dying from cancer at home in Thailand

[helloagain]

On 5/16/2025 at 4:37 PM, 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?

 

Somebody i knew, stopped food and water intake, he got his wish within 3 weeks.

[Nip]

They supply Medical Nurses. Here is an add. This is home care average monthly charge 15 to 20K Baht.
 

Are you looking for a professional nanny, tutor, maid, helper, elderly care or driver? 
Please contact our customer service officer:
=> Pui, 097-0748659 (LINE: madawaofficial)
=> Nan, 094-6409066 (LINE: fongbeer.mdw)
=> Benz, 062-0623799 (Line: 062-0623799)

หากคุณกำลังมองหาผู้เชี่ยวชาญด้านการบริการ โปรดติดต่อเจ้าหน้าที่บริการลูกค้าของเรา:
=> Pui, 097-0748659 (LINE: madawaofficial)
=> Nan, 094-6409066 (LINE: fongbeer.mdw)
=> Benz, 062-0623799 (LINE: 062-0623799)

 

There is another company I can forward you. Good luck and best wishes. 

[xtrnuno41]

10 hours ago, Sheryl said:

Oral morphine is certainly available and not necessarily expensive. Even government hospitals will prescribe it for home use in terminal situations (though not necessarily in enough dose and quantity).

 

I have never seen or heard of IV morphine drips in the home (and I know wealthy people who certainly tried). If you do, please share the details. By PM if not here.

What are details?, but a neighbor woman age 85 had pains in body. They couldnt define where it was from.

She had a mobile morphine pump. Once in a while I meet her and she tells everything, also about the morphine pump. She is tough lady and goes on and on, now about 89 !

she even had heart surgery, despite her age in late 70ties then ! As I understood (red) cant , healing proces is a worry. And sedation could be a problem, however she had. I go by what she is telling me and then Im only flabbergasted.

Cant say if she really had morphine, she just told me , she had. I have though seen the device on her, but substance injected? no clue, she tells me it was morphine.

She doesnt have the device anymore , I believe, as the morphine didnt work !?

Im not sure, have to ask her again some time.

She forces herself out of the house to walk , if possible. Sometimes good times , sometimes worse.

If she is really feeling good, she walks to the shops about 300 meter away, do little shopping and walks back !

At one time saw her walking out and I offered to walk with her. Her words:

"No, thank you, dont be slilly, I want to walk by myself and not bothering someone"

Amazing woman, tough lovely lady.

[connda]

23 hours ago, PoorSucker said:

Yes, breaking the law.

Know it.

Social security card gives it for free, but have to wait 3h to see doctor, I work.

Paying 600 baht is worth it at this pharmacy.

I make 5000-7000 baht per day, so waiting 3h costs ,I only work 6h/Day

 

My pharmaceutical is is Katoy, kicked out from med school

Then 3 years in prison would cost you between 5.5 to 7.5 million THB.  Plus you'd be kicked out of Thailand at the end of your sentence.

Private psychiatrists can be seen by appointment.  Then you have a legal prescription.  But hell, I'm not going to argue with you.  You consider it to be an acceptable risk - up to you.  I wear a helmet when I ride a motorcycle and a seat-belt in my car.  And I have a prescription for diazepam.  If others chose not to wear a helmet, not to put on their seat-belts, or choose to carry and consume tranquilizers without a prescription - hey, up to them.  You pay your money and take your chances. 

[connda]

On 5/17/2025 at 1:34 PM, Sheryl said:

Codeine (which comes only in oral form) would also not be enough for advanced cancer pain.  At that stage one needs morphine or related drugs like fentanyl.

 

Are you sure you got codeine from a pharmacy? It is a schedule 2 narcotic in Thailand and sale allowed only from hospitals and clinics.

 

On 5/17/2025 at 1:36 PM, Sheryl said:

Oral morphine is certainly available and not necessarily expensive. Even government hospitals will prescribe it for home use in terminal situations (though not necessarily in enough dose and quantity).

 

I have never seen or heard of IV morphine drips in the home (and I know wealthy people who certainly tried). If you do, please share the details. By PM if not here.

