Bringing My Ailing Parents To Thailand.

[tartempion]

I post this in General because there is more than just visa issues here.

Firstly I live near a village and have all required resources nearby: car food, room, money.

My parents had to leave their house last July, they can no longer take care of themselves (buying food, making food, cleaning the house, washing clothes) They now live in a "Home for Retired People" waiting to die, pun intended.

My father suffers from Alzheimer disease, he does not recognize me anymore, but has no problem walking around.

I went to visit them this October and wonder.

Why not bring them over to my house and have them spend their last months/years here?

I really felt depressed every time I walked into that place, enough said.

Are there any issues which make this impossible???

A possible list of what's needed is:

Two passports with non-O immigrant visa.

2x 800k in separate bank accounts for each. Not sure I can open bank accounts with their passports without bringing them in person to the bank agency, I might need some document authorizing me to take care of their financial matters, especially for my father. I might ask a judge in my home country to issue such a document and have it translated/certified by foreign affairs (if that is a requirement?).

Does immigration have issues with elderly people in fact?

I will have them fly in business class, I will join them on that trip, hope no problems with airline with such elderly people, I sent them a mail.

I will have a room set-up with direct access to the garden, have gate to street always locked.

I will arrange for a maid every day: cleaning, washing, ironing; if necessary live-in possible.

I covered the food issues, will keep their habitues, most available in town, warm lunch no problem.

I understand it will be difficult if not impossible for us to leave the village for several days, not to say week(s) (no more holidays?)

We have first aid at 100m, plan to make agreement with doctor/nurse.

Can they keep their official address in home country or should I register them at the Bangkok embassy. Their pension can continue to be paid in home country anyway, online banking today makes transfer easy.

I do see potential problems with serious illness. At their age they can't get health insurance in Thailand. Hospitalization in local government hospital gives me serious doubts and international hospital bill might soon run into 100's k. I wonder how Thais manage, unless I follow the Thai way.... I see people dying at home.

They do take medication, not sure all of them are useful, anyway we can cope with the expense. Always could order big quantities in home country on social security.

They have extra medical insurance now, no need to pay for hospital home country, might consider bringing one or both to home country hospital in case of serious illness, but might have problem with airline...this is an issue.

If and when their health will degrade if they stay in homeland I will be in serious problems anyway having to fly back for possibly long and hard times. So why not having them over here?

I certainly will have more issues with this.

Any comments, advice, issues welcome.

[Maizefarmer]

Good on you tartempion - taking care of your elderly folks 11/10!

Well it sounds like you have everything to keep them comfortable - just so long as they can cope with the heat and humidity (air con in their room!).

I wouldn;t have though getting a POA (power of attorney) issued in Thailand would be a problem - has nothing to do with the authrorities, it's a recognised document type in Thailand (I've used them before - albeit for different reasons) - just get hold of a lawyer to get it drawn up correctly in Thai using the correct terminology, layout, format ect ect .....(get an english translation copy as well), and get the lawyer to sign and stamp it (notarise it), witnesess ect .... It's a legal doc - nothig unusualy about it in Thailand.

And then go off to a bank (same bank as you use) and present it with their passports and whatever else is needed, and if you're Thai is not upto scratch in been able to explain what alzheimers is, take along with you someone who can explain all this - and you should have no prob's.

Yup - register them at the embassy.

You don't say where you are, so the hospital mater may be an issue, but my experience of Thai state hospitals is nothing but positive. Yes, its a bit of a culturale shock and the food is not exactly "ex-pat" (so bring food in for them) - but most have private rooms, and all the main regional state hospitals can offer all that the private hospitals offer - I wouldn't be to concerned about that.

I don't see these matters been issues, it's how caring for them is going to impact on your lifestyle and time - my guess is there'll be some big changes to your lifestyle(?).

[Matan]

Your dad might marry someone his grandchildren's age? Apart from that sunshine, fresh air and good food might do them good.

[PeaceBlondie]

You mentioned "social security..." Of course, American Medicare pays nothing in Thailand.

