place to be if you are wheelchair bound.

It is a nightmare for disabled people, i know i am wheelchair bound and very wary of going outside the gate. 

[VocalNeal]

^ Why the pain? What is the diagnosis? 

[Dick Crank]

12 minutes ago, colinneil said:

OP if you have mobility problem Thailand is not the place for you.

AS simon1490 said Thailand is not the place to be if you are wheelchair bound.

It is a nightmare for disabled people, i know i am wheelchair bound and very wary of going outside the gate. 

How do you cope with necessities, cooking, daily tasks? Is it easy to hire assistants for that sort of thing and how much does that kind of help cost?

[simoh1490]

1 minute ago, Dick Crank said:

How do you cope with necessities, cooking, daily tasks? Is it easy to hire assistants for that sort of thing and how much does that kind of help cost?

I'm currently mobile but I'm looking to the future. 

 

There are homes for people with disabilities but they are not inexpensive, I also know of one neighbour who has a full time live in home help so it can be done, I can't speak to costs however.

[OJAS]

1 hour ago, simoh1490 said:

I'm 68 and I've lived here for 16 years, I'm now starting to have mobility problems resulting from spinal damage and am looking ahead to my future, clearly, Thailand is not the place to be if you're wheelchair bound. As a consequence, I'm now looking to transition out over time spending less and less time here beginning this year.  There isn't much here by way of wheelchair friendly environments, the UK is much better but is far from perfect - given a choice between the two locations and being mobile versus static AND bored versus not so bored, I have to choose being mobile but perhaps slightly bored in the UK, boredom is, however, something a person can influence and control, much more so than mobility.. 

I am the same age as you and with similar mobility problems to yours. I agree with you that the UK is more disabled-friendly than Thailand. But, in addition to mobility v. boredom, I think that another key issue relates to the availability of support mechanisms. Here in Thailand, I have my wife and her family who, I hope, will take care of me in my advancing years, in accordance with the Thai tradition of the younger family members looking after their elders. But no such tradition exists in the UK, of course, and, in any event, I no longer have any close family members living there. So, were I to relocate back to the UK, I could eventually find myself having to shell out a fortune for so-called "professional" care, just like my parents had to do in their final years.

[simoh1490]

1 minute ago, OJAS said:

I am the same age as you and with similar mobility problems to yours. I agree with you that the UK is more disabled-friendly than Thailand. But, in addition to mobility v. boredom, I think that another key issue relates to the availability of support mechanisms. Here in Thailand, I have my wife and her family who, I hope, will take care of me in my advancing years, in accordance with the Thai tradition of the younger family members looking after their elders. But no such tradition exists in the UK, of course, and, in any event, I no longer have any close family members living there. So, were I to relocate back to the UK, I could eventually find myself having to shell out a fortune for so-called "professional" care, just like my parents had to do in their final years.

I've had this discussion with my wife several times and she's quite prepared to look after me. I, on the other hand, am not prepared to let her waste substantial parts of her life when she could be off doing far more interesting and useful things. Either way, there's going to be a cost involved, my outlook is that the cost will be lower in the UK than here plus I stand a better chance there of having my wishes adhered to in terms of care in my final years.

[NancyL]

I'm involved with Lanna Care Net, an informal group of expats that assist other expats who have difficulties, usually medical problems in Chiang Mai.  http://www.lannacarenet.org/lessons-learned-at-the-end-of-life/

 

If you look at the page I posted from the LCN website, under "Lesson Two", you'll see links to documents that list the assisted living facilities near Chiang Mai and their monthly costs.  Chiang Mai seems to have better options than other parts of Thailand.  But, all of these facilities are outside the center of town and it's an effort for a resident to come into town to enjoy restaurants or shopping.  It can be done, but I wish there were organized assisted living options right in town, so the residents could easily get to malls and restaurants.

 

I know many western retirees living here who have some degree of a mobility problem.  But, few people come here already disabled.  Usually, they develop the problem after they've been here for time and have had a chance to build their own group of friends and acquaintances who can help or at least put them in touch with potential caregivers.  

