Home Nursing Services

[Mapguy]

I rather take to the notion of motoring around town by specially adapted motorcycle when I am otherwise immobilized. Considering the many French poodles which have apparently learned to drive motorcycles in this town (and don’t even get pulled over for not wearing helmets!), I'll be able to get around okay, but then will come the time when I drive off that awful step at Spicey's and end up an invalid. Ah well! So, what next?! A 20 year-old girlfriend to provide me tender loving care the rest of my days? I don't think so!

So, what about home nursing services? There is at least one home nursing service in Chiang Mai. It is called "Centa Care." It appears to be a franchise business operating in different countries. An attractive web site << centa-care.com >>.

Take a look if you wish. Otherwise, I'd be very interested in knowledge of and experience with this outfit. Or any other like it. And so, I think, would other cholesterol-enriched and wobbly-kneed TV members not quite past their prime.

[Mapguy]

It has been about two weeks since I posted this topic, and I am really quite surprised that no one (considering the demographics of the community) has responded. Perhaps the question was wrong. Should it be broader? What are people planning for if not some sort of managed service (at home or in a facility) for extended convalescence, disability (such as stroke), or simple frailty of age? These were major considerations were I came from.

[Ulysses G.]

A 20 year-old girlfriend to provide me tender loving care the rest of my days? I

TIT!

Edited October 13, 2008 by Ulysses G.

[Mapguy]

A 20 year-old girlfriend to provide me tender loving care the rest of my days? I

TIT!

Checked your meds for arsenic lately?!

[harrry]

I am one of those who may be in need of some help this way. I think in my case it could be that I will manage a long time with unskilled help when individual options such as the modified motorbike or car stop working. I think if it does get to the stage that I cannot manage with local village type help for cleaning, food buying and occasional pushing my wheelchair around it will probably be time to return home and hope I get into a nursing home. Hopefully that will be a while coming.

I would be interested in your responses about modified motorcycles etc. Could you PM me if you get any specific information. I was hoping to be in CM for the party but may be a week or two late unfortunately.

[ataloss]

Centa Care looks promising; but, as I do not see a listing of their fees this absence may indicate their fees could be 'pricey' for many of us.

Another option would be the private hiring of 3-4 Thai nurses/ nursing aids, retired and in good physical, who would work 8-hour shifts. The 4th would provide for holidays and days off and to allow rotating shifts such that one nursing aid is not continually working the midnight period.

[Ajarn]

Personally, I have been in need of such care for the last few years. There are plenty of trained and non-trained staff to help out. Cost to me is an extra 20,000 per month for great care and help

[harrry]

Personally, I have been in need of such care for the last few years. There are plenty of trained and non-trained staff to help out. Cost to me is an extra 20,000 per month for great care and help

Thanks for that Ajarn. It supports what I had hoped. I dont need it now as I am still mobile in an electric wheelchair but will need help pushing a manual and could need some care with my lung problem.

[geriatrickid]

In many western countries, many hospitals have a registry of nurses available for private duty. It's a good way to make extra money. Would the same hold true in CM? Have you considered inquiring at one of the local hospitals that cater to farangs? Just a thought if you have hit a dead end.

[BEENTHEREDONETHAT]

It seems to me that someone looking for a business to start up could do rather well cattering to elderly farangs with a nursing home. A nursing home for thais would not do to well as the family looks after each other.

You could gear it up to supply the things they need and want pretty easily. Labor would be no problem. It could build into something very rewarding for the investors, the clients and the people running the venture.

Hurry though,LOS can age you rapidly.

[Mapguy]

It is good to read some practical advice and experience relevant to Thailand. That's really what the topic is meant to be about. There are , I suppose, a few basic routes that cover most cases preparing for temporary or permanent disability or inability.

Expatriates abroad normally do not have the support of a family network, which is a very strong tradition in Thailand for cultural reasons as well as for economic reasons.

That aside, even with family care, in a busy family that works for a living, time for knowledgeable personal care can be at a premium. So, who manages things? I know from very practical experience that hiring and managing caregivers (Hate the expression but it works.) is no easy task, especially hiring a few people that might work in shifts. Now, some older folks who are frail can manage the situation, but who happens with more serious forms of disability/inability --- stroke, Alzeimer's, and so on --- when you are physically or mentally not able to take care of your own affairs. Who does the managing then?

