Too old for Thailand?

[thaibeachlovers]

12 minutes ago, mommysboy said:

Why not just come for a holiday when you can?

Because we like living here more?

[JLCrab]

1 hour ago, Jip99 said:

 

I think that you are under-rating Colin’s wife and over-rating Thai ‘care givers’.

I guess so --

Edited May 13, 2018 by JLCrab

[NancyL]

4 hours ago, KiChakayan said:

What kind of "exit" options are there here? I reckon I am too pragmatic to stick around willingly  once I have reached that stage, and I wouldn't want my daughter to see me like that.

 

For instance could one refuse any permanent tube feeding in living will?

Yes, you can refuse permanent tube feeding in your Living Will or Advance Directive, according to the template of the Lanna Care Net Advance Directive, which has been widely accepted by local hospitals.  The following conditions must exist.  You must be either 1.) close to death; 2.) permanently unconscious; 3.) have an advanced progressive illnes or 4.) have extraordinary suffering.  http://www.lannacarenet.org/wp-content/uploads/2015/02/LCN-CCCM-ADVANCE-DIRECTIVE-July-2017.pdf

 

Note, there are many situations where temporary tube feeding makes much sense, if it is anticipated that your condition will improve.  

 

Some hospitals may refuse to stop tube feeding once they've started the procedure, but there is the option to transfer to McKean where they will honor the wishes of an Advance Directive.   

[The Deerhunter]

Do not plan to live in a rural area well away from good hospitals. Make sure the house you stay in is ground level and disabled friendly.  If you are single now I do not know how to advise you on relationships and finding carers.  I am 70 and am dug in with my wife and her family and am relying on her to help manage my dotage as she is 25 years younger.  She currently cares well for her 86 y.o. mother.  All my plans go out  the window if she dies or becomes incapable early in life.  I have no plan B as I was married earlier too but we never had kids in either marriage.

Edited May 13, 2018 by The Deerhunter

[Dick Crank]

9 hours ago, KiChakayan said:

What kind of "exit" options are there here? I reckon I am too pragmatic to stick around willingly  once I have reached that stage, and I wouldn't want my daughter to see me like that.

 

For instance could one refuse any permanent tube feeding in living will?

 I Could see a thai hospital not willing to do that even if it were in your will...

 

they dont even even put down soi dogs here...

Edited May 13, 2018 by Dick Crank

[Different]

I would suggest you stay in your affluent country and visit Thailand when ever you like to.

[Jip99]

9 hours ago, JLCrab said:

I guess so --

 

 

Good effort JLC.....  it I don’t think she is Thai ?

 

 

If I am wrong, I retract my earlier comment.

[JLCrab]

OK so she is Japanese but I have no idea what happens next in the video. I thought I was responding to NancyL's comment about the 2 Thai care givers working 12 hour shifts with a third for relief shifts and the comment that some guy has a 72 year old friend who has a care giver and sex partner ...

 

but next time, before I post anything, I will ask myself: Now how does this relate to colinneil?

Edited May 13, 2018 by JLCrab

[neeray]

45 minutes ago, Jip99 said:

 

 

Good effort JLC.....  it I don’t think she is Thai ?

 

 

If I am wrong, I retract my earlier comment.

Maybe JLC is having a fantasy about having a caregiver like this. Depending on how deep the pockets are, could have a whole bevvy of them.

[JLCrab]

No -- as I have said the care givers and the sex partners do not have to be the same persons and likely -- if young nurses -- should not be. But this being Thailand, especially with deep pockets, just who is the sex partner or partners is up-to-you.

 

[colinneil]

2 hours ago, JLCrab said:

No -- as I have said the care givers and the sex partners do not have to be the same persons and likely -- if young nurses -- should not be. But this being Thailand, especially with deep pockets, just who is the sex partner or partners is up-to-you.

 

You are living in a fantasy world, you have no idea about what you are talking about.

[JLCrab]

Thank you. I guess Nancy L doesn't either.

 

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. ...

 

 

Edited May 13, 2018 by JLCrab

[Ban Phe Dezza]

On 5/7/2018 at 8:37 AM, NancyL said:

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.