 

That being said, foreign retirees who come to rely on assistance from hired caregivers in their home can find themselves very vulnerable to financial exploitation.  Often, they trust a caregiver with their ATM and PIN number to go pay bills and the results can be predictable.  

 

Some retirees have found a good Thai wife and extended family who promise to care for him for the rest of his life at home.  What they don't realize, however, is the difficulty of caring for a large man without special equipment -- the average Thai home isn't handicap friendly.  Also, they usually lack knowledge to cook easy-to-chew and digest food appealing to westerners.  Thai people think that rice porridge is the correct food for old people.

[colinneil]

How do i cope?

Well mate i am fortunate that after my accident we had a bedroom/ bathroom/ kitchen built downstairs, with everything suited to wheelchair height.

I had a carer for nearly 2 years, but she was very unreliable, worked a few weeks, stopped for few weeks.

Now in our area near khonkaen it is around 450/500 baht per day for a helper.

[NancyL]

I know people who have set up good 24/7 care situations in their homes, but it requires employing three people.  At least two working 12 hour shifts and a third working part-time to give the other two some time off.  The primary two are paid at least 10,000 baht/month, actually as high as 15,000 baht/month and get free food when they're working.  

 

The key to making this arrangement work is to have someone "in charge" who can act when one of the caregivers doesn't show up and who is handling bill payment, scheduling medical appointments, supervising meds, etc.  Often this can be a wife, but not always.  

 

There would be no way to get good quality care here in Chiang Mai for the 450-500 baht/day number given by Colinneil.  You can maybe hire a full-time maid for that, but not someone who has skills needed to take care of a handicapped person.  Maybe in KhonKaew, but as he pointed out someone working at that low a wage isn't very reliable.

[keeniau96]

I am 78 and still in quite good shape and mobile. Have a wonderful Thai wife (Phuket native, has never ever been in a bar), married now 16 years and expecting more. She took very good care of her grandmother who lived with us until the old lady dies, and tells me she will do same for me, and I believe her. So my answer would be that you find a good Thai woman, maybe even marry her (not really necessary). Easier said than done, but they do exist, I know of goodly number of friends here who same. 

[JLCrab]

I am 67 and in good shape and mobile. I was never married or had children in USA so my long-term care plans are definitely here in Thailand. However they do not include finding a 'good' Thai woman to look after me ... not that I don't plan to find Thai women good or otherwise but I do not expect that any Thai woman in a relationship to be my principal care giver.

[Hummin]

44 minutes ago, JLCrab said:

I am 67 and in good shape and mobile. I was never married or had children in USA so my long-term care plans are definitely here in Thailand. However they do not include finding a 'good' Thai woman to look after me ... not that I don't plan to find Thai women good or otherwise but I do not expect that any Thai woman in a relationship to be my principal care giver.

If I ever get singel at that age, I am going to find a nurse who can take care of me, pay her little bit over average wages, rent her a room in my house, and let her take me to massage and other fysioterapy places for my well being. Call in day care in house ;-) 

 

At least she have to keep me alive and happy to keep her job. 

[JLCrab]

If you look at NancyL's numbers above it could be about US $2000 per month to have round-the-clock professional nurse assistance. Do you realize what that would cost in the USA?

Edited May 6, 2018 by JLCrab

[Hummin]

10 minutes ago, JLCrab said:

If you look at NancyL's numbers above it could be about US $2000 per month to have round-the-clock professional nurse assistance. Do you realize what that would cost in the USA?

 

Where you get your usd 2000 a month? If I need 24 hours help, I will jump to if I can climb over that f fence. 

 

It should not be more than 18 000,- bath a month for normal daycare help. She have to pay me 4000,- back for the room to, 

[JLCrab]

As I said from NancyL's numbers 

 

"The primary two are paid at least 10,000 baht/month, actually as high as 15,000 baht/month and get free food when they're working." ... and then I would be willing to pay maybe more than the going rate.

Edited May 6, 2018 by JLCrab

[janclaes47]

5 hours ago, NancyL said:

 

There would be no way to get good quality care here in Chiang Mai for the 450-500 baht/day number given by Colinneil.

