Is Thailand really a good place to be in if REALLY old ?

[thailiketoo]

Come on, guys, this is an easy one.

If you have enough money to hire a good, caring, full time, live-in helper in your old country and maintain a good standard of living there, then *maybe* you're rich enough that Thailand is not the best place to live when you are getting REALLY old. Maybe.

But for the rest of us, aside from a family ethic here in Thailand that calls for taking care of old members of the family, it's also possible to hire a good, caring, full time, live-in helper for a fraction of what it would cost at home. And you can list off all the other institutional "benefits" of being taken care of in your home country, but no institutional solution comes even close to what's available here in Thailand from a full time live in helper, who speaks at least some English or other language you can understand.

One caveat -- when you're REALLY old and sick and weak and helpless, at least two natural laws (natural selection and survival of the fittest) are working against you. So it's also going to take some luck and/or a very caring and devoted family if you're going to get good care when you're getting REALLY old -- whether you're in Thailand or someplace else.

What do you bring to the table? Do you have a pension that is worth millions as long as you are alive but worthless if you are dead?

[sustento]

The OP assumes that all foreigners speak English.

[ericjt]

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

Come on, guys, this is an easy one.

If you have enough money to hire a good, caring, full time, live-in helper in your old country and maintain a good standard of living there, then *maybe* you're rich enough that Thailand is not the best place to live when you are getting REALLY old. Maybe.

But for the rest of us, aside from a family ethic here in Thailand that calls for taking care of old members of the family, it's also possible to hire a good, caring, full time, live-in helper for a fraction of what it would cost at home. And you can list off all the other institutional "benefits" of being taken care of in your home country, but no institutional solution comes even close to what's available here in Thailand from a full time live in helper, who speaks at least some English or other language you can understand.

One caveat -- when you're REALLY old and sick and weak and helpless, at least two natural laws (natural selection and survival of the fittest) are working against you. So it's also going to take some luck and/or a very caring and devoted family if you're going to get good care when you're getting REALLY old -- whether you're in Thailand or someplace else.

What do you bring to the table? Do you have a pension that is worth millions as long as you are alive but worthless if you are dead?

I don't get your comment, Thailiketoo. You can hire a live in maid/cook/housekeeper here for around 7000 baht/month + room and board. Round it off to $300 USD/month + room and board. Add a little more if you want someone to take more personal, nursing kind of care, and you're looking at maybe $500/month + room and board. And you don't need a pension worth millions to afford that. Even a modest retirement income should be able to handle something like that.

So I don't bring anything to the table, other than a little knowledge about what it costs to hire a live in maid/helper in Thailand. And I don't see what having a "pension that is worth millions" has to do with my comment. If $500 USD/month is too much for someone's budget, they're going to have a hard time when they get old no matter where they live.

And if I did have a pension worth millions, I think I'd be able to buy the best care available no matter what country I chose to live in, so again, I don't see what your comment has to do with the OP's question or my comment.

[thailiketoo]

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

Come on, guys, this is an easy one.

If you have enough money to hire a good, caring, full time, live-in helper in your old country and maintain a good standard of living there, then *maybe* you're rich enough that Thailand is not the best place to live when you are getting REALLY old. Maybe.

But for the rest of us, aside from a family ethic here in Thailand that calls for taking care of old members of the family, it's also possible to hire a good, caring, full time, live-in helper for a fraction of what it would cost at home. And you can list off all the other institutional "benefits" of being taken care of in your home country, but no institutional solution comes even close to what's available here in Thailand from a full time live in helper, who speaks at least some English or other language you can understand.

One caveat -- when you're REALLY old and sick and weak and helpless, at least two natural laws (natural selection and survival of the fittest) are working against you. So it's also going to take some luck and/or a very caring and devoted family if you're going to get good care when you're getting REALLY old -- whether you're in Thailand or someplace else.

What do you bring to the table? Do you have a pension that is worth millions as long as you are alive but worthless if you are dead?