Nancy has a good point about those of us on the Pension, when I first retired 21 years ago I was financially comfortable, at least by Thai standards, 

Due to Financial advisers bad advice plus the Melt down I lost heaps of my funds, on top of that Local Lawyers made sure I lost every thing  else  plus low exchange rates  Ended up Broke.

 

Now at 4 score  years I just have the Pension.

 I get by each month however it is a challenge luckily I still have some of my Marbles left rattling around in my head 

 

My main Point is I hope to go to Valhalla before I have to resort to going back to either of my home countries.

 I saw what happened to my Dad and no way am i going into one of those places.

 

I guess it is not a good idea to input here my thoughts on various options to end it all, some  cre8ive

some we see every  week in the news

Any way thanks for reading this not that I am religious  i am reminded of an Irish blessing

May I be in Valhalla 30 minutes before the Devil finds out 

s 

 

[The Deerhunter]

8 hours ago, Dick Crank said:

 I Could see a thai hospital not willing to do that even if it were in your will...

 

they dont even even put down soi dogs here...

Not possible here. Sadly it is DIY.  Hence some of the regular occurences of messy balcony diving.  Ugly but true.

[Naam]

On 5/6/2018 at 1:04 PM, Dick Crank said:

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.

assuming that your "comfortable situation in an affluent country" is based on "comfortable" finances i'd say GO FOR IT! cost of services to assist you in any situation (maid, driver, even nurse) are peanuts compared to those in affluent countries.

[Naam]

2 hours ago, Ban Phe Dezza said:

May I be in Valhalla 30 minutes before the Devil finds out 

[Naam]

On 5/7/2018 at 7:59 AM, simoh1490 said:

On 5/7/2018 at 7:49 AM, 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!

Colin is quoting per person too!

[colinneil]

5 minutes ago, Naam said:

Colin is quoting per person too!

Thank you Naam, good to see another person who can understand my calculations, i was beginning to think, my maths were wrong, but they are not.

Edited May 14, 2018 by colinneil

[Naam]

On 5/7/2018 at 8:52 AM, poanoi said:

......sounds lovely, but death sounds a whole lot more attractive then needing

my arse wiped and powdered

basically i agree, but i'm not sure as our views might change once we face the "arse wiping" situation.

[JLCrab]

But NancyL is quoting for 2 full-time and one part-time assistant care givers.

[NancyL]

10 hours ago, Dick Crank said:

 I Could see a thai hospital not willing to do that even if it were in your will...

 

they dont even even put down soi dogs here...

As I said in post No. 153, you can state in your Advance Directive (aka Living Will) the conditions under which you do not want permanent tube feeding.  And, yes some hospitals here will refuse to honor your wishes.  This is why it's important to select a good Health Care Representative who will advocate on your behalf, as per your written wishes.  Fortunately, in Chiang Mai, there is the option to transfer a patient to McKean, a Christian facility, where a patient's written instructions are honored.

 

Where it becomes difficult is when someone hasn't executed an Advance Directive, yet all members of the person's family are in agreement that "he wouldn't want to continue living this way."  For example, there can be situation where a patient's family members want to transfer him to McKean to carry what what they think their loved one would want to be done, yet the hospital will refuse to release him because they say that McKean can't deliver the standard of care that he needs.  In the absence of an Advance Directive or any other written document from the comatose patient the family has little ammunition with the hospital.  And saying they'll refuse to pay the bill isn't intimidation enough.  The hospital will keep delivering care and use whatever means they have to collect the bill.

[rumak]

On 5/12/2018 at 2:21 PM, NancyL said:

Or assists someone sitting in one.

see nancy, you don't approve of us old guys having younger "friends".....but I actually train them in the

art of wheelchair management.   good for building up the muscles that will be needed when/if I should need

an "assistant".   

maybe this attempt at humor will not find its mark with some.....but a laugh does help keep one young.

 

[rumak]

1 hour ago, Naam said:

basically i agree, but i'm not sure as our views might change once we face the "arse wiping" situation.

William Saroyan — 'Everybody has got to die, but I have always believed an exception would be made in my case.'

[thaibeachlovers]

4 hours ago, Ban Phe Dezza said:

Nancy has a good point about those of us on the Pension, when I first retired 21 years ago I was financially comfortable, at least by Thai standards, 

Due to Financial advisers bad advice plus the Melt down I lost heaps of my funds, on top of that Local Lawyers made sure I lost every thing  else  plus low exchange rates  Ended up Broke.