[Atmos]

can't offer any advice; but just like to say i admire your attitude and commitment to your parents, and wish you all the best in looking after them here.

[Sheryl]

You have identified the main issue, which is medical care. It will all have to be out of pocket.

At home custodial care and even skilled nursing care is pretty affordable here. So is out-patient medical care even if at an international hospital. Problem would be if they needed inpatient care. In the case of your father, given his Alzheimers has progressed to the point where he no longer recognizes his own child, and that as you know this is a relentlessley progressive disease, it would not be unreasonable to decide in advance not to have him hospitalized even if critically ill, i.e. to limit care to comfort measures and simple treatments that can be done in the home setting. Certainly if it were me in his shoes that is the most I would want done. But of course that is a deep decision and one that needs to take account of your mother's views and also any wishes your father may have expressed in the past.

Your mother I gather is still lucid, so in her case you may need to think about the costs of hospital care should the need arise. It is no easy matter to send a critically ill person back home. While the medical quality of care at government hospitals is OK form provincial level on up (do avoid the district hosps), being admitted in one would probably be a bewildering and highly stressful experience for her given the lack of English speaking. Could make it a bit less so by getting a private room and staying with her throughout. And, as you know, neither Medicare/National health would pay for her care in Thailand and she would not be able to get insurance. One option would be to self insurance i.e. put aside money to be used in the event she requires hospitalization.

Other consideration is whether the move to a foreign country would be unsettling to your Mom, which depends on how much she goes out these days, how she feels about where she is now, etc. if you think she could be content mostly staying at home and that she is not happy where she is, then inded this move might be for the better for her.

[jaideeguy]

3.5 yrs ago I did that with my [then] 87 yr old father with osteoporosis and a broken hip as his only other options were to go into an 'old folks institution' and watch his pension and social security disapear and lead a miserable lonely life. He was fully insured and of sound mind when after 6 months here he comitted to stay and dropped his insurance.

He has had several fractures since then and the Thai private medical system has taken excellent care of him and he is ahead of the $game so far by paying out of pocket.

I have been the primary caregiver [with the support of my wife as back-up] and was approaching 'caregiver's burnout' [it is the hardest job I've ever had], but luckily before I crashed and burned, we found a great caregiver that gives me relief for 9 hrs a day and I can now have some quality time with Pop, as he is now bed bound and needs constant attention and I was spread too thin to do the job with a good attitude, which is the first requirement of a caregiver.

The immigration issue was not a problem, as you can get a temporary POA for free to represent them and the immigration officers have always been very helpful and acomodating....making it easier for my Pop's visa than mine. Bank issues, I think are the same.....one time POA is small baht and easy to get from any stationary store.

It is not an easy chore that you may be taking on and I will admit that at times, I wish I didn't take my father on, but I did offer and will see it through to the end.

If you have any more questions, send me a Pm and I will help or share my experiences and maybe cry on your shoulder when you need it.....I need it sometimes and have tried in the past to organize other falang caregivers here for a casual support group......it's reassuring to know that there are others in the same boat.

I can also share some helpful websites for caregiver support......if you want.

Best of luck and keep in touch.....

JDG

[Ijustwannateach]

Money and health care are not the only things to consider. You might want to consider the issues of culture shock and disorientation, especially as your dad is apparently a bit out of touch already. Will he panic if he suddenly realises (over and over again) that he is in a foreign country? Will communication with second-language speakers be a troublesome issue? Will either he or your mom be able to adjust to new foods, climates, etc.? Will removing them from their old environments and/or friends be a loss for them? What about access for other family members and friends?

[caf]

A very good post from jaideeguy with sound advice from someone who understands the problems and is speaking from experience

Justwanttoteach: Your post suggests that you don't undestand what Alzeimers is. If you had read the op more closely he indicated his father no longer recognises him so your comment about dealing with second-language speakers - which I assume you mean Thais who do not speak English - seems a bit odd.

There have been some helpful posts on this thread. Jaideeguy has offered to answer pms and I also make that offer.