 

On 5/17/2025 at 1:37 PM, Sheryl said:

Your pharmacy is breaking the law, big time.  (not for the tramadol. But for the rest). And so are you, in buying these over the counter.

 

What does Social Security have to do with buying meds from a private pharmacy?

 

On 5/17/2025 at 1:40 PM, Sheryl said:

 

I would not necessarily agree, there are other considerations, as I outlined. Money is essential but not sufficient.

 

He will not remain in a condition able to direct his care and supervise paid attendants. 

 

Someone else has to be willing and able to do that, if he is set against going into a private facility even in the last stages.

 

On 5/17/2025 at 1:44 PM, Sheryl said:

Yes, I discussed and linked to this in my first post.

 

Looks quite good but I have no first hand feedback.

 

However OP needs to clarify if he would accept this at some stage since his original post specified dying at home.  That, much harder to manage as things progress, and needs a capable person to manage it.

 

Besides Koon, as I previously said, St Louis has a wing for palliative care and I have had good feedback on it.  https://www.saintlouis.or.th/clinics/palliative-care-center/40

 

On 5/17/2025 at 1:50 PM, Sheryl said:

 

 

This is not a hospice.

 

It is a  center for diagnosis and treatment of breast cancer.

 

There are some (few) hospices in the Western sense here, as I previously described. But not many.

 

There are also foundations/temples that provide very basic, unskilled custodial care to homeless people with terminal illnesses. But I would nto really call that "hospice" in the palliative sense.

 

 

It would be an immense service to our community if you could create a "pinned" post with as many resource for end of life issues as you know of and which have been discussed in various posts on the topic over the years.  We're all getting to be that age where end of life issues just become a reality, especially for those of us with family here or who otherwise plan to live out their lives in Thailand.  It would be an excellent and worthwhile topic. It would be better than having a bunch of threads on the subject.  It would be nice to have this information pinned in one topic in the Wellness and Health forum which you could do as our Asean Now resident health expert.  

[fredwiggy]

On 5/16/2025 at 4:37 PM, 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 just want to say, I'm sorry for your diagnosis. I lost my mom at 84 from bladder cancer. The doctor waited too long and should have done a cistectomy and it spread. She never smoked, which is a leading cause of the bladder type. I hope you find help for this and hope you have more time here.

[GinBoy2]

I'm in the go back home to die camp.

 

Hopefully you have family there to support you, but they will be able to obtain care and will get you through this difficult phase of end of life.

 

I don't know how fluent you are in Thai, but being able to express yourself in a native language at this stage will help too

[hotandsticky]

34 minutes ago, GinBoy2 said:

I'm in the go back home to die camp.

 

Hopefully you have family there to support you, but they will be able to obtain care and will get you through this difficult phase of end of life.

 

I don't know how fluent you are in Thai, but being able to express yourself in a native language at this stage will help too

 

 

I am in the opposite camp. Whilst I understand your view, I would not wish to burden my family with any end of life responsibilities.

 

If I suffer a difficult end of life phase, I will seek to shorten it.

 

A long time ago I discussed with my daughters the fact that I expected to die in Thailand and would be cremated in whichever country I died in. I checked that they neither wished to attend the cremation, nor required any of the 'ashes'. I have included £1,000 in my bequests for the family to have a 'celebration of my life' if they so wish.

[emptypockets]

On 5/17/2025 at 6:14 PM, PoorSucker said:

Yes, breaking the law.

Know it.

Social security card gives it for free, but have to wait 3h to see doctor, I work.

Paying 600 baht is worth it at this pharmacy.

I make 5000-7000 baht per day, so waiting 3h costs ,I only work 6h/Day

 

My pharmaceutical is is Katoy, kicked out from med school

How does this information help the OP who is suffering from cancer?

[jori123]

Im in same boat as OP (almost)   diagnosed with cancer there in India/Thailand...came back to UK,..Radiation ,chemo ,one session.   Getting on for 2 years now,got bottles of  morphine lying around,never use it Co-D  too strong stuff,hardly use that,its my damned knees,they are painful,awaiting double knee whatever,if bone doc will do it in few months time.There are plenty of places there  if pain gets too much that Snow White is available,just asking the correct people for it.  Coming back there to TH in few weeks again,when and if pain takes hold Ill resort to plan B.   DWP treat cancer patients OK  increase benefits 110 quid a week tax free,was in fire brigade and army before  but they all in some way help out

[xtrnuno41]

Question is with cancer, do you want to go on in living.

