Good care-home or live-in nurse?

[Korat88]

I hope someone with some experience can help with this query. I am in the difficult position (difficult in letting her go into someone else's care when I promised I would never do that to her!) of trying to do what is best for my mother which is probably to let a good home with registered nurses take care of her as my wonderful wife has gone as far as she can with looking after her mother-in-law . My mother has been at our house in Korat for just over two years now and each month gets harder and harder for my wife. She now has to deal with her like she would a baby and change her at least three times a day and clean up after any accidents. She now wears adult diapers all the time. It is a cruel disease as it is bad for the person afflicted and the carers. I have to think about my wife too, she has a life as well.

So... Does anyone know of any home in or near Korat that would be able to cope with an Alzheimer's patient in her mid 80's? A live-in nurse is another option if that fails however I think my wife needs her life back so the former option would probably be the most appreciated. Since I work in Bangkok a home in the city may also be an option. I have heard of Golden Years in Bangkok http://www.goldenyears.co.th/en/ before but have no idea about any other options and need to see what costs are like at different places so any advise or experiences would be welcomed. I will post this on the Isaan Forum too in the hope that more people with some useful feedback will see it. Thank you for any assistance. We, especially my wife, would really appreciate any help.

Nick

[NeverSure]

I don't know the answers. What a sad, sad place you and your family are in. You have my utmost admiration for your care and concern for your mother and your wife.

I truly hope you find a good answer. My best to you and your family. You're a good man.

[asdecas]

You've probably tried this already, but googling "alzheimer's care in thailand" will bring up several leads for you to follow.

Good luck to you and your family, Nick.

[craigt3365]

Can't really help with a home in Korat, but I'm in exactly the same situation. Unfortunately, this disease, at least stress wise, is much harder on the caregivers than on the patient. We're almost at a breaking point too.

Not sure of all the conditions of your mother, but mine is starting to get combative, angry, mean. She seems to have sundowners syndrome. Ting tong time is cocktail hour. And it's bizarre to put it mildly. She's also into her poop. Amazing the places we find it.

Why don't we leave this thread here for a few days, then move it over to the Issan forum for comments over there. My wife is from Korat and we have many relatives there. I'll see if any have heard of a nursing home. I've run across some here in the Pattaya area. More and more are opening all the time. Several are oriented towards Thais, so it's hard to find them as they are not on the internet in English. Here's one I just found. We're headed there next week to have a peek.

http://www.zbreeze.net/#

[peterpop]

There are good care homes for ex pat alzheimers patients in Chiang Mai. Probably not much help but if your mother is unaware of her surroundings it may be OK. Not cheap, around Bht 30k pm.

[kuifje]

I know this is hard. In the same situation with my mother in law.

[AsiaCheese]

There's a place north of Buriram that advertises as a care-for-the-elderly home. Don't take her there: I personally know several people who fled the place...

Chapeau to your wife - really nice! And best wishes to your mom, and to you finding an adequate place.

Edited June 12, 2014 by AsiaCheese

[mkmike]

I can fully appreciate the situation you are in and you have my sympathy, my mother who is now 86 developed Alzheimer's in the UK six years ago and we decided to bring her out here. By the end of last year she had become to difficult for myself and my wife to look after and we found ourselves in a very similar situation as you.

We live in Ratchaburi and we managed to find a couple of care homes local to us, the one we chose is small, there are only 5 residents, but it is well run by a registered nurse. It is light and airy and clean but most importantly the staff are kind and caring. My mum has now been there seven months and her general health has improved. I must admit I did not hold out a lot of hope in finding somewhere suitable when we started looking but I was pleasantly surprised. The costs are very reasonable and easily covered by her pension from the UK.

She requires round the clock care and uses adult nappies and must be fed, all things that we tried to do for her but it became a huge strain on our relationship, since she has been in the home our life has returned to normal and we are still able to visit her every day. I really wish you the best of luck in finding a home for her it will improve your life and that of your mother I suspect.

[slipperylobster]

I cannot direct you, in Thailand, to those services.

However, I do sympathize with your loyalty to your mom. My wife's mom just passed away, after 15 years as a parapelegic and alzheimers. My wife took care of her for most of the time and then her sister recently took over. She died 3 days ago, and had 400 friends/family present at her services. The family loyalty was beyond belief.

