caring for an elderly falang in thailand - any experiences to share?

[Caroline Page]

Hi does anyone have experience of bringing an elderly relative over to Thailand to be cared for. My mother in law is in Australia in a residential home (low care) and has just been assess as needing to go to high care. This absolutely horrifies me as I have not found a high care facility in Perth that has the capacity to provide proper dignity based care. She is very mentally alert, no great medical problems other than being immobile (she is confined to a wheelchair)

We are therefore thinking of buying a house in our village and employing two or three full time carers to look after her (the house will be big enough for her to have one or two live in/stay overnight) . Does anyone have any experience of doing this in terms of the quality of staff that one can employ here, emergency treatment for the elderly (eg in case of heart attack or similar) or indeed if it is possible to buy specialised equipment such as hoist, disabled equipment for bathrooms etc?

Also, does anyone have any idea of cost of good quality care staff who speak some English (think MIL is too old to start learning Thai)

We live south of Hua Hin

Thanks in advance for any experiences shared - it's a great responsibilty to bring someone over of this age and just want to be sure that if it's practical that we do everything possible to make things comfortable and enjoyable for her

[NancyL]

Yes, I've known several resident expats who have done exactly what you're proposing. www.LannaCreNet.org Sometimes it works out OK, often it doesn't. In order for it work out, it's essential that you have a good relationship with your MIL, that she thinks it's a good idea to come here, and that you have good local connections. It sounds like both you and your husband are foreigners. Is there a Thai speaker who can co-ordinate the care? Someone who is top-notch, well-respected locally? Not necessarily the person who will be the actual caregiver, but someone who can recruit, train, and manage the caregivers. Someone who knows her way around the village and can tell you where to go for help.

As for medical care for MIL. Well, it's probably free or nearly free in Australia. It won't be here. Do you a good local hospital with some English-speaking doctors and nurses? A doctor who will make house calls?

As for fitting out a home. It can be done. This is where a good Thai co-ordinator can help line up tradesmen. Equipment like hoists, walk-in tubs, etc is imported and very expensive. Often they just use muscle power in caring for the elderly. If MIL is a large woman, that's going to scare off potential caregivers.

I'm in Chiang Mai, so can't tell you much about Hua Hin. Hope someone from that area will come along. Check with the high-end hospitals and nursing homes in the area. Eventually, you will need their services if you decide to bring MIL here.

Oh, just re-read your post. The cost of finding good quality Thai carers who speak Thai-accented English is much higher than you think. Here in Chiang Mai, there is a core of ladies we call upon, mostly for end-of-life care, who typically earn 1000 baht for a 12 hr shift. That's 60,000 baht/month. Most people think you can hire "some little Thai girl" for the same wages as a 7-11 clerk to do this job. Sorry, that just isn't the case, not if you want to have peace of mind that the caregiver is going to show up to work on time, we able to communicate with your MIL and be sensitive to her needs. The average 7-11 clerk type of carer is going to sit around and watch Thai soap operas while you MIL lies in bed all day, without being turned to prevent bedsores, offered water, or given any food beyond what the caregiver fixed herself for lunch.

[Caroline Page]

Thank you Nancy L. Yes, I am a foreigner but speak quite good Thai and we are lucky enough to have a qualified nurse (Thai) who we know locally who is happy to help us set things up at the beginning in terms of how to choose staff etc (and we certainly weren't thinking of the 7.11 reject route!!!!). I really appreciated your post - some of your points confirmed some things I was thinking, others brought up new points to consider which is good as want to make sure this is the right move for MIL so thank you for taking the time to respond to my post - much appreciated

[siamtwin]

Caroline:

Four years ago my Thai wife and I relocated to Bangkok from the US with our handicapped son (now 12 years old). He is confined to a wheelchair, has a trach and feeding tube, cannot talk, and requires 24 hour attention. The home health care services in the US are quite poor and unreliable, and we have found it much easier here to find and train local people to take care of our son.

During the day (7am-7pm) we have a local woman taking care of him -- she had no prior healthcare experience and my wife trained her in how to do everything necessary with our son. At night (7pm-7am) we have a group of local nurses and nurse's aides who rotate in taking care of him.

We bought a hoist from Modernform Health & Care, which also sells other medical equipment like hospital beds, wheelchairs, etc. Their website is www.modernformhealthcare.co.th, and phone is 02-722-8033-5.