The "manager" could then, I suppose, be a service like Centa Care purports to be. Alternatively, it might be going into the "home." But what home where?! I am not familiar with any such places in Chiang Mai, or for that fact, in Thailand. Are there any?

On a related issue, many expatriates have probably experienced the work that hospitals do these days in places like America and the U.K. in providing not just medical but social services to support people recuperating from surgeries and illnesses as well as for the infirm who don't stay in hospital. This can vary from counseling to home visits to making arrangements for hospice care. Are any physicians or hospitals in Chiang Mai (Thailand) geared up to handle this?

So, what's available folks? What's the plan?!

Edited October 16, 2008 by Mapguy

[Gladiator]

It has been about two weeks since I posted this topic, and I am really quite surprised that no one (considering the demographics of the community) has responded. Perhaps the question was wrong. Should it be broader? What are people planning for if not some sort of managed service (at home or in a facility) for extended convalescence, disability (such as stroke), or simple frailty of age? These were major considerations were I came from.

Hi Mapguy,

Its a bit late at night to fully respond to your posting and PM you with my personal contact should you wish for a more detailed account, but in brief, during the past several years my Mum, 83 years old, has suffered major health problems and has really 'been through the wars'. Various hospitals and a number of agencies which have provided 24 hour Care ,throughout the year, have never totally satified her needs.

My brother and I have looked into Nursing Care Centres, even McKains, and are still deliberating on what may be the best option.

I will try to provide further information tomorrow.

[jfchandler]

Personally, I have been in need of such care for the last few years. There are plenty of trained and non-trained staff to help out. Cost to me is an extra 20,000 per month for great care and help

Ajarn, what level of care have you been able to arrange for that price??

24/7??? or... so many days and so many hours per day???

And, just "civilian" help or medical/nurse qualified folks???

I'm assuming you mean... at-home care....

[Ajarn]

Personally, I have been in need of such care for the last few years. There are plenty of trained and non-trained staff to help out. Cost to me is an extra 20,000 per month for great care and help

Ajarn, what level of care have you been able to arrange for that price??

24/7??? or... so many days and so many hours per day???

And, just "civilian" help or medical/nurse qualified folks???

I'm assuming you mean... at-home care....

I have a physical therapist that comes 4 times a week @ 4oo baht per hour. Otherwise, I have a civilian housekeeper who helps me around the house with cooking, paying all my bills, and helping me to walk to where I need to go. 24 hours perday. Trusting someone to go to the ATM for me is the hardest part, but so far, no problems

[jfchandler]

I think this is a very good topic, and one that hasn't produced a lot of available resources..at least as yet.

There was another Thai Visa thread on this subject recently....that did contain one care provider reference... The thread is here...

I'm not old enough yet or have any condition that puts me in the situation of needing these services... now.... But, I have a family member with a chronic care condition, requiring pretty much 24/7. so it really set me to thinking about the future prospects... especially since I plan to stay in Thailand.

The general impression I get is, because Thais tend to rely on the family structure for these kinds of things, there hasn't developed as yet much of an organized business structure here for that kind of care, unlike in the West.

For farang, of course, many end up being married with Thais, and have an extended family in that way. But I'd suspect, many also end up getting divorced or separated at some point. Other folks choose to stay single. And I'm not sure, if I got into a care-needing situation, I'd want that handled entirely by Thai inlaws and such. Especially if there were medical needs involved.

The one thing I have taken on already, is looking at financial options for long-term care insurance coverage in Thailand. My local insurance broker checked and basically came back saying Thai companies aren't really offering that (specific long-term care policies), except for some limited options through life insurance products.

I have an ex in the U.S. who's in the insurance business who tells me some of the international providers have LTC coverage that will apply anywhere in the world. Before I moved from the U.S., I had long-term care coverage thru my government job, and could have kept the policy by paying the premiums on my own post-employment. But, that policy would only have provided coverage within the U.S. (not Thailand or abroad). So I let it go.

So back here in Thailand, I'm looking now at one regular medical insurance policy offered thru one of the international firms that includes specific coverage for long-term disability, both for acute care, and home palliative care. The medical policy is more expensive than some others, but it's good coverage, renewable for life (no age cutoff) and includes the disability coverage...

The policy details in that regard are: Chronic condition coverage... 100% for "acute exacerbation" up to the annual policy limit of 83 million baht per year, and "routine management and palliative treatment" up to 360,000 baht per year (30,000 baht per month or roughly $10,000 U.S. per year at current rates).

