I have used Thai public and private hospitals (mainly the former) for a decade - and I have nothing to complain about.  I have had an operation in a public hospital, and admitted on 2 other occassions for treatment, and I have nothing to complain about.   The public hospital medical professionals are generally excellent (every country has good and bad medical professionals), but over worked and the hospitals are understaffed.  In public hospitals, yes, in open wards families are expected to help (have you seen how many patients the handful of nurses on duty have to look after?) and some staff do not speak English; but this is Thailand, not Farangland, and Thai is the language used here - be thankful that at least some of the staff speak English, and your can communicate your medical problems and health needs.

If you are unhappy with the government hospitals, feel free to pay through the nose at a private hospital.

The end result will be the same, it will come at a greater cost is all

I once spent 10 days in the ICU of an upcountry public hospital here.  They saved my life.  The care I received was excellent, and, if I compare it with my brother's tale of his recent experience in an Australian public hospital, far better than he got.  I've also had stays in three different upcountry private hospitals - including one for an operation, and was very happy with the way I was treated in those too.

The underlying problem is that the government health care system here  does not yet include long term care or residential hospice care. 

 

These are acute care hospitals. Bed space is at a premium and they cannot afford to keep patients who need palliative care only, nor elderly in need of a nursing home. They also cannot provide much by way of inpatient  rehabilitative care.

 

Some of the larger government hospitals do have palliative care programs but only outpatient.  Would at least provide pain relief though family would still have to provide the nursing care.  If OP could say where he is located I could advise better.

 

There are also private nursing homes which cost considerably less than private hospitals.

She is getting decent care, for a (nearly free) public hospital. If you want great care, you need a private hospital and have to pay a small fortune for it. 

 

She sounds like she might need hospice, or a full time nurse at home. My friend hired one for 16,000 baht a month. She lived there and worked 24/7, 6 days a week. 

What are you comparing them to?

In UK, now virtually impossible to get a Dr. appointment, or admission to hospital.  

Thailand you can see a Dr. at the local hospital, 9quicker if you go to private hospital.  Visit to hospital last week, I had blood test and X-ray all done while I waited. I prefer the Thai 'pay for service'option to the UK 'pay nothing, get nothing' 

1 hour ago, glegolo18 said:

Yes in your case, but in this cancer case and ALL cancer-cases here in Thailand it is alarmingly bad, really bad. Just as OP said.... People are being sent hoem to die home.. Discusting...

Not disgusting at all. Happens in the Netherlands too. My mother got a hospital bed at home and very strong pain killers. This way she could spend her last days with family in a familiar surrounding, not bothered by other patients or visitors. When she had enough they helped her ending her life.

4 hours ago, NORDO said:

Good friend of mine hooked up with a Thai nurse years ago.   She worked at Bum for 13 years before going tp USA on an Ed visa.   She recently completed her two year degree in Nursing and is now enrolled in a 4 year program.

 

The comments of comparison from her are very entertaining.  But the most significant advancement in her opinion is the med staff working as a team and not being isolated as a Nurse.

 

She is also shocked a medical fees and doctor salaries in Yankland.

What does a Bumrungrad nurse studying in the US this have to do with palliative care in a rural Thai public hospital?

13 minutes ago, Robin said:

What are you comparing them to?

In UK, now virtually impossible to get a Dr. appointment, or admission to hospital.  

Thailand you can see a Dr. at the local hospital, 9quicker if you go to private hospital.  Visit to hospital last week, I had blood test and X-ray all done while I waited. I prefer the Thai 'pay for service'option to the UK 'pay nothing, get nothing' 

Ah, so we are making things up now and comparing excellent free medical care with underfunded developing nation medical care.

OP,  she's in severe pain. Stay at home is not a option, as only morphine and tramadol tablets are allowed at home without nurse supervision.

In her end of life stage, this is not adequate.

 

Option A, hire a nurse who can give her morphine and maybe fentanyl by IV at home.

25,000+ per month, + medication and heart monitor etc.

 

Option B, admit her to private hospital if you can afford to pay 50,000+ per day. Cost vary so ask all hospitals.

 

My mother died of cancer, doctor gave her 3 months to live. She passed away after 3 weeks only.

 

OP, You seem to be expecting full-on round the clock private care from overworked, underpaid Doctors and Nurses at a government hospital.

 

Put your hand in your pocket and move her to a private hospital, and stop making unfair criticism of the hard working Doctors and Nurses, that are neither being paid well enough, nor have the time, to provide the 5 star service that your sense of entitlement is demanding.

I go to the government hospital generally monthly for heart check up and must say I’ve been treated well and spent a few nights there in the standard rooms (bay) which usually has 20+ beds. 

You'll need a Private hospital for anything beyond administering medicine and occasional medical advice.

 

Sorry to hear about your plight.  Perhaps you can pay a person in your area to help. 

 

 

13 hours ago, digbeth said:

you can pay to upgrade to special rooms at most government hospitals

Not only rooms, but when I was in Gov Hospital upgrade for 500b a night to a different ward with extra space and a fold down sofa. but none of this helps if they just want to send you home. 

The only complaint I have about Govt. hospitals that I have attended is that the hygiene and cleaning of shower and toilet facilities was IMO disgusting, and the smaller the hospital the worse it was, and I was there for a bacterial infection! 

I now worry about coming out worse than when I go in.

My experience at public hospitals has been excellent. As an elderly diabetic I am essentially uninsurable here. I have been well treated at Sirikhorn and the old Cholera hospital, also provincials at Mai Hong Son and near Chiang Mai.

Wait times can be long, but I have more time than money. I usually lose a couple kilos if in for any time as the food is not great, but that’s a plus for me.