We also bought a Toyota van and installed a wheelchair lift through Siam Nissin, whose website is www.siamnissin.com, telephone 02-454-1340.

Feel free to PM me if you have any specific questions and I will try to answer them for you.

[Caroline Page]

Dear Siam Twin

thank you so much for taking the trouble to respond - a number of points were so helpful so thank you

[Sheryl]

I have walked several expats here through the process of terminal care for an elder. I realize that she is not at that stage now but it will come. Be warned that this is not easy in Thailand. Custodial care at home is OK, but anything of a medical nature runs into the following problems:

1. Cost - at that age, impossible to get insurance.

2. Thailand is more than 50 years behind the times as regards palliative care. If hospitalized, may have difficulty getting wishes honored re life support and so forth and will definitely have difficulty getting hospice level care at home. The people I have assisted all had to do it themselves, and it was not easy, and the preferred drugs could not be obtained.Of course on the other hand are the incalulable benefits of her being with caring family rather than in an institution.

If she does come:

1- Self insure for major medical costs by setting aside eat least 2 million baht, preferrably closer to 5. Even if she does not want any extraordinary measures (see below) there are plenty of things that can occur that would cause pain and bad quality of life and be potentially treatable but costly.

2. Have a frank discussion with her regarding her wishes in terms of heroic measures/end of life care and if appropriate have her draw up a Thai living will (get legal assistance for this).

3. Shop around for a GP who understands the "living will" concept and is prepared to honor it (this may take some doing, it is a very new thing in Thailand).

4. Avoid having her hospitalized as much as is realistically possible, and get her discharged as quickly as possible when/if hospitalization is unavoidable (for example, if she breaks a hip, as older women often do). Even with a living will, you may have trouble getting wishes honored in a hospital setting here. Plus it will be confusing and traumatic for her to be in a Thai speaking environment like that.

[NancyL]

Oops, I realized I had a typo in the name of our organization, www.LannaCareNet.org Some good points from all the people posting.

I can't stress enough the importance of your MIL wanting to do this. I'm aware of situations where elderly people brought here in similar situations have managed to contact their embassies and claim they were brought to Thailand against their will, that their adult children are controlling their finances without their consent, that they are being exploited, ignored, or worse.

[thepool]

Have you contacted/spoken to these people?

http://www.whiteoak.com.au/professional-services.shtml

[NancyL]

There seems to be two threads running on this topic. Perhaps the mods have some magic to merge them since both have some useful information.

[Commercial HEO2 Diver]

Anda Nursing Care - [email protected]

A Super capable Nurse took excellent care of me when I was recuperating ..

The service she woks for is in Chiang Mai ... maybe one staff wants to relocate

[LukKrueng]

I had my father moved here a while back (2002). He had heart condition and was after a severe stroke. He was on a multitude of meds which were at first sent by mail from back home. After a while we found the wholesale drugstores in BKK and started buying all there - no need for prescriptions. Costs were about the same as the subsidized costs from back home.

At first he didn't need any special equipment at all, and at later stages he needed a wheel chair, and nearer to the end of his life he needed some other more special equipment - all was bought in BKK for very reasonable prices.

For normal day by day care we got a helping hand from one of the nursing agencies. Please note mostly these are not nurses, but helpers. We were lucky to get a very good person on the first attempt. She stayed with us from day one till the very end and was loving and caring. She even went with us for a visit back home after 2 years and performed very well in the month stay there.

The service is a 24/6 type of service, and extra need to be paid for the 7th day. She hardly ever took a day off (she preferred the extra day pay) and when she wanted a week off she never ever left before a replacement came and was ready to be left alone with my father - meaning both my father and I were happy with the replacement. There was a time or 2 we didn't like the replacement and the regular girl stayed till another was sent.

We paid the agency 8000 THB per month, she got about 6000 at first and later it was increased to about 6500 or 7000. Apparently the agency didn't treat her fairly, delayed her salary, were not cooperative in finding replacement when she wanted holidays and so ion - we never knew about it as she never complain. After about 5 years she got fed up with the agency and told us she will quit as soon as a good replacement will be found. When we realized what was going on, and after confronting the agency with no success, we just employed her directly and we were all happy - she got better pay (we paid her the full amount we used to pay to the agency), she used her connection to find replacement when she wanted a holiday and so on.