Ever calculated how much 30 times 500 is? And by per day I would assume that mean a normal day shift.

 

5 hours ago, NancyL said:

The primary two are paid at least 10,000 baht/month, actually as high as 15,000 baht/month and get free food when they're working.  

 

[Dick Crank]

9 hours ago, OJAS said:

I am the same age as you and with similar mobility problems to yours. I agree with you that the UK is more disabled-friendly than Thailand. But, in addition to mobility v. boredom, I think that another key issue relates to the availability of support mechanisms. Here in Thailand, I have my wife and her family who, I hope, will take care of me in my advancing years, in accordance with the Thai tradition of the younger family members looking after their elders. But no such tradition exists in the UK, of course, and, in any event, I no longer have any close family members living there. So, were I to relocate back to the UK, I could eventually find myself having to shell out a fortune for so-called "professional" care, just like my parents had to do in their final years.

That is my concern as we'll, being that returning Thailand now when I'm much older I may not have the time to marry and/or have the relationships in place formed over time which would enable me to rely on care from an extended family there.

[JLCrab]

2 hours ago, Dick Crank said:

That is my concern as we'll, being that returning Thailand now when I'm much older I may not have the time to marry and/or have the relationships in place formed over time which would enable me to rely on care from an extended family there.

How romantic.

[simoh1490]

6 hours ago, janclaes47 said:

Ever calculated how much 30 times 500 is? And by per day I would assume that mean a normal day shift.

 

 

I believe Nancy quoted a monthly salary of THB10,000/15,000 per person rather than a total for the pair, both working 12 hour shifts, which seems like a sensible salary.

[NancyL]

3 hours ago, simoh1490 said:

I believe Nancy quoted a monthly salary of THB10,000/15,000 per person rather than a total for the pair, both working 12 hour shifts, which seems like a sensible salary.

Yes, I'm quoting 10,000/15,000 per person, for two full time people with an additional third person needed part-time for the main staff's days off.   This is a reasonable rate for someone who is a certified nursing assistant and knows how to do things like beyond just spoon-feeding a patient or helping them dress.  As people age, they often need more advanced care for things like changing dressings on bedsores or other wounds, administering tube feeding (including reinserting the tube if the patient pulls it out), suctioning a respirator, having a bed-bath, etc. 

 

You may think you're "healthy and active" now, but that has a way of changing and it can change fairly quickly for people beyond age 75.  If someone makes it to that age, then they rarely die suddenly from something like a stroke or heart attack.  Instead, they experience years of declining mobility and increasing frailty and have a multitude of little health problems that take their toll.  You should plan for several years of needing this type of care, especially if you're older and have a healthy lifestyle, so you've dodged the bullet on getting cancer or having a stroke in your 60s.

 

Another concern is people who maintain good physical health but develop dementia.  These folks can be VERY difficult to care for because they want to wander and stay active.  The solution there is to keep them busy with physical therapy including activities that will challenge their bodies and make it easier for them to sleep -- like water exercises, treadmills, stationary bikes or even long walks with a caregiver watching, sometimes from a distance, out of sight of the person, if they resent always having someone around.  It takes a special kind of caregiver, trained not to do it the Thai way of hovering over a elderly person and expecting them to be still.  Someone who is able to work alongside the elderly patient to keep them physically active.  

[colinneil]

15 hours ago, NancyL said:

I know people who have set up good 24/7 care situations in their homes, but it requires employing three people.  At least two working 12 hour shifts and a third working part-time to give the other two some time off.  The primary two are paid at least 10,000 baht/month, actually as high as 15,000 baht/month and get free food when they're working.  

 

The key to making this arrangement work is to have someone "in charge" who can act when one of the caregivers doesn't show up and who is handling bill payment, scheduling medical appointments, supervising meds, etc.  Often this can be a wife, but not always.  

 

There would be no way to get good quality care here in Chiang Mai for the 450-500 baht/day number given by Colinneil.  You can maybe hire a full-time maid for that, but not someone who has skills needed to take care of a handicapped person.  Maybe in KhonKaew, but as he pointed out someone working at that low a wage isn't very reliable.