I don't get your comment, Thailiketoo. You can hire a live in maid/cook/housekeeper here for around 7000 baht/month + room and board. Round it off to $300 USD/month + room and board. Add a little more if you want someone to take more personal, nursing kind of care, and you're looking at maybe $500/month + room and board. And you don't need a pension worth millions to afford that. Even a modest retirement income should be able to handle something like that.

So I don't bring anything to the table, other than a little knowledge about what it costs to hire a live in maid/helper in Thailand. And I don't see what having a "pension that is worth millions" has to do with my comment. If $500 USD/month is too much for someone's budget, they're going to have a hard time when they get old no matter where they live.

And if I did have a pension worth millions, I think I'd be able to buy the best care available no matter what country I chose to live in, so again, I don't see what your comment has to do with the OP's question or my comment.

My point was to be worth more alive than dead. The quality of care will depend on the worth.

[jdinasia]

20k thb/mo will get you private live-in English speaking nursing care. (RN)

[KonaRain]

I had a healthcare experience in LOS with a lot of hospital visits for my Ladyfriend..

She got the resident price with a retirement visa.

Palliative care is better home than nursing home.

Easy to afford a caregiver in Thailand.

We couldn't get morphine, but xanax was enough, and she had trammadol, which she called zombie pills.Capsules, actually. The more one takes, the quicker the end.(She quit taking them after I arrived)

I argued with the head nurse about certain procedures. Most spoke good Englisb,or not so good.

More later..I have internet issues..

Aloha

[lioness]

I guess it's up to the individual to look at their options and make their own choice, I have grown old in Thailand, there's lots of things I can't do now due to age and pain.

I do agree however that caring even by family members needs money, but then if someone is caring for you then they are not working outside the home and earning an income. This "caring" is a lot cheaper here than my home country.

If I dwell on it my choice wouldn't be to die in Thailand, I have been to too many funerals (cremations) here and well... some of them have been quite horrific. But then none of us know when we are going to pass on, and I sincerley hope dead is dead and I won't know anything about it.

[williet98248]

I have to say that Thailand and a caring Family with probably hiring someone to assist my Family to "hump and dump" me about the place beats a cold, miserable UK and a not so good NHS. Soon I will no longer be insurable for medical treatment, but am building up a war chest for any ailments, I am also very fortunate that a very dear and close Thai Neice is due to qualify as a Doctor in the not too distant future who will have plenty of "connections" to help me get buy. If the worse comes to the worse and eventually whatever might become terminal, I think voluntary euthanasia will be the order of the day - a couple of bottles of wine and something very sleepy and it will be goodnight Vienna.

Indeed. I too am uninsurable but have some cash saved up for the emergency. In good health at age 72 but if a debilitating and terminal disease occurs I will take the same journey. Best way is to have a fatal heart attack while humping your young wife but not always possible. Many posters on this forum question the verdicts of 'suicide' that accompany many of the deaths of farangs in Thailand but why not? Most of us who live here plan to die here too. If they run out of money or health I believe many expats end it for themselves.

[KhnomKhnom]

To all who think checking out permanently by one's self can easily be done, think again.

1. You are old and in pain enuf to think suicide would be ok.... LATER.

2. You are really sure this is the time... but

a. are you strong enuf to get the pills or other method, can you get out of bed? If you can get out of bed, are you so so bad off?

b. do you have enuf mental capacity to make a decision?

c. doubt in Thailand you could get anyone to help you due to karma on them.

There are two books I have forgotten titles which are written for movie script writers on the clinical details of the ways humans die. One is about poisons and the other is for other means. The writer's bookshop in Los Angeles has them but only for your information if you plan to write a movie script.

News story said one guy got up the nerve to use his Colt .45 but after long agonizing, he decided to do it and his hands were too weak to throw the bolt and chamber a round.