All the above is just to show you don't need to go to the highest expenses of employing 3 qualified nurses if no actual medical treatment needed on a daily basis,

As for hospitalization - my father was admitted twice for hear attacks - no insurance due to his age and medical condition. We used Bamrungrad and it was COSTLY, but very good treatment.

At the end of his life he was hospitalized at Bamrungrad for over a month starting with Pneumonia and then other complications due to cancer (he was given radiology treatment in the months before - after we discovered he had cancer). As he was stage 4 and basically cancer treatment would have killed him anyway, all we wanted for him was hospice facilities - pain control and comfort. This was basically not possible. I was told by a Dr that they are legally obligated to actually treat every patient. I think it is also hospital policy as they get paid for the treatment.

after a while at the hospital I managed to get them to cut out most of the treatment (heart medication - what's the point to extend his life in this stage?and the cardiologist follow up, and a neurologist that has decided to treat a 10 years old brain damage caused by the stroke - he actually promised me that within 6 months my father will gain speech ability when the oncologist's prognosis was that he had about 4 weeks to live...)

I don't know if there has been a change of attitude regarding hospice facilitation so I guess you have to check it out.

To sum it all up - bringing an elderly person in need of daily care and help with all functions is doable, and when no actual medical treatment needed it is not too costly either. But as someone above mentioned - your M/I should be willing to be here. With my father - at first he refused to even discuss it, but once I explained the other option and mainly emphasized the fact that he will be with me and the family he was happy to come and I know he never regretted his decision.

For me and my family it was also great having him here.

[slipperylobster]

My mom hit 90, and wants to stay in her house (alone). I fly there once a year for two or three months and have 3 other brothers who live close to her. Well, her wishes are granted, and we do not try to relocate her for convenience. I think, just ask you mom what she wants, as she still is metally alert. My mom worked 40 years as a nurse, and after that, private duty and home care for the elderly. She knows what she wants.

[Commercial HEO2 Diver]

Hi ..... Just got this nice reply from Anda Nursing:

Nice to read this message, it's encouraging to know that people value my work and dedication to nursing care - I really love it! So much that I have opened my own nursing care called Nonna Home Care Chiangmai. We have room for 2 more patients as I have one on the premises now. I will send the website address to you soon, it will be finished over Songkran. Thanks so much for your help !

Respectfully,

Anda

They are kind and caring ....

[NancyL]

........snip.....................

As for hospitalization - my father was admitted twice for hear attacks - no insurance due to his age and medical condition. We used Bamrungrad and it was COSTLY, but very good treatment.

At the end of his life he was hospitalized at Bamrungrad for over a month starting with Pneumonia and then other complications due to cancer (he was given radiology treatment in the months before - after we discovered he had cancer). As he was stage 4 and basically cancer treatment would have killed him anyway, all we wanted for him was hospice facilities - pain control and comfort. This was basically not possible. I was told by a Dr that they are legally obligated to actually treat every patient. I think it is also hospital policy as they get paid for the treatment.

after a while at the hospital I managed to get them to cut out most of the treatment (heart medication - what's the point to extend his life in this stage?and the cardiologist follow up, and a neurologist that has decided to treat a 10 years old brain damage caused by the stroke - he actually promised me that within 6 months my father will gain speech ability when the oncologist's prognosis was that he had about 4 weeks to live...)

I don't know if there has been a change of attitude regarding hospice facilitation so I guess you have to check it out.

.................snip....................

It is possible for a Living Will or Advance Directive to be honored here, but it's imperative that it be discussed with the doctors BEFORE care is needed. I don't know about Bumrungrad, but it is possible to set up a pallative, end-of-life care situation in Chiang Mai -- but only with the cooperation of the patient's primary care physician and involvement of one of the few pain specialists physicians. I doubt it would have been possible in 2002, though.

But, it must be done at the early stages of a diagnosis, and is rarely done. In practice what happens is either one of two paths. If the patient has money, then it's the path Luk Krueng describes where an elderly patient with a terminal diagnosis is treated (tortured) for all his health problems with pain control low on the priority list --- or--- if the patient has no money, then he's sent to the district's government hospital where he receives little to no pain control because the cause of his pain has never been diagnosed, due to lack of funds. Both scenarios are hellish.

