seeking help for treating depression

[stephenterry]

A very good friend of mine aged 80 has been bedridden in a government hospital  - he has very little money - for over two months fighting an abdomen infection. While it has been successfully treated, and he no longer has a fever, he's slipped into not making any effort to leave his bed, or eating any food - relies on a nutrition drip -, and rejecting any attempt for physiotherapy. 

 

We don't seem to get through to him on any level - and clearly we don't know how. It's as if he just wants to slip away from life. One problem is, he's in a ward of 100% Thais, so any hope of conversation is limited to a couple of English speaking nurses who give him massages and a bed bath. And that is fraught with problems. His latest comment to me was, 'they're bullying me'.

 

Any helping suggestions welcomed. BTW as he has a tube stuck down his throat, and while he can understand what we''re saying, his conversation ability is minimal. As in a few words only.

[SteveK]

Sounds like more than just depression, and Thailand is an awful place to seek treatment for mental health issues. Does he have any family or options to get back home to get the treatment he needs?

[OneMoreFarang]

If he is old and has no money then I guess his future won't look too bright.

Maybe he realized this and thinks: that's it, there is no bright future for me.

 

I saw enough old people who just somehow survive one day and then the next day. Do they still have any joy or hope in their life? Maybe, but at least I can't see it.

And I know about a couple of them who just decided they had enough and they want to die. I think we should respect that.

[Chivas]

I expect some abuse to this post but this is why after around 70 years old or so people really ought to be back in their own Country UNLESS you're very well off with money no object.

If you're sat reading in your 60's thinking yes money would be very tight when any issue arises than yes go back home. Throw yourself at the mercy of your own countries welfare system if need be because Thailand when you're short of cash is absolutely the worst place to be

[steven100]

as mentioned ….  80 is not a bad innings as they say. 

hope he can get the strength to go back home.

 

[from the home of CC]

That's a tough spot. If he can write, tell him to put any contacts he has down on paper. If you can't reach them forward it to his embassy, maybe they can contact. Unless you're willing to front the bill for him to go to a rental with home care (if he ever gets back to eating food normally), I do not see a way out of that hospital unless he has some relatives that want to help with the costs. Good luck to you and him.    

[Denim]

If I were in his exact position I think I would also be depressed.

 

When my gran was 105 she had to go into hospital for a couple of weeks. Prior to this she had managed to get around her flat unassisted plus do her weekly shopping at Sainsburys with my mum assistance.

 

In hospital she got lazy and insisted on being wheelchaired everywhere.

When she came out her muscles had atrophied and she could no longer walk. The last two years of her life were spent in a reclining chair in a small box room until the boredom of it sent her senile and she died at 107. 

 

A good innings yes , but lets face it, when you are old and helpless with nothing to look forward to it must be hard not to feel that you have little to be happy about.

 

I'm only 62 but sometimes feel sad that although I have had a good life packed full of dissipation of all sorts and not much work I can't turn back the clock and do it all again.

 

The only thing I can sincerely recommend for your friend is medicinal cannabis because any smoker will tell you , it totally cures boredom and makes you content with the simplest of things.

 

Not speaking Thai ? Sometimes a good thing sometimes bad. Depends who's in the bed next to you. Check out the movie ' Bucket List '

[Puchaiyank]

Sad...every ex-pat's worst nightmare...????

[steven100]

 

9 hours ago, OneMoreFarang said:

If he is old and has no money

I'd be depressed too ….

[OneMoreFarang]

10 hours ago, Chivas said:

I expect some abuse to this post but this is why after around 70 years old or so people really ought to be back in their own Country UNLESS you're very well off with money no object.

If you're sat reading in your 60's thinking yes money would be very tight when any issue arises than yes go back home. Throw yourself at the mercy of your own countries welfare system if need be because Thailand when you're short of cash is absolutely the worst place to be

That depends. I would like to see a survey of 60 year old farangs in Thailand which they would chose:

a) stay in Thailand until you die - maybe until 70

b) relocate "home" and live there on welfare with all the care you get until you are 80 or 90

[Nyezhov]

If you cant do nothing more than eat and poop, time to think about going to meet Brumphilius, The Avatar of Eternity, on his Great heavenly Throne

[OneMoreFarang]

1 hour ago, Nyezhov said:

If you cant do nothing more than eat and poop, time to think about going to meet Brumphilius, The Avatar of Eternity, on his Great heavenly Throne

I would consider converting to Islam on my last day and die the martyr death - including the martyr reward...

[soalbundy]

12 hours ago, Chivas said:

I expect some abuse to this post but this is why after around 70 years old or so people really ought to be back in their own Country UNLESS you're very well off with money no object.