Cancer is painful, very unreliable and eats you from inside out.

Me, myself and I made the decision to step out if cancer occurs.

You hear the stories and they arent nice. Stories of people they thought they had it beaten.

Fi a college. had cancer , had stoma and in time, he was declared free of cancer !

Then cancer hit back and he was gone in jiffy time due to aggressive form of cancer returning.

He never made it to pension, just one year away from it.

 

So then how?

Both my parents died in hospital. Both were on morphine to have the body grow weak and stop.

Passive euthanasia, the morphine shuts you off and then time has to do the rest.

Takes some time, depending on weakness overal body.

Im "happy" they could go that way, both didnt have cancer, but other bad conditions. 

They both decided to end by passive euthanasia.

No they werent married anymore and time period was far apart.

Father died on age 67 and my mom 83, while they differed 3 years in age. 

 

Just saw on wikipedia, Thailand is a country with "Passieve euthanasie is legal" and there are way more.

Also as in active euthanasia, but then not in Thailand.

 

Active euthanasia is mostly a very long proces with many rules. And in that many things can go wrong.

Fi a doctor was on a euthanasie "mission", thought he had all done right.

Comité thought otherwise and the doctor was for murder in court.

It ended up with the doctor committing suicide over this case.

His wife went on with courtcase and she won. However very very sad, the doc wasnt there anymore.

Really, a comité declaring you are a murderer, you are not a doctor. The impact it had on the doc, completely destroying him and costing him his life. Not even talking about his family, how would they do just after and all these years after? But ok that is "my" country. Zum Kotzen ! 

  

However try to find such a hospital in Thailand, willing to do so. Budhism isnt like that.

They already have problems with dogs neutering.

 

FVW53, I wish you all the strength and hope your last option brings you a better live and you may live to be 100 years or over. CAnt do anything else. Succes FVW53.

[fvw53]

On 5/17/2025 at 7:20 AM, PoorSucker said:

My father in-law got a hospital bed at home and nurse came every week.

Small village in north Chiang Mai.

Died from stomach cancer

 

Did he receive sufficient pain treatment with only one visit a week.    I am not scared to die but worried about lack of care for severe pains

[fvw53]

On 5/16/2025 at 11:46 AM, 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

 

 

Thanks but the link you gave does not work / it is may-be the same institution as https://aphn.org/services/ramathibodi-palliative-care-excellent-center/

[fvw53]

On 5/16/2025 at 3:53 PM, Sheryl said:

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/

The number one need is pain management / my Thai wife is well educated (63 yrs old) and doing now a wonderful jog in renewing every few days the stoma bag I have now / however she has no access to powerful pain killers although she could learn to inject them /  I am reluctant about a private hospital because in Thailand you are a customer more than a patient / my father died here in my home country of prostate cancer and they gradually increased the morphine and I doubt I this will be done in Thailand

[save the frogs]

11 hours ago, fvw53 said:

Thanks but the link you gave does not work / it is may-be the same institution as https://aphn.org/services/ramathibodi-palliative-care-excellent-center/

 

Sorry, not sure if it's the same.

You can try typing this in google: 

"mahidol university faculty of medicine ramayana hospital palliative care"

 

I wish you strength and courage in facing your adversity. And I sincerely hope you find caring people who will help alleviate any suffering. 

 

 

[Sheryl]

6 minutes ago, fvw53 said:

The number one need is pain management / my Thai wife is well educated (63 yrs old) and doing now a wonderful jog in renewing every few days the stoma bag I have now / however she has no access to powerful pain killers although she could learn to inject them /  I am reluctant about a private hospital because in Thailand you are a customer more than a patient / my father died here in my home country of prostate cancer and they gradually increased the morphine and I doubt I this will be done in Thailand

A well educated Thai wife makes a big difference. Especially if she is comfortable being assertive with doctors as may become necessary. With your wife to supervise things, hiring in nurses/nurses aides becomes feasible. 