The devil, of course, is always in the details. So my insurance broker today delivered the actual policy language (all the legalese stuff) to me at home, which I'll be reading this weekend... and report back further here.

Of course, it's not only where you get such care and who you get it from, but also making sure that you don't go broke or spiral downward financially and find yourself unable to maintain your needs.

PS - I should have added, re the med insurance policy, I'd assume it includes the standard provisions for excluding pre-existing conditions. So these kinds of things are really ones you want to provide for... before.... you end up needing them.

Edited October 17, 2008 by jfchandler

[jfchandler]

Thanks Ajarn... So...the bulk of your 30K per month is for a live-in housekeeper? I hope he or she gets a holiday off sometime???

[RogerL]

Wife and I are getting ready to retire to CM next month from the US. We researched all our insurance (life, long-term care, medical, etc) and just sat down with our financial advisor to see what we should keep and what we should let go now that we're retired, no house payment, etc. We bought long-term care (John Hancock) about 20 yrs ago thru our employer group. We kept it up after leaving that employer. It doesn't pay for overseas coverage. John Hancock rep told wife that newer policy does have feature that allows payment of 75% of US benefits for overseas care. Unfortunately, that plan is unaffordable for us. If we were younger, it would be a good deal, but long-term care coverage gets more expensive if you sign on at an older age.

We never had kids and no extended family, so long-term care is a concern. Wife says I should find a Thai wife to take care of me if something happens to her, but I don't know what older western women would for long-term care in Thailand. Looks like she'll have to return to US if something happens to me and she needs long-term care. Definitely seems to be a business opportunity here in CM.

[harrry]

Wife and I are getting ready to retire to CM next month from the US. We researched all our insurance (life, long-term care, medical, etc) and just sat down with our financial advisor to see what we should keep and what we should let go now that we're retired, no house payment, etc. We bought long-term care (John Hancock) about 20 yrs ago thru our employer group. We kept it up after leaving that employer. It doesn't pay for overseas coverage. John Hancock rep told wife that newer policy does have feature that allows payment of 75% of US benefits for overseas care. Unfortunately, that plan is unaffordable for us. If we were younger, it would be a good deal, but long-term care coverage gets more expensive if you sign on at an older age.

We never had kids and no extended family, so long-term care is a concern. Wife says I should find a Thai wife to take care of me if something happens to her, but I don't know what older western women would for long-term care in Thailand. Looks like she'll have to return to US if something happens to me and she needs long-term care. Definitely seems to be a business opportunity here in CM.

There are at least a couple of nursing homes available in thailand. You could try googling for them. From memory one of them was listed on one of the Pattaya hospital websites.

From the photos and descriptions they seem to probide similar care to australian ones but I remember a note on one saying thai only. I used to find that sometimes thai only related to language and as I understand yau are well localised and I believe speak thai from pasts posts you may find something if you must go that way.

[harrry]

http://books.google.com.au/books?id=8mC4-q...esult#PPA210,M1

http://www.idrc.ca/en/ev-28478-201-1-DO_TOPIC.html

seem on first glance to be good overall resoruces on the state of aged care and availability in Thailand.

As I am getting ready to come over to Thailand at the moment I dont have much time to research more. I hope these help.

[Mapguy]

http://books.google.com.au/books?id=8mC4-q...esult#PPA210,M1

http://www.idrc.ca/en/ev-28478-201-1-DO_TOPIC.html

seem on first glance to be good overall resoruces on the state of aged care and availability in Thailand.

As I am getting ready to come over to Thailand at the moment I dont have much time to research more. I hope these help.

These references are discussions of national policy for elderly care in Thailand. They are quite interesting but do not refer to specific services, facilities and their locations today.

I have explored some more myself and have found two specific references so far. The first is a residential hospital for the infirm (Golden Years Hospital) in Bangkok. The second is a residential community (Tanaboon Village) in Hang Dong that in various places has advertised "independent living" and "assisted care" for residents:

http://www.goldenyears.co.th/en/

http://www.tanaboon.com/meet.html

I have not contacted either of these places. Perhaps some of you know about them and can comment.

Edited October 18, 2008 by Mapguy

[Ajarn]

Thanks Ajarn... So...the bulk of your 30K per month is for a live-in housekeeper? I hope he or she gets a holiday off sometime???

