dying from cancer at home in Thailand

[fvw53]

I am 82 years old and I live in Thailand since 1987.

Last year during holidays in my home country (EU) a bladder cancer was detected. Since then I have undergone TURBT, cistectomy, radiotherapy but the cancer always came back and now as a last option immunotherapy will be tried.

If this does not work I would prefer to be no longer a burden for the friends where I am now staying and return to Thailand to dy in my own house.

However I do not know if in Thailand there is palliative care at home 

What do Forum members recommend?

 

[PoorSucker]

Where do you live in Thailand?

[save the frogs]

this hospital appears to offer home palliative care services, but it's in bangkok

 

https://www.rama.mahidol.ac.th/fammed/en/postgrad/palliative

 

 

[PoorSucker]

10 minutes ago, save the frogs said:

this hospital appears to offer home palliative care services, but it's in bangkok

 

https://www.rama.mahidol.ac.th/fammed/en/postgrad/palliative

 

 

But where do you live?

There was a post today with a palliative nurse that worked in Europe for 10 years, looking for work (not her but husband)

[save the frogs]

11 hours ago, PoorSucker said:

But where do you live?

I'm not the OP.

 

It exists in Thailand. But maybe not in the sticks. Can he try to make an arrangement with his local hospital? Or hire a private nurse?

I'm out. I got nothing else.

Sheryl should have some info. Is she still around?

[PoorSucker]

Just now, save the frogs said:

I'm not the OP.

 

It exists in Thailand. But maybe not in the sticks. Can he try to make an arrangement with his local hospital? Or hire a private nurse?

I'm out. I got nothing else.

Sheryl should have some info. Is she still around?

Sheryl is #1

[PoorSucker]

2 minutes ago, save the frogs said:

 

How is saving to frogs go, really didn't want shaving

[PoorSucker]

4 minutes ago, save the frogs said:

I'm not the OP.

 

It exists in Thailand. But maybe not in the sticks. Can he try to make an arrangement with his local hospital? Or hire a private nurse?

I'm out. I got nothing else.

Sheryl should have some info. Is she still around?

Must know where, Thailand is huge.

Pattaya, phuket, Samui,Chiang Mai should be easy

[Jerzy Swirski]

They are several business that will provide a nurse that will live in your house to provide care on a monthly basis.

Here is one.  I have never used them.

Google will provide you many others.

It doesn't really matter where you live because they will be living in your house.

I think they ask for a couple of days off per month.

 

https://healthathome.in.th/en/price

[Jerzy Swirski]

Here's another one

 

https://simplycarethailand.com/costs-%26-fees

[Yagoda]

49 minutes ago, fvw53 said:

I am 82 years old and I live in Thailand since 1987.

Last year during holidays in my home country (EU) a bladder cancer was detected. Since then I have undergone TURBT, cistectomy, radiotherapy but the cancer always came back and now as a last option immunotherapy will be tried.

If this does not work I would prefer to be no longer a burden for the friends where I am now staying and return to Thailand to dy in my own house.

However I do not know if in Thailand there is palliative care at home 

What do Forum members recommend?

 

God be With You 

 

[connda]

1 hour ago, fvw53 said:

However I do not know if in Thailand there is palliative care at home 

Nope.  Nor are there any hospices. They don't exist here. And palliative care in hospitals is in the stone-ages, or non-existent. They'll hand you a bottle of Tylenol and wish you good luck. And the palliative care you can obtain will probably be inadequate if you can get it as Thai doctors have two problems.  1) They feel that the pain you experience is your karma and your own fault, and 2) they feel that if they give you adequate amounts of painkillers you'll become an "addict" (heaven forbid).  And they aren't going to give you morphine to take home. It's extremely difficult to obtain except in hospitals and then only under certain conditions. And don't plan to be put on a machine to self-administer morphine based on your pain levels.  They'll ration morphine and they won't care how much pain you are experiencing.   They use to have fentanyl patches, but I'm pretty sure those were discontinued.  See reasons 1 and 2 above.

You're better off staying in your home country.  This is no place to die if you're in pain.  Where do you think wealthy Thais go to die if they have cancer?  They don't stay here.  Check Soapy Massage tycoon and politician Chuwit Kamolvisit.  He left to go die in the UK.  You can't get adequate palliative care here, and you won't get it at all for home use. 

Wishing you the best.  🙏

[steven100]

so sad to hear about your cancer fvw53,  there are healthcare services here in Thailand that provide care 7 days a week,  but is your home near a populated city that has a large hospital ?   or are you remote .... 