My mom in the States, was just admitted to a Nursing Home (very high class), by my older brother. She wanted to stay home, but all three of the sons were having difficulties with jobs and family pressures, and could only visit sparingly. She was 90, and unable to attend to herself anymore. We had her evaluated, in a hospital, for a week...and went on with recommendations. It looks like her care will be 45,000 usd a year...for 3 years, before Medicare takes it over. Fortunately, she has assets, and they may cover most of the initial expenses. My mom is very happy now, and is actually thinking much more clearly. She enjoys the care and companionship

Lucky you, Thailand must have more affordable.

As you can see...there are two alternatives. When family care becomes undo-able, Nursing Facilities/Professional Caregiving...becomes a viable option. As long as you visit her and ensure she is being cared for...it is all good. If stress within the family makes it overly difficult...choosing help outside is the right thing to do.

[SantiSuk]

My sympathies - my two sisters and I had a year of taking turns in looking after my father, then with a live-in-nurse and then at a specialist nursing home for my mid eighties Dad. This was all in the UK.

I'm afraid that I have no knowledge to answer your specific question about resources here in Thailand. It is likely that your MIL is already past the point where a live-in nurse is the best answer. That would be particularly the case if she is a night waker/walker. It is always tempting to keep a close relative at home as long as you can but we decided after it was all over that we should probably have made the move to a home a bit sooner than we did - my Dad had long-since stopped getting any benefit himself from being in familiar surroundings and with familiar people (ie he was not cognisant).

An ordinary nursing home is unlikely to have the skills or routines to treat an Alzheimer's patient at a relatively advanced stage and your wife is likely to get distressed when she sees the level of care. The fact that they may appear not know where they are does not make it any easier on the family.

Best of luck and do post any experiences you have with nurses or places. I'm hoping my mother's genes will interfere with my father's - as both he and his two brothers died from dementia in their mid eighties - so I might need the references myself in twenty years time.

Edited June 12, 2014 by SantiSuk

[dotpoom]

I don't know the answers. What a sad, sad place you and your family are in. You have my utmost admiration for your care and concern for your mother and your wife.

I truly hope you find a good answer. My best to you and your family. You're a good man.

Amen the that....... Your family are in my prayers.

Edited June 12, 2014 by dotpoom

[Justanotherpassword]

All right, I should say to you first you and your wife need a vacation. Health care professionals call it "respite" and it truly is necessary. Is mother on Excelon? It truly helps. It costs about 5K a month here. A "clinical" dose will cost 10K. I have cared for a father and now a spouse with this disease. I found a live in caregiver to attend so that I can be "out of the house." If I may make the suggestion as your mom is an "elder" that she have a "younger sister" to attend to her, sing with her, care for her and stay where you and your wife can see her most days in your home. Recruit a nice young lady from a Thai massage studio who can give mother a foot massage, face massage, etc on alternate days and keep her distracted in a calm place. One of the miracles of Thailand is that young people consider caring for elders to be a necessity and you should take advantage of their natural kindness.

The point is, mother is in a lost place, and if she ever seems angry or short tempered it is because she resents not being able to find her way out. If you cannot have a Thai "live in" have a Thai nearby to assist your wife fully with the care of mother. If mother is too "lost" and does not recognise you any more your promise to her to keep her at home is pointless as she can no longer recognise home. Your home may still be the best place for her, but she should never be alone and no one person can have charge of her 24/7.

It then comes down to what you do not regret doing later. You did not mention, but I presume your wife is Thai. She may find it impossible to live with herself letting someone else take full care of her mother in law. Remember too, how considerate you act toward mother at this jucture may well determine how others act toward you upon the day you are more work than pleasure to be around. That Karma is something!

[belg]

ask yourself, do you want to go to an age where you dont know who you are or where you are ? I hope before that time to check out meself or have some kind of will that states if i lost it, they could help me in...

not intented to troll or anything, honest question

[davidmann]

IV SEEN OAP run my the catholic church in Udon thani on the main road to nong khai i think

[johnnyw]

I have a smilar problem with my father in Hua Hin, I really feel for everyone out there dealing with this problem - it really is soul destroying to see someone very close to you become a different person. At the moment we can handle dad with a full time carer but thats coming to an end so my search for a good care home is on.

Thoughts with all of those in the same situation.