Edited April 6, 2014 by NancyL

[slipperylobster]

Hi ..... Just got this nice reply from Anda Nursing:

Nice to read this message, it's encouraging to know that people value my work and dedication to nursing care - I really love it! So much that I have opened my own nursing care called Nonna Home Care Chiangmai. We have room for 2 more patients as I have one on the premises now. I will send the website address to you soon, it will be finished over Songkran. Thanks so much for your help !

Respectfully,

Anda

They are kind and caring ....

Are you advertising on this thread?

I have some things I need to sell, should I post them here?

Also, my gal can do homecare...and she is looking for that kind of situation. How much is the salary....?

[donmuang37]

Hi Caroline,

One reason that I have retired in Thailand (among a few others) is that the cost of nursing home care in the USA will bankrupt most people. And home health care can be even more expensive. Obviously, the quality of the care is another issue.

The two Thai young ladies who live across the street from us had to care for an elderly grandmother who needed bottled oxygen and had very restricted mobility. They hired a live-in maid, a young gal, who could cook and they trained to take care of grandma. The gal was very nice according to my Thai wife, and seemed to really take good care of the old lady. She also handled laundry and cleaning. Cost was reasonable; much less than hiring nurses. The ladies told my wife that they were very happy with the arrangement. It continued until grandma passed away. In your case, perhaps a combo of a live-in maid plus some supplementary care givers would work best.

As you probably know, health care in Thailand is quite good. It is inexpensive for routine care, but expensive for major problems if you don't have insurance. Government hospitals are less expensive, but less convenient. I recently had surgery for a torn rotator cuff, which was expensive (150,000 baht - VIP patient = head of the line) even at Thammasat University Hospital, which is an excellent government hospital. World class doctor and facilities, but long lines.

Best of luck

[gamini]

does anone know where we can buy a walk-in bath for seniors in Thailand?

[philw]

I had my father moved here a while back (2002). He had heart condition and was after a severe stroke. He was on a multitude of meds which were at first sent by mail from back home. After a while we found the wholesale drugstores in BKK and started buying all there - no need for prescriptions. Costs were about the same as the subsidized costs from back home.

At first he didn't need any special equipment at all, and at later stages he needed a wheel chair, and nearer to the end of his life he needed some other more special equipment - all was bought in BKK for very reasonable prices.

For normal day by day care we got a helping hand from one of the nursing agencies. Please note mostly these are not nurses, but helpers. We were lucky to get a very good person on the first attempt. She stayed with us from day one till the very end and was loving and caring. She even went with us for a visit back home after 2 years and performed very well in the month stay there.

The service is a 24/6 type of service, and extra need to be paid for the 7th day. She hardly ever took a day off (she preferred the extra day pay) and when she wanted a week off she never ever left before a replacement came and was ready to be left alone with my father - meaning both my father and I were happy with the replacement. There was a time or 2 we didn't like the replacement and the regular girl stayed till another was sent.

We paid the agency 8000 THB per month, she got about 6000 at first and later it was increased to about 6500 or 7000. Apparently the agency didn't treat her fairly, delayed her salary, were not cooperative in finding replacement when she wanted holidays and so ion - we never knew about it as she never complain. After about 5 years she got fed up with the agency and told us she will quit as soon as a good replacement will be found. When we realized what was going on, and after confronting the agency with no success, we just employed her directly and we were all happy - she got better pay (we paid her the full amount we used to pay to the agency), she used her connection to find replacement when she wanted a holiday and so on.

All the above is just to show you don't need to go to the highest expenses of employing 3 qualified nurses if no actual medical treatment needed on a daily basis,

As for hospitalization - my father was admitted twice for hear attacks - no insurance due to his age and medical condition. We used Bamrungrad and it was COSTLY, but very good treatment.

At the end of his life he was hospitalized at Bamrungrad for over a month starting with Pneumonia and then other complications due to cancer (he was given radiology treatment in the months before - after we discovered he had cancer). As he was stage 4 and basically cancer treatment would have killed him anyway, all we wanted for him was hospice facilities - pain control and comfort. This was basically not possible. I was told by a Dr that they are legally obligated to actually treat every patient. I think it is also hospital policy as they get paid for the treatment.

after a while at the hospital I managed to get them to cut out most of the treatment (heart medication - what's the point to extend his life in this stage?and the cardiologist follow up, and a neurologist that has decided to treat a 10 years old brain damage caused by the stroke - he actually promised me that within 6 months my father will gain speech ability when the oncologist's prognosis was that he had about 4 weeks to live...)