If you're sat reading in your 60's thinking yes money would be very tight when any issue arises than yes go back home. Throw yourself at the mercy of your own countries welfare system if need be because Thailand when you're short of cash is absolutely the worst place to be

The Uk would be a close second with lousy weather

[soalbundy]

6 hours ago, Puchaiyank said:

Sad...every ex-pat's worst nightmare...????

Which is why I practice detachment then nothing matters

[soalbundy]

It would appear that he wants to die, it is his right. I've had dogs who know when their time has come, they stop eating and want to be left alone. The analogy isn't a bad one, Neuroscientists have found that the emotional part of a dogs brain is very similar to our own.

[stephenterry]

Update: his son will be paying his hospital bill, and he will be transferred back to his Thai family home. While he will be receiving pseudo medical care from his wife, his future doesn't look promising.

 

It's really sad, because he is in no way frail, but seems to have given up. 

 

 

[stephenterry]

1 minute ago, soalbundy said:

It would appear that he wants to die, it is his right. I've had dogs who know when their time has come, they stop eating and want to be left alone. The analogy isn't a bad one, Neuroscientists have found that the emotional part of a dogs brain is very similar to our own.

While I respect what you say, IMO, it's depression, which I interpret as 'the whole world is ganging up on me, just leave me alone, and I'm better off not thinking about it'.

 

Which is a different mindset than wanting to die.  What he needs, IMO, is a stimulus to trigger off taking responsibility for his life again. He has one teenage Thai daughter, and she could be the key.

 

Any suggestions?

[Sheryl]

Remember that he is 80 years old and has just been through a grueling illness and very difficult and unpleasant  treatments which he may not have wanted (and refusing them should have been his right -- but odds are he was not able to assert that right).

 

He quite likely feels his autonomy was stripped away and things done to him without his consent and frankly that may be the case. In that situation a type of passive resistance may be the only means a person has of asserting any sort of agency.

 

In my experience, after something like this an 80 year old almost never gets back to where they were prior to the illness no matter how hard they try. Your expectations of what would happen if he "tried more" may not be realistic.

 

It is great that they are taking him home.  More than anything he needs to start to feel he has some agency, some autonomy and the ability to make his own decisions regardless of whether others feel that these decisions are correct. How he feels, and the quality of his remaining time,  is in my opinion  much more important that how much time he has.

 

If he starts to feel that he is once again able to make choices and decisions that are respected,  his mood will likely brighten a bit.

 

When visiting him I suggest  not to try to persuade him to do things he does not want to do,  but rather to show concern for his feelings and what he wants,  and support/help him in regaining control over decisions about his own care and future. Even if you disagree with those decisions.

 

 

 

 

[SteveK]

I have worked on some geriatric wards in England and Scotland and seen people in their last few days. Being served luke-warm, stinking disgusting food which I wouldn't feed a cat in a miserable place with nothing to do except maybe play cards, and pi**ing down with rain outside. Not a nice way to go.

[Moonlover]

1 hour ago, soalbundy said:

It would appear that he wants to die, it is his right. I've had dogs who know when their time has come, they stop eating and want to be left alone. The analogy isn't a bad one, Neuroscientists have found that the emotional part of a dogs brain is very similar to our own.

I've also been in close contact with a small number of humans who show the same responses when they become aware of the imminence of death.

 

Our problem in our western culture is the 'fear of death' that we have been indoctrinated with by our religious teachings.

 

I agree with you. If this gentleman wishes to die, then stop worrying about him and allow him to do so. And I hope that sometime in the future someone allow me that same right.

[1FinickyOne]

1 hour ago, stephenterry said:

it's depression,

I had a medical issue and be it drugs/hallucination/brain ramblings... though I did not have a life threatening condition, I thought I was going to die... or i dreamed that I was going to die... being in a hospital can be much more difficult/damaging than one might imagine...

 

hopefully it is a temporary condition, but if not, they have meds for depression. right?

[stephenterry]

Thanks for some thoughtful answers. Much appreciated. IMO, Sheryl has hit it on the head, it's exactly what he's going through and rejects - lack of autonomy and control.

[NancyL]

Stephen, once he's home you can help by visiting and bringing food that you know he will like.  You said he has a Thai family and often they think that sick and elderly people should eat bland rice gruel.  As you know, there are soft and easily digested western foods that are more appealing.  Or maybe he's up for something more adventurous like pizza or fish & chips.  Even just a nibble or two to enjoy the flavor.  

 

If he's into movies and TV, you can help him to have access to English-language shows via Netflix or other sources so he doesn't have to listen to a steady stream of Thai soap operas and game shows from the family TV.  Elderly people often have trouble using the computer and/or phone so just visiting and watching a movie with him could be a treat.

 

Being stuck in a Thai household could be as boring and depressing as existing in a Thai government hospital ward, so it's up to his friends to visit from time-to-time to keep him stimulated.