[Sheryl]

You have my full sympathies. My father had Alzheimers so I know exactly what you face.

I am not aware of any homes in Issan. There probably are some small ones but there is no listing of them - nursing homes are not required to register with the government in Thailand so there are many small places scattered about and no central listing. And, as that situation would suggest, quality is all over the map as there is no regulation or oversight.

Any places in Issan, in addition to being hard to locate, would probably be all Thai and you have to consider the additional confusion and stress she would face being in a non-English speaking environment.

there are some care homes catering to farang but located mostly in Chiang Mai and other "farang hotspots".

in Bangkok, I have heard good things about Golden Years.

The other option would indeed to get live in help and that is what most people do in Thailand. It will likely cost the same or less and you won't have to worry about whether she is being well cared for as it will be directly under your eye, plus it will be less unsettling for her. Alzheimers patients do not do well when moved into a new environment as they can't form new memories and thus never believe it is where they live, and keep thinking they are in the wrong place and trying to leave. In the later stages of Alzheimers when someone is no longer ambulatory or aware of their surroundings this doesn't matter of course, but prior to then it is a factor.

For a care taker, a nurses aide would be perfect. (You definitely do not need an actual nurse). You can ask around at local hospitals, but in addition to talking with their nursing departments, go into the ER and OPD areas and chat up the nurses to put the word out. The private hospitals will often not provide you with names because they'll want you to hire through them at considerable added cost, the government hospitals will be more amenable. You could also ask at St. Mary's as I think they are non-profit.

It will take a while to find someone -- word of mouth being the best thing, but you could also advertise in local papers -- but once you do life will improve greatly.

That or Golden Years in Bkk would be my suggestion. Good luck.

[craigt3365]

Excellent post, Sheryl.

This thread spurred me on, so I visited that place I listed above. It's actually very, very nice. With different levels of rooms/care. I think shared rooms are around 30/month. Small private room is 40k. Very large private room is 50k. With the latter, the nurse is with the patient 24/7 as it's big enough for the extra person. The owner speaks very good English. And will also accommodate varying terms of stays from 1 day to ????. I think 2k per night.

We spent an hour talking about Alzheimers. They are well aware of all the problems and it didn't faze them when I said mom plays with her poop and smears it all over everything. They said they've got an Alzheimers patient now, farang, and that's what she also does. She also roams around 24/7, so requires constant supervision. My mom roams constantly also.

They have daily activities, get them to help with cooking and cleaning (if desired). Sing to them, play music for them, games, etc. Very, very nice staff.

It's a big decision. My mom is still relatively aware of her surroundings. If she wasn't, I'd choose this option tomorrow.

Best of luck. As Sheryl mentioned above, maybe stop by the local hospital and see if they know a facility? Some of the nurses might actually be working at these facilities. The lady at the place here says that's where she gets her help from.

[ROB58]

My sympathies to you and your family.

Problem with a lot of places I learned about is that they usually cater to a certain nationality. So, there's an Alzheimers care in Chiangmai for Scandi patients, but the service must be very good. Lotuswell in Huahin is German, etc. Maybe Care Resort Chiang Mai might be international.

I came across this one in Pattaya: Absolute Living - http://www.absolutelivingthailand.com/aboutus.php The location is a bit outside and very quiet/peaceful. I know they just opened and are at the moment extending their offers. They are preparing special Alzheimers care and definitely seem to have the heart at the right place.

Good luck! It would be great of you could share your findings here.

Rob.

[grabitanrun]

My sympathies are with you, my mother passed away last year after several years with Alzheimer's, it was difficult to deal with, we too had to eventually use a care home, which cost over £3k per month here in the UK.

I hope you find a good home, it's a terrible decision to make but I truly understand the strain of caring 24/7. I'm moving to my house on the outskirts of Pattaya in a few years and given that I've now seen Alzheimer's in 2 generations of my family, I will be searching out a home in case I fall to this disease as I won't want my wife having to try to deal with it.

[craigt3365]

My sympathies to you and your family.

Problem with a lot of places I learned about is that they usually cater to a certain nationality. So, there's an Alzheimers care in Chiangmai for Scandi patients, but the service must be very good. Lotuswell in Huahin is German, etc. Maybe Care Resort Chiang Mai might be international.