I don't know if there has been a change of attitude regarding hospice facilitation so I guess you have to check it out.

To sum it all up - bringing an elderly person in need of daily care and help with all functions is doable, and when no actual medical treatment needed it is not too costly either. But as someone above mentioned - your M/I should be willing to be here. With my father - at first he refused to even discuss it, but once I explained the other option and mainly emphasized the fact that he will be with me and the family he was happy to come and I know he never regretted his decision.

For me and my family it was also great having him here.

Very much like your comments and attitude.

Well done and it's encouraging to hear and learn from a caring person who has been through the effort, experience and worry.

Thanks for sharing the info and experience.

Phil

[glegolo]

Would appreciate to be informed that posts are taken away, thanks for that!! I wanted to give another perspektive of this situation. A situation where local thais will observe how falang treat their elderly. Letting them live alone in a house a stonethrow away. Not letting them stay together at old age... I did just wonder how the thais will react.....

Glegolo

Edited April 6, 2014 by glegolo

[siamtwin]

Would appreciate to be informed that posts are taken away, thanks for that!! I wanted to give another perspektive of this situation. A situation where local thais will observe how falang treat their elderly. Letting them live alone in a house a stonethrow away. Not letting them stay together at old age... I did just wonder how the thais will react.....

Glegolo

Glegolo

Who cares what the local Thais think? This person has to decide what's best for the MIL and the family. Appearances hardly matter in such a situation.

Sent from my iPad using Thaivisa Connect Thailand

[pauleddy]

This is one of the most important threads on TV for anybody who is staying here long-term.

I have a medical background and a background in hospital administration. One of my close friends is a senior nurse in Palliative Care in the UK. He knows far more than I do.

If you are getting older, or have a relative here, then you really must devote some thought to this.

To die suddenly from cardiovascular disease may be a blessing. To linger with cancer, multiple sclerosis or any other debilitating disease ALWAYS results in secondary (and very uncomfortable) conditions such as urine infections, bedsores, hypostatic pneumonia with hypoxia (one reason for confusion, among many), muscle-wasting, poor nutrition, constipation...and many other things.

McMillan and other agencies in the UK or the West have now honed end-stage care to a fine art and science. My uncle, after several amputations, diabetes and other things, died peacefully last year in a UK hospice. The nurses had brought him a nice gin-and-tonic, his favourite, from the free drinks trolley, Cadbury's chocolate too... and he could control how much morphine he needed by pressing a button on his IVI. The family were with him, and he had no pain.

My observations of Thailand seem to bear out some comments on this thread. Doctors at Bumrungrad get paid more for zapping your cancer with painful lasers and chemo which makes your hair fall out and makes you vomit all day. Village girls, even those with the best intentions, are not trained. Even university-trained nurses are good at taking your blood and being technically adept, although may not understand end-stage care. Old fashioned nurses knew how to make you comfortable.

Perhaps this is tied up with Buddhism i.e. Never Kill Anything and All Life Consists of Suffering and, well, It's Your Karma. Just my opinion.

Refreshing to see that one or two people have experience of end-stage care, but unless you are very rich and you are lucky enough to have an understanding doctor, you need to get all of your little ducks in a row in advance. Or, hope that you keel over in three seconds.

In the West, we think that we will go to a nice free hospital and that nice doctors and nice nurses will cure us or help us to pass away nicely and comfortably. Here, it might be lonely, painful and uncomfortable.

Eddy

[philw]

"Here, it might be lonely, painful and uncomfortable."

Change the "might" to probably and you will be a lot closer to the truth methinks.

[ableguy]

Yes, I've known several resident expats who have done exactly what you're proposing. www.LannaCreNet.org Sometimes it works out OK, often it doesn't. In order for it work out, it's essential that you have a good relationship with your MIL, that she thinks it's a good idea to come here, and that you have good local connections. It sounds like both you and your husband are foreigners. Is there a Thai speaker who can co-ordinate the care? Someone who is top-notch, well-respected locally? Not necessarily the person who will be the actual caregiver, but someone who can recruit, train, and manage the caregivers. Someone who knows her way around the village and can tell you where to go for help.