I might beg my wife for an upgraded semi private room if I have to be readmitted, but the medical service has been great   (Gall bladder removal, strokes, broken pelvis, et Al) and at lower cost than with US Medicare, believe it or not.

2 hours ago, Gaccha said:

This is an issue of control norms and not an issue of deprivation or cruelty or incompetence.

 

Please see the substantive comment by Nurse Sheryl ( @Sheryl) in another recent topic on palliative care in a forum post by a member who is about to die.

@seajae

https://aseannow.com/topic/1297273-where-to-die/#comment-18131739

 

10 hours ago, nightfox said:

Why complain as like anything in life you get what you pay for and when it comes to government hospitals where it's free due to the Thai 30 bht medical plan it's the way it is. 

YOu as a rich farang of course can always ensure that her care is better by paying for her to move.  As has been stated the idea is for terminally ill paitients to die at home or in patative care.  This is actually the same in a lot of western hospitals the last thing they want is someone taking up bed space.

 

As to family looking after her Look at it this way to nurses she is a patient that is not gong to get better  

To your other half she is family and the care is going to be better.

 

My condolences I went through this with a gf grandmother as well as my own mother.  Family is the best to look after and I guarantee that her family do not see it as a big burden

"Wifes mum has severe cancer and is in hospital, she cant poo or pee by herself and her kidneys have shut down now as well,  they want us to take her home to take care of her ."

 

Most hospitals I assume will give the home patient a morphine drip or equivalent to stop or minimize pain, and show you how to maintain it, as well as come by to check on the patient. That's how I have seen it done in Nakhon ratchasima.  From my experience, they give enough to keep the patient in a "near-coma" like state.

Cancer here is real common and is usually not caught until late stage 4. When symptoms occur, it is usually too late to stop it. Unless you have big money for treatments that might give a little extra time only. Weeks, not years.

 

 

 

 

I found the government hospital  where we stay provide a good service 

The place is packed daily plus patients get free medication 

The wife stayed overnight for a eye operation I paid for a private room 600 baht 

The service she received was very good I would have no problems using the hospital if required 

Just  been for my 3 month blood test. Annoying to have to  wait for result and then wait for doctor  to come back from lunch. Doctor  also wanted me to see another  doctor  for second opinion which would have incolved  another long wait so I refused and he made me sign a disclaimer! Every hospital  visit  makes me feel unwell. Spending the whole day  for a blood test and follow up makes it  even  worse. Referral to a second doctor doubles the fee and uncertainty and is part of the guessing game  consisting of 'now try this and see if it works' that doctors  pursue

4 minutes ago, chilly07 said:

Just  been for my 3 month blood test. Annoying to have to  wait for result and then wait for doctor  to come back from lunch. Doctor  also wanted me to see another  doctor  for second opinion which would have incolved  another long wait so I refused and he made me sign a disclaimer! Every hospital  visit  makes me feel unwell. Spending the whole day  for a blood test and follow up makes it  even  worse. Referral to a second doctor doubles the fee and uncertainty and is part of the guessing game  consisting of 'now try this and see if it works' that doctors  pursue

If that annoys you, you should check out the situation in so-called first world countries. You would be shocked.

At least for Germany I know what I'm talking about and I doubt, the situation in GB and some EU countries is very different.

35 minutes ago, PeterA said:

"Wifes mum has severe cancer and is in hospital, she cant poo or pee by herself and her kidneys have shut down now as well,  they want us to take her home to take care of her ."

 

Most hospitals I assume will give the home patient a morphine drip or equivalent to stop or minimize pain, and show you how to maintain it, as well as come by to check on the patient. That's how I have seen it done in Nakhon ratchasima.  From my experience, they give enough to keep the patient in a "near-coma" like state.

Cancer here is real common and is usually not caught until late stage 4. When symptoms occur, it is usually too late to stop it. Unless you have big money for treatments that might give a little extra time only. Weeks, not years.

 

 

 

 

Both my sister and mother had terminal cancer and were treated with increased doses of morphine and as you say they were in a coma state and not suffering pain which is a concern for the poster . Also to take care of bodily functions of your mother must be a difficult task for both involved . A local nurse to " live in " may be the answer . My sympathies to Seajae

There are private hospices around that will do end of life care. Unfortunately it comes at a cost, however it is much cheaper than Europe or the US.

The system is just wrong but we don't have the powers to change it. There are billions spent by the "Government" for absolutely useless stuff but there is no money for healthcare.

Dying at home is often preferred by most patients, if asked. There are several options for managing pain at home for end-of-life cancer patients, including the use of oral morphine for those who can swallow pills. Patients who are unable to take pills can receive continuous subcutaneous infusion of morphine and other medications. This approach is gradually becoming a standard practice in Thai government hospitals, although the progress is not as rapid as desired. I wish the best for the OP and the patients.

3 hours ago, Deli said:

The system is just wrong but we don't have the powers to change it. There are billions spent by the "Government" for absolutely useless stuff but there is no money for healthcare.

The 30b scheme..... The government does not cover the costs ?

11 hours ago, ezzra said:

With 70+ millions population who pays peanuts for admission, procedures, medicines and health care in general, Thailand hospitals are not bad at all considering the above, you want a better care? go private.

Or back to the US with their wonderful free health care for everyone.....oh, wait a minute....

Went to the Dermatology Institute again in Bkk, 2 hour wait. 486 baht for 6 weeks antibiotics anti histamines and ointments. Do not seem to charge for seeing the Dr, the senile dermatology clinic, so I fit right in!

12 minutes ago, DavisH said:

Or back to the US with their wonderful free health care for everyone.....oh, wait a minute....

Indeed. Even with the added facetious twist, not a decent or wise comparison. 

The American systems are unattainable and heartless without a soul.