I came across this one in Pattaya: Absolute Living - http://www.absolutelivingthailand.com/aboutus.php The location is a bit outside and very quiet/peaceful. I know they just opened and are at the moment extending their offers. They are preparing special Alzheimers care and definitely seem to have the heart at the right place.

Good luck! It would be great of you could share your findings here.

Rob.

I checked with these guys. A bit pricey at 120k/month for Alzheimers patients, but offering a 30% discount now, with higher discounts being offered for longer stays. The largest room type is required for Alzheimers patients.

The contact did say there was an governmental Alzheimers organization, one which she'd put us in contact with when we stopped by. Which we hope to do in a few days. Very interesting.

[sailor59]

My father past away 2 months ago suffering from Alzheimer's and i know what it is like because we kept him at home

and my mother went up her own Golgotha with the help of my thai wife.

Every day i go to his grave and ask for forgivenes because i think there could be so much

more i could do and i didnt, but the truth is that there is nothing anyone can do but give his love and understanding.

And most important, they will most certainly forget you But you must Never Forget them!

I wish you and your family the best!

[1FinickyOne]

Sorry for your problems - I had 2 alz parents in USA and the laws are a big problem. Be thankful you are out from under the bureaucracy and have to only deal with the insidious nature of the disease. And your wife should not be burdened with this. I know it feels awful to put your mom in a home, but caring for alz patients is above and beyond one persons ability. The best care is what you owe your mom, not necessarily doing it all yourself, which is impossible.

Just compare pricing and make your decision that way.

My dad did not want to go in a home and we struggled to keep him at home - he eventually became too much for even the magnificent 24/7 care we had. He needed professionals to medicate and deal with him. I am sure your mom would want you to live your life too… best of luck to you and all my sympathy.

[Korat88]

Thank you so much for all your amazing replies. Much appreciated whether offering suggestions or just sharing experiences and offering support. I will look into some of the leads and see what develops. I did actually check out Absolute Living and it was too pricey for my budget or mother's savings, so I did not pursue the idea any further. Your lead in Pattaya (zbreeze) is much appreciated craigt3365 and the personal recount of your experience is very helpful to many I am sure. If I was nearer Pattaya I would be down there tomorrow to check it out and see for myself. It would be nice for my mother to be nearer me or my wife so we can visit though. I would feel so guilty moving her far away from anyone who can visit even if it is an amazing place as per your report. Sounds like it! Golden Years seems possible at the moment but they are full at the moment. I can fund mother's stay on top of the very minor monthly income she gets from her pension and moderate rent from a house in the UK she still owns. I will keep the thread updated with progress but once again am truly touched by the support and kind comments from all of you. Some of you have had a much harder time than my wife by the sounds of it so I have nothing but admiration and respect for all who have family members in such a condition and are taking care of them.

[asdecas]

As a follow up to my earlier post, here are a few links (in Thai) that might lead you somewhere useful. Assuming you do not read Thai, you can get a (poor) automatic translation using a Chrome browser, or if your wife is Thai, she can read them to you:

https://www.google.com.ph/search?q=%E0%B8%9A%E0%B9%89%E0%B8%B2%E0%B8%99%E0%B8%84%E0%B8%99%E0%B9%81%E0%B8%81%E0%B9%88&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-GB:official&client=firefox-a&channel=sb&gfe_rd=cr&ei=Qk6aU6HLEeaK8QeStoC4BA

http://www.maneeyaseniorhome.com/

http://www.eldercarethailand.com/

[craigt3365]

Wow! Great info. Especially the last one. Thanks!!

[ROB58]

My sympathies to you and your family.

Problem with a lot of places I learned about is that they usually cater to a certain nationality. So, there's an Alzheimers care in Chiangmai for Scandi patients, but the service must be very good. Lotuswell in Huahin is German, etc. Maybe Care Resort Chiang Mai might be international.

I came across this one in Pattaya: Absolute Living - http://www.absolutelivingthailand.com/aboutus.php The location is a bit outside and very quiet/peaceful. I know they just opened and are at the moment extending their offers. They are preparing special Alzheimers care and definitely seem to have the heart at the right place.

Good luck! It would be great of you could share your findings here.

Rob.

I checked with these guys. A bit pricey at 120k/month for Alzheimers patients, but offering a 30% discount now, with higher discounts being offered for longer stays. The largest room type is required for Alzheimers patients.