Good luck to him. His heart is clearly in the right place with the concern and care he is showing his parents

[thunder30101]

A heart being in the right place does not always make things right. I think the shock of thailand would be way too much for them in the condition he talks about. You always have to ask yourself are you doing this for yourself or for them ?

[jaideeguy]

As far as culture shock.....I live in a remote development and have built Pop a small handicapp friendly bungalow and he has very little contact with the outside world except for intenet and CNN. he can handle Thai food several times a week if not too spicey, but I provide falang food about half of the meals.

One frustrating thing about LOS is the lack of geriatics specialist doctors and you will find yourself on your own....especially out in the sticks, but we have managed by making contact with a few good hearted doctors here in Chiang Mai.

[tartempion]

Maizefarmer and Sheryl, thanks for your insight.

The idea of having the legal stuff done by a Thai lawyer is a relief, less hassle in Home country.

Actually they both sit and wait in that "home for the retired", they have no intention/incentive to walk out of the front door, they don't socialize with other pensioners, it's cold and raining there.

I was thinking they could at least enjoy the sun and sit in the garden at my place.

I am worried indeed: will they feel OK the 9 months with temperatures of 30C+?

No one can tell unless I try.

I mentioned this idea to my mother before leaving to Thailand this October, because she looked very depressed both because they had to leave their house and my father's state and attention he requires, but my idea then was to harbor her after my father's gone.

My shift of ideas comes from the knowledge my father's behavior causes problems in the Home they reside now, it might become difficult to keep him/them there one day soon enough, if he gets seriously ill (and I don't know how (fasts) Alzheimer will degrade -he still has no shaking hands when drinking coffee) I subsequently will need to leave Thailand for some unknown duration. So the whole idea comes from turning the problem upside down.

Medical care indeed will be the main issue then. As Sheryl mentioned, I was thinking following the Thai way for palliative care. There is a district hospital at 8kms, although I have been there a few times I will need to investigate more (private rooms and care?) and consider the language issues. Money is not an issue as long we talk a few 100K's. So savings versus insurance applies indeed.

I still consider keeping homeland social security active essential, especially for my mother, thus if need arises I always could get her hospitalized back in home country, thus maintaining theire legal address there.

It will put some burden on our lives for sure, but we are at home every day, except for some shopping and occasional trips a few times/year.

I still need my wife to go 100% with this, it is partially her idea in the first place and my mother will need to agree with the move.

We will think this over some more days before moving ahead.

[BangkokJazz]

Best of luck! I hope your parents enjoy being close to their son. With the amount of homework you have done, I think they are in great hands.

[tartempion]

Jaideeguy, thanks for your comments and congrats for taking care of your father.

Although we have a guest room I consider transforming the carport (extension of our bungalow) into a 5x4m room because the rest of our house is elevated. We have one rai of land, sufficient space to build a new car port elsewhere, even consider building a separate bungalow, but don't think that's necessary, unless 5x4 is too small a room? Also need a bathroom to be built nearby, not sure where/how to do. I realize airco might need to run 24h day 9 months/year, no problem. I understand they will need two good chairs and two medical types one person beds. I plan to buy a wooden sala to sit outside in the shade.

My project just one month ago was to transform the carport into an elevated terrace-sitting area, so that changed into building an extra room...

I don't see a culture shock, they are already cut off from the outside world. When my mother switches the TV on, he leaves the room....

Food: they eat coffee and bread morning/evening with cheese, ham or other transformed meat, easy to find Lotus, Big C, Carrefoor, I bake my own bread. Warm lunch: mashed potatoes, vegs, some meat (chicken, pork) rice, bring in some Thai food from the village 1km away, like kao pad kai etc, don't see problems here. We could try to switch to more warm food for dinner. Soups etc.

Now your comment on "caregiver's burnout" and "geriatric doctors" is serious enough.

Therefore we do plan getting help 8h/day, but what would the job requirements be like?