[Doc 69]

Okay,

Here's my experience:

August 2011 I had a heart attack at 2:00 am. I knew it was a heart attack, but, decided to smoke on it first, then take a shower, so by the time I got out to the Soi, it was about 2:30. Got in a cab and thought, we'll be there soon. But, as anyone that lives around Sukhumvit knows, at 2:30 things are hopping with people just leaving bars, grabbing a bite to eat, or grabbing other things. The taxi did not move for several minutes. I finally set up to ask my poor Thai wife what the problem was and that's when the driver got a good look at me. He was a young kid and I guess he decided he didn't want this faring dying in his cab, so he shot up on the sidewalk, made a turn the wrong way on a one way street and as we passed the police box, he just honked and waved. When we got to Bumrundgrad, they were there to meet us even though no one called. They hooked me to the machines and this nice (beautiful) nurse informed me I was having an "event". Then she told my frightened wife she would need to put up the 50K Baht retainer. I remember my wife trying to haggle with her!!!

Needless to say, I have a great doctor, had a wonderful experience (if you can say that about a heart attack!) Still my doctor to this day.

No, I don't have a lot of money and will say it cost me 500K baht, but, think of the price for that stay in the US. I have since retired here in Ban Pho, in a village where only my wife and one other speak some English, but, am happy and content to know there is another hospital close by. Once I cut myself while fishing and although I knew I was fine, my wife called for an "Air Ambulance" to come, so they do have them. And, I found each ambulance has a Dr. and/or trained nurse in it. I realize things would be different in the US, but, I have had 3 surgeries and numerous other procedures here in Thailand and am more than satisfied with all. Also, I have an extensive medical background so I know what to look at when I'm there and have an idea what I'm getting in to for each visit. I can still get around, just slower, but, glad to be in Thailand!

Doc

[Sheryl]

Your story would have been very different if you had not had the wherewithal to pay 500,000 baht, or even the 50,000 intial retainer. Unfortunatley many of the older expats living here would not.

I have seen some really ugly scenes with Bumrungrad and other hospitals refusing to release people who were unable to pay their bills and/or witholding essential treatment until accumulated bill was paid.

Uninsured people really need to self insure by setting aside a good sum of money against a medical emergency. Elderly people with neither insurance nor the means to do this are in a precarious situation living here.

[jdinasia]

Sheryl

Could you estimate the cost of treatment in a gov't hospital? (heart attack)

I was transported to the hospital at CRMA via ambulance for a suspected heart attack. They kept me for 24 hours. It was not a heart attack. I had 7 EKG's and some random meds.

Total bill was 3000 including the private room.

I wonder what it would have been had it actually been a heart attack.

[giddyup]

Your story would have been very different if you had not had the wherewithal to pay 500,000 baht, or even the 50,000 intial retainer. Unfortunatley many of the older expats living here would not.

I have seen some really ugly scenes with Bumrungrad and other hospitals refusing to release people who were unable to pay their bills and/or witholding essential treatment until accumulated bill was paid.

Uninsured people really need to self insure by setting aside a good sum of money against a medical emergency. Elderly people with neither insurance nor the means to do this are in a precarious situation living here.

You're right, it can be pretty dire without the money to pay for emergency health care. I knew two falangs who have died in the last year purely because they didn't have any cash reserves, absolutely none, only their monthly pensions. Both could have survived their conditions given the necessary medical treatment.

[Sheryl]

Depends on how severe your condition and also the treatment given (?stents? bypass surgery?).

Worst case scenario, i.e. long stay in ICU, bypass surgery or multiple stents, can easily exceed a million baht.

And don't overlook cancer, strokes, major accidents with multiple trauma, all of which can be equally or more costly.

There are plenty of ways to wrack up a 1-2 million baht bill in a government hospital and most of them are things you can neither predict nor control.

Unfortunately the low cost of outpatient care and simple hospitalizations /minor surgeries etc at government hospitals lull some people into a false sense of complacency.

For people who want to self insure my general advice is:

2 million baht if you are prepared to limit care to government hospitals (or transfer to them as soon as possible after initial emergency care elsewhere).

5 million if you want the option of private care.

And these are not lifetime amounts, i.e. could expend them in one event at which point you'd need to have similiar sum on hand again.