The contact did say there was an governmental Alzheimers organization, one which she'd put us in contact with when we stopped by. Which we hope to do in a few days. Very interesting.

Hi Craigt3365,

That seems a bit pricey (-30% doesn't sound too bad), but I believe they offer a one-one care as well for Alzheimer patients. Not sure how many hours a day that includes though.

Please share what you think after your visit.

[Korat88]

All right, I should say to you first you and your wife need a vacation. Health care professionals call it "respite" and it truly is necessary. Is mother on Excelon? It truly helps. It costs about 5K a month here. A "clinical" dose will cost 10K. I have cared for a father and now a spouse with this disease. I found a live in caregiver to attend so that I can be "out of the house." If I may make the suggestion as your mom is an "elder" that she have a "younger sister" to attend to her, sing with her, care for her and stay where you and your wife can see her most days in your home. Recruit a nice young lady from a Thai massage studio who can give mother a foot massage, face massage, etc on alternate days and keep her distracted in a calm place. One of the miracles of Thailand is that young people consider caring for elders to be a necessity and you should take advantage of their natural kindness.

The point is, mother is in a lost place, and if she ever seems angry or short tempered it is because she resents not being able to find her way out. If you cannot have a Thai "live in" have a Thai nearby to assist your wife fully with the care of mother. If mother is too "lost" and does not recognise you any more your promise to her to keep her at home is pointless as she can no longer recognise home. Your home may still be the best place for her, but she should never be alone and no one person can have charge of her 24/7.

It then comes down to what you do not regret doing later. You did not mention, but I presume your wife is Thai. She may find it impossible to live with herself letting someone else take full care of her mother in law. Remember too, how considerate you act toward mother at this jucture may well determine how others act toward you upon the day you are more work than pleasure to be around. That Karma is something!

[Korat88]

Justanotherpassword - I checked the medication my mother is on and it is not "Excelon". She has been prescribed "Reminyl 8mg" & "Ebixa 10mg". Around the same cost but different. I wonder whether others on this thread have been using Excelon or Reminyl + Ebixa. Many thanks for any feedback about this particular matter. I am sure it will help others who find this thread in future. Best wishes - Nick

[cmsally]

You have my utmost sympathy. We have been in the same situation until last March when my mother passed away. We looked after her for just over 2 years and it was very very tough. Although my mother was totally totally out of it there were some amazing moments and elements of clarity. For me that was enough to rule out putting her into any sort of care.

Unfortunately she couldn't remember anyone apart from me, although she would have awareness of people being familiar if she saw them every day. That makes it very difficult to change surroundings and people. Routine seems paramount and reassuring, my mother also liked to read and seemed to hold onto that ability, even though she couldn't really process speech later on.

A lot of confusion is often caused by not knowing how to figure things out. She would tend to obsess about things and maybe look for them. So we would write notes - for example saying a,b,c had been put away carefully in the office and locked up so no need to look for them. What ever the" theme" of the moment was, we would try and have a note to cover it. A lot of the time reading would be clearer to her than having someone talk to her.

Sometimes you have to devise a strategy to stop the agitation - especially in the evening crazy hour. Often talking about the "excuse" on hand would make the agitation worse. At times like that you had to get her total attention by making her stop, telling her to take a deep breath and that everything has been taken care of, then distract her with something like a good magazine.

It really is a tough situation and was only possible for us as I can work partly from home and with somebody to help every day and about 50% of nights. No one can really advise you what you should be doing and it is slightly different as your wife has to do the caring. But make no mistake it is a very difficult thing to do, no one can know unless they have walked in those shoes..

Edited June 14, 2014 by cmsally

[Justanotherpassword]

Justanotherpassword - I checked the medication my mother is on and it is not "Excelon". She has been prescribed "Reminyl 8mg" & "Ebixa 10mg". Around the same cost but different. I wonder whether others on this thread have been using Excelon or Reminyl + Ebixa. Many thanks for any feedback about this particular matter. I am sure it will help others who find this thread in future. Best wishes - Nick

My dad used Aricept when it was the newest thing out there but he passed on in 2000. The two drungs indicated seem to work in a similar manner and for the same level of dementia, but I observed "there is something new again" for more severe cases. A change of medication might make the difference for mom until her time. For your information friend.

http://www.ihs.com/products/global-insight/industry-economic-report.aspx?id=106593744