Just family help or is there need for nurse qualification? We do live 40kms from any major town. The situation to day is that my mother cares for my father 24/24, she runs after him when he leaves their room because he often walks into other peoples rooms and takes whatever his hands get on. The situation will become more difficult as time passes by. I also understand average life expectation for Alzheimer is 7 years and it seems 5 years passed by.

As for thunder30101 and Ijustwannateach, the only shock for them will be the climate.

This was my wife's main concern before we built our house here, but I enjoy it more than living on the seaboard. Still many compatriots complain loudly when temperature home country reaches 25C

If they find 33C hard to bear and dislike airco I will be in trouble.

What I don't get thunder30101 is: Why should I be doing this for myself???

Edited December 14, 2009 by tartempion

[harrry]

I think here is the better place for them. YOu may need to get some one to watch them more than 8hrs a day but this will not be hard as most thais are very good at looking after their older people. You do not need a trained nurse to do this. That way if there is a tendancy to wander it is easier to stop them. Also get a very hard to remove bracelet with contact info engraved in Thai.

Good luck.

Edited December 14, 2009 by harrry

[alfieconn]

What I don't get thunder30101 is: Why should I be doing this for myself???

Yes,must admit didn't understand either, but you must remember that on TV there's always someone who will be negative with peoples good ideas.

Anyway good luck and i'm sure everything will work out fine with perhaps a few little hiccups along the way.

[jaideeguy]

Tart,

It sounds like you have done your homework and have some idea of what you are in for, but THERE WILL ALWAYS BE SURPRISES in this business. Maybe a good idea to check with medicl professionals before they get on the plane. Don't know if Alzheimers' sould come under medical or phychological??

I'm off to town in a few minutes, but upon return, I'll try to find some links that may be helpful for you....starting with building handicapped friendly and you may have other special needs with alzheimers. I heard that by simply placing the doorknob in a different position, the paitient doesn't/can't escape.

also will provide links that have been helpful for caregivers all over the world.

re: banking isssues, my friendly bank manager set me/pop up with an fixed term account that has me on as a legal entitity and I can access funds if I need and it still satisfies immigration.

As you imply, you can simulate most of the enviornment, diet and social needs here and if communication is not an issue, then less problems, but that puts you in the middle and after 3.5 yrs being in the middle has had it's toll on me, but Pop is well taken care of and not by strangers, except fot this new caregiver we just hired a month ago for 7kthb/mo and he is worth evey satang...we were lucky and hope you will be too.

later.....

[thunder30101]

Why ??? How about they are your parents and are having late life med problems, so you feel the need to step in and help, as they always did for you when you were growing up. I hope it works out for you, but be realistic, this isnt the usa. You wont find the support system here for them that they have where they are even spending tons of money. Consider your family and yourself before you commit to this, I dont think you have truly thought out the problems that will come from such a major change in their moving to a totally foreign enviroment especially with the alzheimers thrown in.

[klikster]

I strongly agree with the sentiments of harrry and a few others. Thailand and Thai care-givers seem a much better option than western nursing homes and cold weather.

A retirement home professional told me once that Alzheimers suffers often benefit from lots of walking. And walking around a Thai village seems so much more civil than ..

I also admire and respect anyone who treats their parents with so much care and respect.

[MikeyIdea]

Nothing new to add that hasn't already been said. My mother is starting to have a difficult time at home alone and I have asked her come over and stay with me in Thailand but she's not ready for it yet she says. When the day comes and she can't take care of herself alone, then I'll be happy and proud to bring her here and take care of her. I'm warming her up with a 2-month stay right now, it'll come one day

Good on you to take on taking care of your parents, you are doing the right thing for sure.

[NanLaew]

If I was in the game of sending Christmas cards, tartempion and jaideeguy would be on my list. Caring for ones parents in their twilight years when you don't live near them is also a great concern of mine. You two show much love and compassion and the obvious burdens and tribulations of such a brave move was only a secondary concern in being able to be closer to and take better care of your parent(s). Life isn't supposed to be easy!