Nancy i do not understand you saying that 500 baht a day is any diffrerent to your posts.

As 500 baht a day over 25 days is 12500 baht a month exactly in the middle of your estimate.

 

Edited May 7, 2018 by colinneil

[simoh1490]

9 minutes ago, colinneil said:

Nancy i do not understand you saying that 500 baht a day is any diffrerent to your posts.

As 500 baht a day over 25 days is 12500 baht a month exactly in the middle of your estimate.

 

Nancy is quoting a PER PERSON cost, for the second time!

[colinneil]

1 minute ago, simoh1490 said:

Nancy is quoting a PER PERSON cost, for the second time!

So am i

[simoh1490]

7 minutes ago, colinneil said:

So am i

With all due respect to your carers I doubt that at that price you have fully trained and qualified staff, I suspect location may also determine rates to some degree with cities being more expensive. Also, are your rates factoring in 2 x 12 hour shifts?

[neeray]

16 hours ago, colinneil said:

How do i cope?

Well mate i am fortunate that after my accident we had a bedroom/ bathroom/ kitchen built downstairs, with everything suited to wheelchair height.

I had a carer for nearly 2 years, but she was very unreliable, worked a few weeks, stopped for few weeks.

Now in our area near khonkaen it is around 450/500 baht per day for a helper.

Colin, this is the first post of yours where you did not mention your dual duty, hard working, great caring wife. I always enjoy reading your tributes to this fine Thai woman.

[JLCrab]

I am not interested in the numbers game but the options available to me and some of the arrangements I have made tentatively or otherwise in Thailand for long-term care can astound persons in the USA who are knowledgeable of how things work there.

 

... and while it is nice to know that a family or significant others can help with your long-term care, it's also nice to know that they can do so at THEIR choice and that you are not solely dependent on them.

Edited May 7, 2018 by JLCrab

[NancyL]

18 minutes ago, JLCrab said:

I am not interested in the numbers game but the options available to me and some of the arrangements I have made tentatively or otherwise in Thailand for long-term care can astound persons in the USA who are knowledgeable of know how things work there.

Yes, as I pointed out you can arrange 24/7 care from certified nursing assistants for about $2500 per month.  The labor cost is cheap, but you also have to factor the cost of specialized equipment and this can get expensive here.  For example, a manual patient hoist that sells  $700 - 1000 in the U.S., with free delivery, will run 50,000 - 70,000 baht here because of import duty.  Same thing with hospital beds.

 

But, if someone is anticipated to need long-term care, it can be arranged for less than half the cost of what you'd pay in the U.S.  Remember, too, that the assisted living centers in Chiang Mai are a very good bargain compared with the U.S.  The most popular Dok Kaew Gardens, part of McKean Rehab Center, is 32,000 baht/month for someone who still has some independence and 45,000 baht/month for higher care, as for those with dementia. The high-end assisted living center here is Vivo Bene, like staying in a five star resort.  The cost there ranges from 80,000 -100,000 baht/month.  Less than $4000.  Ten years ago my father was in a facility in the U.S. that cost $5000 per month and was nowhere near as nice as Vivo Bene, maybe more like Dok Kaew.  That was ten years ago; I shutter to think what it costs now. 

 

If someone is bedbound and needs tube feeding, daily dressing changes and other regular nursing services, they can live at McKean Rehab Center.  I've assisted one man who had high care needs and was in a very nice, private room at McKean.  His monthly bills were about 80,000 baht/month for daily wound changes, daily physical therapy, bedbaths, and other attention needed because he couldn't leave the bed.   Less than $3000, about 1/3 what this level of service would have cost in the U.S. and chances are it would have been given by disinterested caregivers.  At McKean, the nurses are sweet and kind and have a nice rapport with the patients.

 

Yet for many expats, especially those living pension-check-to-pension-check just on a gov't pension, these numbers seem astronomical.  There are many retirees here getting by on 30,000 - 40,000 per month.  This is not a realistic income to support assisted care here and people in this situation should have a plan in place to return to their home countries when the time comes so they can avail themselves of public assistance.