 

Now at 4 score  years I just have the Pension.

 I get by each month however it is a challenge luckily I still have some of my Marbles left rattling around in my head 

 

My main Point is I hope to go to Valhalla before I have to resort to going back to either of my home countries.

 I saw what happened to my Dad and no way am i going into one of those places.

 

I guess it is not a good idea to input here my thoughts on various options to end it all, some  cre8ive

some we see every  week in the news

Any way thanks for reading this not that I am religious  i am reminded of an Irish blessing

May I be in Valhalla 30 minutes before the Devil finds out 

s 

 

In LOS if one needs care of any sort, better have lotasacash available, or one's last days will be horrible.

Thailand is wonderful for those with money, or at least a family that cares, but not at all for those without.

The slow move in western countries to assisted suicide is encouraging, but I suspect as the baby boomer generation hits full force, it will become far easier to get an exit pill. The cost of full time care for millions of aged people will cripple economies everywhere, and there just aren't enough people prepared to be carers, that would be any good at it. I'd never have gone into geriatric care myself, though I had to do it as part of my training.

[thaibeachlovers]

1 hour ago, NancyL said:

As I said in post No. 153, you can state in your Advance Directive (aka Living Will) the conditions under which you do not want permanent tube feeding.  And, yes some hospitals here will refuse to honor your wishes.  This is why it's important to select a good Health Care Representative who will advocate on your behalf, as per your written wishes.  Fortunately, in Chiang Mai, there is the option to transfer a patient to McKean, a Christian facility, where a patient's written instructions are honored.

 

Where it becomes difficult is when someone hasn't executed an Advance Directive, yet all members of the person's family are in agreement that "he wouldn't want to continue living this way."  For example, there can be situation where a patient's family members want to transfer him to McKean to carry what what they think their loved one would want to be done, yet the hospital will refuse to release him because they say that McKean can't deliver the standard of care that he needs.  In the absence of an Advance Directive or any other written document from the comatose patient the family has little ammunition with the hospital.  And saying they'll refuse to pay the bill isn't intimidation enough.  The hospital will keep delivering care and use whatever means they have to collect the bill.

So, what would happen in my case, where I don't have enough money to pay for long term care, don't have a Thai family to extort, and I have instructed my NOK back home to refuse to pay anything to keep me alive in hospital here? Would the hospital keep me alive entirely at their own expense?

[Dick Crank]

1 hour ago, thaibeachlovers said:

So, what would happen in my case, where I don't have enough money to pay for long term care, don't have a Thai family to extort, and I have instructed my NOK back home to refuse to pay anything to keep me alive in hospital here? Would the hospital keep me alive entirely at their own expense?

You'd probably be transferred to a not at all nice government hospital and just put on maintenance until you expire or until a trusted friend snuck in and resolved things.

[Ban Phe Dezza]

3 hours ago, Naam said:

basically i agree, but i'm not sure as our views might change once we face the "arse wiping" situation.

The sad part is that once we reach the arse wiping situation we might not comprehend and just be a burden to others

[Dick Crank]

5 hours ago, Ban Phe Dezza said:

 

 I saw what happened to my Dad and no way am i going into one of those places

 

Can you explain?

[luk AJ]

The sad part is that once we reach the arse wiping situation we might not comprehend and just be a burden to others

Yes, this must be a difficult situation, but I think most of us cling to life and try to postpone the inevitable..it’s like when I was 20, I told myself never to become an old man of 60. Now that I passed this age It looks different from where I stand now. When you need help like arse whiping, one can decide there is still enought to live for and so we continue to postpone until the moment we are not capable anymore of making decisions or until the last breath.
I am afraid I also belong to this category, I have a lot of respect for people who can plan their end.


Sent from my iPhone using Thailand Forum - Thaivisa mobile app

[rumak]

Jeez, i had to go back and take a look at what the title of this thread was.   Maybe it should be renamed :

 

How about :    HANGING ON BY A THREAD

 

Ok,  admit there is good info here.....and lots of food for thought.  Just be careful who is chewing it before

it gets in your mouth.