I have also considered this option and like tartempion, my wife suggested it would be better if my parents stayed with us. My father is 84 and still has his druthers and likes computers and the internet more than the telly. Mum is 6 years younger but she has taken some more hits health-wise and the amount of prescription drugs that the NHS foists off on her is beyond belief. I recall a friend of mine who's aging mothers eyesight was pretty much written-off by the UK doctors due to ocular degeneration. He took her to the US for a holiday and despite the costs, got a 'second opinion' from specialists and as far as I am aware, 6 years after the doom & gloom forecasts, through correct medication and more importantly, correct diet, she still has pretty good eyesight. One of the things I would do first is get the 'second opinion' at the likes of Bamrungrad but the fact that experienced geriatric medical care seems a bit of a nonentity here is a worry. If there's no depth of medical knowledge and experience in elderly health issues, what hope for a correct diagnosis? Her medications are free on the NHS but even with the cheaper prices here, that would still be something to budget for.

I live in Udon where the weather right now would be absolutely perfect for them (being Scottish). However, the rigours of April heat would need some careful planning. Having airconditioning may not be the total answer; may do more harm than good as much of mums problems are bronchial and having lived without airconditioning, excessive heat and humidity for 70-odd years, the changes may be too hard to handle. The house is single-level and relatively open-plan so no worries about trips and falls here.

Mum is a vegetarian so there wouldn't be any major drama with dietary needs. Dad eats what I eat and I can get that locally too, so similarly not a big problem. I would worry about language and some social interaction as it's "All Isaan, All the Time" at my place and I would be away for several weeks at a time. However, I am just outside the ring-road so popping in to town isn't a major trip... just what to pop in to do? The mall? The pub? My parents live in a small village and the weekly shopping trip on a Thursday morning is enough for them and they haven't been in the pub for years. I can see my mum down the Nongbua market though.

Thanks for the post! As you see, it's got me thinking again.

And good luck too!

[ronz28]

I am no lawyer but you might need guardianship rather than only a power of attorney so they will not be conned by a gypsy and have the ability to sign checks and contracts in favor of a con artist running a sweetheart con. I know of caregivers that have stolen checks from the checkbooks, jewelry and gotten "loans" from the elderly even under usual and customary supervision in the US. Some elderly don't even keep a check register, trusting the bank but the bank is not the problem its the checks they aren't sure if they wrote or not. Checks aren't even returned with statements anymore. Also, do you have a back up plan for them if you are killed in Thailand? Sorry that sounds harsh but they will be targets for certain predatory thieves where ever they are.

[yabaaaa]

3.5 yrs ago I did that with my [then] 87 yr old father with osteoporosis and a broken hip as his only other options were to go into an 'old folks institution' and watch his pension and social security disapear and lead a miserable lonely life. He was fully insured and of sound mind when after 6 months here he comitted to stay and dropped his insurance.

He has had several fractures since then and the Thai private medical system has taken excellent care of him and he is ahead of the $game so far by paying out of pocket.

I have been the primary caregiver [with the support of my wife as back-up] and was approaching 'caregiver's burnout' [it is the hardest job I've ever had], but luckily before I crashed and burned, we found a great caregiver that gives me relief for 9 hrs a day and I can now have some quality time with Pop, as he is now bed bound and needs constant attention and I was spread too thin to do the job with a good attitude, which is the first requirement of a caregiver.

The immigration issue was not a problem, as you can get a temporary POA for free to represent them and the immigration officers have always been very helpful and acomodating....making it easier for my Pop's visa than mine. Bank issues, I think are the same.....one time POA is small baht and easy to get from any stationary store.

It is not an easy chore that you may be taking on and I will admit that at times, I wish I didn't take my father on, but I did offer and will see it through to the end.

If you have any more questions, send me a Pm and I will help or share my experiences and maybe cry on your shoulder when you need it.....I need it sometimes and have tried in the past to organize other falang caregivers here for a casual support group......it's reassuring to know that there are others in the same boat.

I can also share some helpful websites for caregiver support......if you want.

Best of luck and keep in touch.....

JDG

I suggest the OP pm Jaidee he will have the full experience on this probably including stuff the OP hasnt thought of.