[giddyup]

Sheryl

Could you estimate the cost of treatment in a gov't hospital? (heart attack)

I was transported to the hospital at CRMA via ambulance for a suspected heart attack. They kept me for 24 hours. It was not a heart attack. I had 7 EKG's and some random meds.

Total bill was 3000 including the private room.

I wonder what it would have been had it actually been a heart attack.

Any idea what the same treatment would have cost you in a private hospital? I doubt if you would have got any change out of 30,000 baht.

[jdinasia]

I didn't even submit the bill to my insurance company.

I have both private insurance and social security here. I am fairly safe I think.

[Sheryl]

Sheryl

Could you estimate the cost of treatment in a gov't hospital? (heart attack)

I was transported to the hospital at CRMA via ambulance for a suspected heart attack. They kept me for 24 hours. It was not a heart attack. I had 7 EKG's and some random meds.

Total bill was 3000 including the private room.

I wonder what it would have been had it actually been a heart attack.

Any idea what the same treatment would have cost you in a private hospital? I doubt if you would have got any change out of 30,000 baht.

Difference is usually about 3 fold, 4 fold if a really expensive private hospital, a little less of a non-profit (but still more than double). Need to be sure you are comparing facilities of similar level, i.e. tertiary govt facility to a pvt hosp, not a lower level one that lacks ICU etc. If JDIA's cost was really just 3,000 and not 30,000 then I very much doubt he was in a tertiary govt facility and also have to question how throrough the care was.

A close friend was recently treated in a provincial govt hospital for suspected heart attack. Ambulance, some blood work, 2-3 EKGs, about 8 hours close monitoring in the ER and then 2 day stay in a ward came to a little over 30,000 baht.

[elliottm]

Stick to the healthcare of your home country and pay for prostitutes less often.

[giddyup]

Stick to the healthcare of your home country and pay for prostitutes less often.

What does that have to do with anything?

[ginglee]

If you have no money when you're old then it doesn't matter where you live - it's not going to be good. Your only hope would be that you treated your kids good !

[NancyL]

If you have no money when you're old then it doesn't matter where you live - it's not going to be good. Your only hope would be that you treated your kids good !

No that's really not true. In most developed countries, there is a safety net for old people, often a fairly good one for people who were military veterans.

I've helped some nearly destitute elderly expats in Chiang Mai who were living on the edge to return to the U.S. after they encountered health problems here. Some have received treatment at places like Mayo Clinic, Cedar Sinai, Johns Hopkins, etc and they certainly aren't wealthy people. These facilities actually made an effort to find the cause of their conditions, rather than just treating their symptoms -- which was what the local amphur hospitals were doing because they were poor foreigners.

Edited October 24, 2014 by NancyL

[thailiketoo]

If you have no money when you're old then it doesn't matter where you live - it's not going to be good. Your only hope would be that you treated your kids good !

No that's really not true. In most developed countries, there is a safety net for old people, often a fairly good one for people who were military veterans.

I've helped some nearly destitute elderly expats in Chiang Mai who were living on the edge to return to the U.S. after they encountered health problems here. Some have received treatment at places like Mayo Clinic, Cedar Sinai, Johns Hopkins, etc and they certainly aren't wealthy people. These facilities actually made an effort to find the cause of their conditions, rather than just treating their symptoms -- which was what the local amphur hospitals were doing because they were poor foreigners.

At least 40 U.S. veterans died while waiting for health care at the Phoenix VA, many of whom were placed on a secret waiting list, according to a CNN report.

The "elaborate scheme," implemented by top management, was an effort to hide that 1,400 to 1,600 sick veterans waited months to see a doctor, said CNN, citing a former Veterans Administration doctor and other agency staff. The secret list also gave the appearance of shorter appointment wait times, which were reported back to Washington, according to the story.

http://www.stripes.com/news/veterans/cnn-at-least-40-vets-died-while-waiting-for-care-at-phoenix-va-1.279589

[ignis]

-No English in smaller hospitals and clinics.