 

You can certainly get  strong pain killers here from private hospitals. You can get them from government hospitals as well but more constraints, harder to get dosage increases,  changes in drug etc; may be hard to get  refills when you can't come in yourself; may have to wait (in pain) if reliant on home visitors through the public sector etc etc. 

 

Sometimes being a customer is advantageous and palliative care is definitely such a time.

 

in addition the palliative care services of private hospitals can offer other treatments, such as nerve ablations, if and when advantageous. You will not get the same level of care through the government system though they will do their best.

[save the frogs]

11 hours ago, fvw53 said:

my father died here in my home country of prostate cancer and they gradually increased the morphine and I doubt I this will be done in Thailand

 

I have no personal experience with it, but apparently CBD oil is used for pain management. 

And since it's now legal in Thailand, it should be easy to obtain.

Maybe some of the shops selling it even have some expertise in how to administer it for pain management for cancer. 

 

 

[fvw53]

On 5/17/2025 at 11:45 AM, PPMMUU said:

 

Palliative care is officially part of the Thai government hospital services, and in reality, the situation is not far behind. Several government hospitals have palliative care departments, and some even have dedicated doctors and nurses for this purpose. However, hospice services are rarely available. Most end-of-life care patients in Thailand are cared for by relatives at home. I assume you may not have such relatives, but perhaps you can hire a full-time nurse to act as a ‘relative’ and receive palliative care services from government hospitals.

 

A quick search shows that Pathum Thani Hospital has a palliative care service guideline, which strongly implies that they offer such services. This kind of care often involves a network of government-run primary care units (known as โรงพยาบาลส่งเสริมสุขภาพตำบล, formerly called สถานีอนามัย — you can ask any Thai person you know about them) that provide home visits. These services almost always include morphine tablets, with dosages adjusted to effectively control pain and discomfort. Most of these services also provide a slow-injection device for subcutaneous morphine administration when oral medication is no longer possible. However, they are legally not allowed to administer a lethal dose.

 

Another quick search shows that Thammasat University Hospital runs a hospice service under the name Thammasat Thammarak Hospice and Palliative Care Center, located in Pathum Thani as well. Their contact number is 095-464-9783. You might consider reaching out to them.

 

May you find peace and comfort during this stage of life.

I live at 15 minutes drive from Thammasat / your info is really important for me

[PoorSucker]

1 hour ago, fvw53 said:

 

Did he receive sufficient pain treatment with only one visit a week.    I am not scared to die but worried about lack of care for severe pains

Half a year, ganja tea that I made him helped, stomach cancer

[proton]

On 5/17/2025 at 3:41 PM, Sheryl said:

 

I duscussed this place in my post.

 

Not in Pathum Thsni however.

 

Thonburi side of the tiver near Rama III. 

 

It's on soi 33 off Rama 2, drive past it all the time

[Sheryl]

2 hours ago, Sheryl said:

A well educated Thai wife makes a big difference. Especially if she is comfortable being assertive with doctors as may become necessary. With your wife to supervise things, hiring in nurses/nurses aides becomes feasible. 

 

You can certainly get  strong pain killers here from private hospitals. You can get them from government hospitals as well but more constraints, harder to get dosage increases,  changes in drug etc; may be hard to get  refills when you can't come in yourself; may have to wait (in pain) if reliant on home visitors through the public sector etc etc. 

 

Sometimes being a customer is advantageous and palliative care is definitely such a time.

 

in addition the palliative care services of private hospitals can offer other treatments, such as nerve ablations, if and when advantageous. You will not get the same level of care through the government system though they will do their best.

I would add, some private hospitals here are not for profit. Including St Louis and Camellian, both of which have  palliative care programs.  You get the advantages of private care but without the (profit driven) frills and more of a normal hospital orientation/attitude towards patients.

 

 

[PPMMUU]

With your well-educated Thai wife, a basic palliative care service at a government hospital can serve you well. They can provide morphine tablets adjusted for your comfort, and when you are no longer able to take medication orally, they can supply an injection device. Your wife can adjust the dose if needed through telephone consultations with the palliative care doctors.