[nakachalet]

....You wont find the support system here for them that they have where they are even spending tons of money.... I dont think you have truly thought out the problems that will come from such a major change in their moving to a totally foreign enviroment especially with the alzheimers thrown in.

thunder30101

i totally disagreed with your elaboration.... sorry!

this is one of the best example of how every male children should be brought up....

regardless of geographical, social, economical and/or cultural differences....

TARTEMPION--i for one am exemplarily proud of you, what is in your heart and how you intend to take care of your progressively deteriorating parents....

well done.... son.... many old folks like us on thaivisa would welcome you with open arms into our family any time....

if you ever need a helping hand or a shoulder to sob on.... we'll be there for you.... you are more than welcomed to email me any time.... God richest and most abundant blessings to you and your loved ones. and meanwhile wishing your family a very merry christmas as well.

[thunder30101]

No apologies needed for me, the op asked for feedback and I have honestly given it, unlike some who have never been in the position of taking care of someone and seem to make it out like its no problem. I sincerly hope if he does decide to do it things work out for him, but sticking your head in the sand and not considering all the problems this scenario will bring is not fair to him, his family here and at home, and also the parents.

[tim armstrong]

can't offer any advice; but just like to say i admire your attitude and commitment to your parents, and wish you all the best in looking after them here.

Ditto. Very commendable. The only thing I would suggest is that you find some GOOD local nurse or minder if you can - as much to give yourself a break as anything else. I wish you well.

[nonthaburial]

A wonderful story of family love and comittment, you have obvuiously sat and thought this through very diligently, however i feel there could be a weak link in your armour, that is the 100% acceptance of this move by your dear old Mum. I have been through this with my 84 year old mum who is widowed, she also suffers from this nasty affliction and she point blank turned the offer down refusing to fly. no amount of effort on my part to convince her worked. So please ensure your mum is up for this

[CrossBones]

dam_n right.... good on you!

Bring them over, get them a nurse maybe 15k per month (would be about 15k per day back home), have them enjoy their days and spend time with them.

Much respect... do it.

[slapout]

In another life and country, My wife and I cared for her mother full time for 2.5 years in our home. My business was home based and until the MIL became bedridden we could handle all the chores etc. The last 7 months when she was confined to a bed and had to be spoon fed, etc we eventually had to hire a nurse to come in for 8 hour a day. This is the only circumstance that you may want to prepare for on top of your plans and thoughts. As others have said, follow your own thoughts, ask for ideas and experience and go for it, if they (parents) agree to your proposal. To see a smile for a little act of kindness is worth the small inconveniences we have in our short life time.

[craigt3365]

Very interesting thread. I am pretty much in the same situation....except it is my Mother. My father passed away 18 months ago. My Mom is 84, legally blind, and has the start of dementia. I lived off and on with my parents for the past 4 years. Going home when Dad had to have surgery, taking a break when he was better. Now, Mom is heading downhill.

Taking care of her is a tough job. Some days are great, others are a nightmare. She is starting to get mean, and gets my Thai wife crying several times a week. We bought a house here several months ago and are in the process of moving in now. After 4 years, we needed a place to call our own. I would love to bring her over here, but she really does not want to. She is a typical American...can't imagine living anywhere else....though she did visit here 5 years ago and loved it.

I have setup her finances so I can manage them via the internet. All checks, credit cards, ATM cards, etc. are locked up in a safe at her home (along with car keys). She has a few thousand dollars in an envelope that gets her through until either I am there or my brother is there. She has no debt and pretty much everything is paid for automatically...or I pre-pay 6-12 months in advance (maid service, gardener, caregiver, trash, etc). I plan to stay with her several times a year, for a few months at a time. Otherwise, we are here. Like others have said, a break is needed from time to time.

I lucked out and got a caregiver who stops by 2 times a day to check on her and cook some meals. Only costs $400 a month. It works out great. She is able to live in her own home for now. But it won't be long until that is not possible any more...not sure what we will do then. It is a horrible situation.

I look forward to reading how others are handling this situation...