As for medical care for MIL. Well, it's probably free or nearly free in Australia. It won't be here. Do you a good local hospital with some English-speaking doctors and nurses? A doctor who will make house calls?

As for fitting out a home. It can be done. This is where a good Thai co-ordinator can help line up tradesmen. Equipment like hoists, walk-in tubs, etc is imported and very expensive. Often they just use muscle power in caring for the elderly. If MIL is a large woman, that's going to scare off potential caregivers.

I'm in Chiang Mai, so can't tell you much about Hua Hin. Hope someone from that area will come along. Check with the high-end hospitals and nursing homes in the area. Eventually, you will need their services if you decide to bring MIL here.

Oh, just re-read your post. The cost of finding good quality Thai carers who speak Thai-accented English is much higher than you think. Here in Chiang Mai, there is a core of ladies we call upon, mostly for end-of-life care, who typically earn 1000 baht for a 12 hr shift. That's 60,000 baht/month. Most people think you can hire "some little Thai girl" for the same wages as a 7-11 clerk to do this job. Sorry, that just isn't the case, not if you want to have peace of mind that the caregiver is going to show up to work on time, we able to communicate with your MIL and be sensitive to her needs. The average 7-11 clerk type of carer is going to sit around and watch Thai soap operas while you MIL lies in bed all day, without being turned to prevent bedsores, offered water, or given any food beyond what the caregiver fixed herself for lunch.

Sixty k a month for a nurse, you must be joking you could get a dr for that.

[benalibina]

Yes, I've known several resident expats who have done exactly what you're proposing. www.LannaCreNet.org Sometimes it works out OK, often it doesn't. In order for it work out, it's essential that you have a good relationship with your MIL, that she thinks it's a good idea to come here, and that you have good local connections. It sounds like both you and your husband are foreigners. Is there a Thai speaker who can co-ordinate the care? Someone who is top-notch, well-respected locally? Not necessarily the person who will be the actual caregiver, but someone who can recruit, train, and manage the caregivers. Someone who knows her way around the village and can tell you where to go for help.

As for medical care for MIL. Well, it's probably free or nearly free in Australia. It won't be here. Do you a good local hospital with some English-speaking doctors and nurses? A doctor who will make house calls?

As for fitting out a home. It can be done. This is where a good Thai co-ordinator can help line up tradesmen. Equipment like hoists, walk-in tubs, etc is imported and very expensive. Often they just use muscle power in caring for the elderly. If MIL is a large woman, that's going to scare off potential caregivers.

I'm in Chiang Mai, so can't tell you much about Hua Hin. Hope someone from that area will come along. Check with the high-end hospitals and nursing homes in the area. Eventually, you will need their services if you decide to bring MIL here.

Oh, just re-read your post. The cost of finding good quality Thai carers who speak Thai-accented English is much higher than you think. Here in Chiang Mai, there is a core of ladies we call upon, mostly for end-of-life care, who typically earn 1000 baht for a 12 hr shift. That's 60,000 baht/month. Most people think you can hire "some little Thai girl" for the same wages as a 7-11 clerk to do this job. Sorry, that just isn't the case, not if you want to have peace of mind that the caregiver is going to show up to work on time, we able to communicate with your MIL and be sensitive to her needs. The average 7-11 clerk type of carer is going to sit around and watch Thai soap operas while you MIL lies in bed all day, without being turned to prevent bedsores, offered water, or given any food beyond what the caregiver fixed herself for lunch.

Sixty k a month for a nurse, you must be joking you could get a dr for that.

30 k a month....12 hr shift....a day has 24 hrs....2 nurses.....2×30=60. This according to above posters logic.

[thepool]

<script type='text/javascript'>window.mod_pagespeed_start = Number(new Date());</script>

Yes, I've known several resident expats who have done exactly what you're proposing. www.LannaCreNet.org Sometimes it works out OK, often it doesn't. In order for it work out, it's essential that you have a good relationship with your MIL, that she thinks it's a good idea to come here, and that you have good local connections. It sounds like both you and your husband are foreigners. Is there a Thai speaker who can co-ordinate the care? Someone who is top-notch, well-respected locally? Not necessarily the person who will be the actual caregiver, but someone who can recruit, train, and manage the caregivers. Someone who knows her way around the village and can tell you where to go for help.