That is 20,000 baht, NOT 30,000 baht. And no, she gets no holiday, only the 10,000 per month

And she is quite happy. Been with me for 6 years.

[jfchandler]

Dunno how you did it... but I'd say you're very lucky to have found someone who meets your needs, at a reasonable price, and who has had the stability to stay with you for 6 years... Congratulations about that!!!!

[jfchandler]

I have explored some more myself and have found two specific references so far. The first is a residential hospital for the infirm (Golden Years Hospital) in Bangkok. The second is a residential community (Tanaboon Village) in Hang Dong that in various places has advertised "independent living" and "assisted care" for residents:

http://www.goldenyears.co.th/en/

http://www.tanaboon.com/meet.html

Thanks for sharing the info, Mapguy...

I was just looking at the web site for the Tanaboon project near Chiang Mai... Thing is, I can't find anything on their web site that even hints at or alludes to any kind of supportive services being available or provided within the community.

Just the usual stuff about a planned community with security and build-to-order houses. So if they have some component of "assisted living," they're not doing a good job of conveying it...

[Mapguy]

I have explored some more myself and have found two specific references so far. The first is a residential hospital for the infirm (Golden Years Hospital) in Bangkok. The second is a residential community (Tanaboon Village) in Hang Dong that in various places has advertised "independent living" and "assisted care" for residents:

http://www.goldenyears.co.th/en/

http://www.tanaboon.com/meet.html

Thanks for sharing the info, Mapguy...

I was just looking at the web site for the Tanaboon project near Chiang Mai... Thing is, I can't find anything on their web site that even hints at or alludes to any kind of supportive services being available or provided within the community.

Just the usual stuff about a planned community with security and build-to-order houses. So if they have some component of "assisted living," they're not doing a good job of conveying it...

I agree re Tanaboon; hence seeking further information on the place.

[Mapguy]

Dunno how you did it... but I'd say you're very lucky to have found someone who meets your needs, at a reasonable price, and who has had the stability to stay with you for 6 years... Congratulations about that!!!!

I too think Ajarn is fortunate to find someone that compatible. The salary (10k plus room and board) is quite good, really, but the no time off bit would be hard for most people, I would think.

[whiterussian]

You will balk at the idea, but this place is down the road to me, its very beautiful and peaceful/secluded, you can forget you are 5 mins from the urban jungle.

mckean hospital. out towards hang dong/san k. 5 mins from airport.

quickest reference i could find to it is:

http://shellyandbrettf.blogspot.com/2008/0...osy-colony.html

and

http://www.pcusa.org/health/international/...iles/mckean.htm

It has huge grounds, but the thing that may be of interest is that around the periphery are just normal thai houses (some even still made out of wood)

God forbid some money making farang spoils the grounds with apartment blocks, i would have thought along the edge a normal thai house could be built, with nurses being just a short hop away, and the mckean could use the profits for its charities.

Give em a ring.

Edited October 19, 2008 by UKWEBPRO

[Ajarn]

Dunno how you did it... but I'd say you're very lucky to have found someone who meets your needs, at a reasonable price, and who has had the stability to stay with you for 6 years... Congratulations about that!!!!

I too think Ajarn is fortunate to find someone that compatible. The salary (10k plus room and board) is quite good, really, but the no time off bit would be hard for most people, I would think.

Sure the salary is good, but with any live-in help, they become part of my family. Once in awhile she will ask for a couple of days to go see her family. No sweat at all. For anyone having live-in staff, I think this is normal, and is expected by most live-in workers. The farangs that I know sometimes offer them a day off during the hiring, but it is rarely taken by the staff

[Pantip]

The problem of the elderly expat population in Northern Thailand finding residential on site health and medical facilities for the aged and incapacitated is an ongoing and growing need here in Chiangmai. Over the years there have been several unsuccessful attempts made to set up such a facility by the expat community with the support of some of the local medical practitioners.

In my opinion the reason for the failure of these attempts was the inexperience of those interested in being able to come up with a professional feasibility study which is needed to raise funding for such a project and the fact that because it was to be a community project their was conflict with so many differing opinions on detail that it became impossible to come up with a coordinated and agreed approach to the planing, financial costing and implementation of the project which is so necessary in raising funding.

This is an interesting topic and I for one would be interested in discussing the matter with interested potential investors. The problem as usual is finance, you need finance even to enable a bankable feasibility study.