Sheryl is the lady who can answer your question .... she will read it and reply soon. 

 

all the best fvw. 

[PoorSucker]

10 minutes ago, connda said:

Where do you think wealthy Thais go to die if they have cancer? 

They go home, family....

[steven100]

1 minute ago, PoorSucker said:

They go home, family....

what if you have no family or they don't want you hanging around as they have their own life to run ... ? 

[connda]

4 minutes ago, PoorSucker said:

They go home, family....

Sure - if their families live in London or New York.  However, I imagine that the really wealthy and connected can get morphine and other pain killers that the "little people" and commoners will never have access to.  If your name is ends in Shin, I'm sure you'd be taken care of.  If your name if Bob Smith or Somchai Satang, you're going to be left to die in agony for lack of adequate palliative care.  Remember? It's your karma and we can't have the hospitals creating morphine addicts now can we!  And fentanyl patches.  Heaven's forbid.  Look at America.  Fentanyl is bad.  Very bad.  Can't allow anyone to have that.  If you're given fentanyl, you might die!!!

[connda]

9 minutes ago, steven100 said:

what if you have no family or they don't want you hanging around as they have their own life to run ... ? 

Go to Switzerland and check out.

[jas007]

Assuming you can afford the care, aren't there nursing home type places in Thailand that offer such services?  There must be. People get old and sick in Thailand, just like anywhere else in the world. 

 

 

 

 

[jayboy]

56 minutes ago, connda said:

Nope.  Nor are there any hospices. They don't exist here. And palliative care in hospitals is in the stone-ages, or non-existent. They'll hand you a bottle of Tylenol and wish you good luck. And the palliative care you can obtain will probably be inadequate if you can get it as Thai doctors have two problems.  1) They feel that the pain you experience is your karma and your own fault, and 2) they feel that if they give you adequate amounts of painkillers you'll become an "addict" (heaven forbid).  And they aren't going to give you morphine to take home. It's extremely difficult to obtain except in hospitals and then only under certain conditions. And don't plan to be put on a machine to self-administer morphine based on your pain levels.  They'll ration morphine and they won't care how much pain you are experiencing.   They use to have fentanyl patches, but I'm pretty sure those were discontinued.  See reasons 1 and 2 above.

You're better off staying in your home country.  This is no place to die if you're in pain.  Where do you think wealthy Thais go to die if they have cancer?  They don't stay here.  Check Soapy Massage tycoon and politician Chuwit Kamolvisit.  He left to go die in the UK.  You can't get adequate palliative care here, and you won't get it at all for home use. 

Wishing you the best.  🙏

 

This is mostly complete nonsense.I know this from anecdotal experience of several ordinary Thais who had palliative care and pain relief drugs administered in their final days.This took place at village level with support from the local government hospitals.I am fairly sure that morphine or similar was provided - obviously in limited quantity and as required - for the family to administer.Not ideal and constrained by funding but equally not terrible.I don't know much about the institutional issues and someone better informed might want to comment.I do know that the post completely misrepresents Thai compassion for pain and suffering.

[connda]

11 minutes ago, jayboy said:

This is mostly complete nonsense.I know this from anecdotal experience of several ordinary Thais who had palliative care and pain relief drugs administered in their final days.

Not at home they didn't.  You don't have to believe me.  Wait for Sheryl to check in.  The locals here who die of cancer and are in extreme pain will be send from our Amphur hospital to a provincial government hospital, in this case Lamphun Government Hospital were they'll be administered enough morphine to keep them out of extreme agony - but not to keep them comfortable.  I've seen the conditions average Thais die in here in Thailand and it's not pretty or dignified.

[KannikaP]

1 hour ago, fvw53 said:

I am 82 years old and I live in Thailand since 1987.

At 82, I would let Mother nature take her course, and personally, help her on her way.

[kingstonkid]

1 hour ago, PoorSucker said:

Where do you live in Thailand?

Op says he is in Pathum Thani 

 

might try https://www.happyhelp.co.th/super-caregivers

 

or I am sure that he uses a thai hospital in his are they might be able to recommend a nurse to look in on him.

[steven100]

the service is available ....  if you have money in Thailand you can get anything,  even palliative care everyday  

[Mark Nothing]

One of my contacts hired home healthcare workers to handle the routine tasks of the home as he became unable to manage on his own.

 

Some of the tasks included cooking, cleaning, shopping, laundry, bathing, taking him to doctors, ensuring he took his daily medicine.