As for medical care for MIL. Well, it's probably free or nearly free in Australia. It won't be here. Do you a good local hospital with some English-speaking doctors and nurses? A doctor who will make house calls?

As for fitting out a home. It can be done. This is where a good Thai co-ordinator can help line up tradesmen. Equipment like hoists, walk-in tubs, etc is imported and very expensive. Often they just use muscle power in caring for the elderly. If MIL is a large woman, that's going to scare off potential caregivers.

I'm in Chiang Mai, so can't tell you much about Hua Hin. Hope someone from that area will come along. Check with the high-end hospitals and nursing homes in the area. Eventually, you will need their services if you decide to bring MIL here.

Oh, just re-read your post. The cost of finding good quality Thai carers who speak Thai-accented English is much higher than you think. Here in Chiang Mai, there is a core of ladies we call upon, mostly for end-of-life care, who typically earn 1000 baht for a 12 hr shift. That's 60,000 baht/month. Most people think you can hire "some little Thai girl" for the same wages as a 7-11 clerk to do this job. Sorry, that just isn't the case, not if you want to have peace of mind that the caregiver is going to show up to work on time, we able to communicate with your MIL and be sensitive to her needs. The average 7-11 clerk type of carer is going to sit around and watch Thai soap operas while you MIL lies in bed all day, without being turned to prevent bedsores, offered water, or given any food beyond what the caregiver fixed herself for lunch.

Sixty k a month for a nurse, you must be joking you could get a dr for that.

Do it !

You may if lucky get one who will not work 24/7 !

[jcnbkk]

Blessings and prayers to all that go through this, and too those that provide help.

[1FinickyOne]

Much of your situation in regards to getting proper in home care will be a crap shoot but that will happen anywhere - at least here it will be less expensive for round the clock care.

Having been through the mill with 2 dementia afflicted parents, much of the need is dependent upon the personality - my mother surely needed to be watched 24/7 as she had no idea of time and no vision and would forget that she couldn't walk and would fall and break bones. And she was the easy one. My father was impossible, uncooperative abt everything and capable of physical violence.

As I am sure you know, do not forget that as they age, any conditions will get worse and require more care. We were lucky to have a fantastic team of helpers in their home 24/7 - and eventually still, they needed a nursing home for their last few months… sometimes there are no good choices. I think it is likely you will do better here than most places in the Western world, which is not to say it will be perfect. Good luck to you. It is not easy stuff.

[glegolo]

Would appreciate to be informed that posts are taken away, thanks for that!! I wanted to give another perspektive of this situation. A situation where local thais will observe how falang treat their elderly. Letting them live alone in a house a stonethrow away. Not letting them stay together at old age... I did just wonder how the thais will react.....

Glegolo

Glegolo

Who cares what the local Thais think? This person has to decide what's best for the MIL and the family. Appearances hardly matter in such a situation.

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Just wanted you to see what other cultures might see. For me you can do what you like to do, take your culture into the deepest village in Thailand and treat your elderlys like you do back home, and the only answer you have is that you do not care what other people think.... plain stupid......

Have a parent living there, good..... But dont let her live too close, and by far do not absolutely let her live in the same house as yourself........ Good thinking and acting..... and believing that you will be respected after that...... hahahahahaha......

Glegolo

[siamtwin]

After your eloquent response, Gigolo, I see your point and now agree with you.

It was the "hahahaha" part that clinched it for me.

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[pauleddy]

Good post KenK.

You were lucky to have good care. Was it in Bangkok?

You are right: it can be a struggle anywhere. A normal geriatric ward in the UK may be understaffed as well. You might just pull it off here if you have good nurses plus hoists, baths and aids. There needs to be paperwork, like a care plan, which the nurses can refer to. Drugs need to be given at certain times, etc etc. For the final days, it can be really bad, so you need a nursing home (not just a care home).

Good luck to all who are facing this, now and in future.

I started my hospital career in 1972, and I have seen many deaths. I attended my first post-mortem when still a student. The young should not have to worry about end-of-life care (rightly). But, as time ticks by, the passing gets nearer.

If it is of any consolation, the doctors and nurses in hospices are among the funniest, happiest people I have ever met!

Eddy