 

I am not sure how he found them.  Or what he paid.  They appeared to be about 30 years old without any medical training.  

 

With time 3 nurses provided round the clock service in 8 hour shifts.

 

 

[kingstonkid]

18 minutes ago, Mark Nothing said:

One of my contacts hired home healthcare workers to handle the routine tasks of the home as he became unable to manage on his own.

 

Some of the tasks included cooking, cleaning, shopping, laundry, bathing, taking him to doctors, ensuring he took his daily medicine.

 

I am not sure how he found them.  Or what he paid.  They appeared to be about 30 years old without any medical training.  

 

With time 3 nurses provided round the clock service in 8 hour shifts.

 

 

 

I think if you can find someone to do the housekeeping and then a nurse to pop in to do the meds thing, that is probably the cheapest way

[gtr]

3 hours ago, connda said:

Nope.  Nor are there any hospices. They don't exist here. And palliative care in hospitals is in the stone-ages, or non-existent. They'll hand you a bottle of Tylenol and wish you good luck. And the palliative care you can obtain will probably be inadequate if you can get it as Thai doctors have two problems.  1) They feel that the pain you experience is your karma and your own fault, and 2) they feel that if they give you adequate amounts of painkillers you'll become an "addict" (heaven forbid).  And they aren't going to give you morphine to take home. It's extremely difficult to obtain except in hospitals and then only under certain conditions. And don't plan to be put on a machine to self-administer morphine based on your pain levels.  They'll ration morphine and they won't care how much pain you are experiencing.   They use to have fentanyl patches, but I'm pretty sure those were discontinued.  See reasons 1 and 2 above.

You're better off staying in your home country.  This is no place to die if you're in pain.  Where do you think wealthy Thais go to die if they have cancer?  They don't stay here.  Check Soapy Massage tycoon and politician Chuwit Kamolvisit.  He left to go die in the UK.  You can't get adequate palliative care here, and you won't get it at all for home use. 

Wishing you the best.  🙏

Saw chuwit on tv channel 3 last week , he is looking remarkable well . He went for actual treatment ,not to die per se . 

[Sheryl]

Thailand does not have the type of home hospice care found in the west.

 

You can certainly get a caretaker, maybe even (if you can afford it) nurses to take care of you at home. But the big problem will be pain relief and other palliative measures to address the various physical discomforts that arise. .No at home morphine drips and the like here, no experienced home hospice nurses or protocols for at home end of life care. You can get oral pain killers of course, but will have to go into the hospital periodically for refills, and once no longer able to take oral pain killers it is a problem.

 

I know cases where, with considerable difficulty and a determined (Western) spouse,  willing and able to take on management of care, people successfully did this but it is not easy.  Lacking a spouse or other close person willing and able to  proactively manage care & communications with doctors, and be assertive with them  on your behalf etc, it does not go well.

 

Usually what happens is that once oral pain killers don't suffice,  or other symptoms become bothersome, the person comes into hospital.

 

There are some good in-hospital hospice type arrangements now (fairly recent). St Louis Hospital in Bangkok has a hospice wing; MacKean Hospital in CM has provided this for some time; and there is also now a hospital specifically for end of life care in Bangkok :

 

https://www.koonhospital.com/

[Lacessit]

4 hours ago, fvw53 said:

I am 82 years old and I live in Thailand since 1987.

Last year during holidays in my home country (EU) a bladder cancer was detected. Since then I have undergone TURBT, cistectomy, radiotherapy but the cancer always came back and now as a last option immunotherapy will be tried.

If this does not work I would prefer to be no longer a burden for the friends where I am now staying and return to Thailand to dy in my own house.

However I do not know if in Thailand there is palliative care at home 

What do Forum members recommend?

 

I am somewhat surprised BCG immunotherapy was not used as a first resort after the TURBT.

 

Radiotherapy is a bit hit and miss with cancer. The success rate with BCG is better than 90%.

[GammaGlobulin]

45 minutes ago, Sheryl said:

No at home morphine drips and the like here

 

If not, then this would be a huge issue.

The entire point of end-of-life care, in such a scenario, would be to reduce pain and suffering.

 

Also, what about hydration?

Just keeping hydrated might be a problem without an IV.

 

But, one might imagine, the main need would be pain relief.

 

Hydration might be a moot point, since one's intent is not to prolong life, but to ease the transition from life to....whatever....

 

[fvw53]

7 hours ago, PoorSucker said:

Where do you live in Thailand?

Pathum Thani