-No ordinary Thai knows what the English word HOSPITAL or DOCTOR means, especially not taxi drivers.

This appear to come up time and time again....... where ?

I live in a little Village, have seen the odd white person but very few in my 11 years here... Nearest Hospital is not far and is a 5 story building in the middle of a field with a long dirt track to it, service is good and English spoken, also been to the [Parent] or main Hospital in Bang-Bua-Thong.. 1x 3 nights stay another 1 night stay, again very cheap and good English spoken, clean and helpful

As for Taxi's have used but very few, most all drivers speak some English or maybe I was lucky ? How difficult is it to print a few cards with Important places on in Thai ? a name and address - I have English on the back. = simple to show the Taxi Driver...... funny even in Thai Village markets find lots speak English both younger and the old speak some English , the few around me 7/11 and Tesco Express all try some English when I go in..

At least here if one need an OP then you are in that day or the next, UK you go on the waiting list for months/years

[thailiketoo]

-No English in smaller hospitals and clinics.

-No ordinary Thai knows what the English word HOSPITAL or DOCTOR means, especially not taxi drivers.

This appear to come up time and time again....... where ?

I live in a little Village, have seen the odd white person but very few in my 11 years here... Nearest Hospital is not far and is a 5 story building in the middle of a field with a long dirt track to it, service is good and English spoken, also been to the [Parent] or main Hospital in Bang-Bua-Thong.. 1x 3 nights stay another 1 night stay, again very cheap and good English spoken, clean and helpful

As for Taxi's have used but very few, most all drivers speak some English or maybe I was lucky ? How difficult is it to print a few cards with Important places on in Thai ? a name and address - I have English on the back. = simple to show the Taxi Driver...... funny even in Thai Village markets find lots speak English both younger and the old speak some English , the few around me 7/11 and Tesco Express all try some English when I go in..

At least here if one need an OP then you are in that day or the next, UK you go on the waiting list for months/years

I agree with you. It is not difficult.

By long pi ya ban. (go hospital) Now that's not too difficult to say; I don't think. Point and say jep (hurts). Or one can come on Thai Visa and ask for an emergency translation.

Edited October 25, 2014 by thailiketoo

[SpokaneAl]

One of my concerns is that I do have a US based health plan, however it is a fairly complex process to get reimbursed while outside the US, and well beyond, IMO, the abilities of my Thai family. With that in mind, I do worry what will happen if I experience a medical issue which renders me unable to file the necessary reimbursement paperwork.

[NancyL]

If you have no money when you're old then it doesn't matter where you live - it's not going to be good. Your only hope would be that you treated your kids good !

No that's really not true. In most developed countries, there is a safety net for old people, often a fairly good one for people who were military veterans.

I've helped some nearly destitute elderly expats in Chiang Mai who were living on the edge to return to the U.S. after they encountered health problems here. Some have received treatment at places like Mayo Clinic, Cedar Sinai, Johns Hopkins, etc and they certainly aren't wealthy people. These facilities actually made an effort to find the cause of their conditions, rather than just treating their symptoms -- which was what the local amphur hospitals were doing because they were poor foreigners.

At least 40 U.S. veterans died while waiting for health care at the Phoenix VA, many of whom were placed on a secret waiting list, according to a CNN report.

The "elaborate scheme," implemented by top management, was an effort to hide that 1,400 to 1,600 sick veterans waited months to see a doctor, said CNN, citing a former Veterans Administration doctor and other agency staff. The secret list also gave the appearance of shorter appointment wait times, which were reported back to Washington, according to the story.

http://www.stripes.com/news/veterans/cnn-at-least-40-vets-died-while-waiting-for-care-at-phoenix-va-1.279589

Yes, the VA is a disgrace in some locations, but at least it is providing care in most and they are working to clean up the system. It is a safety net. Veterans who served just a few years can have access to its services if they are destitute -- in the U.S. They are not able to claim VA-reimbursement for medical services if destitute and outside the U.S.

[thailiketoo]

If you have no money when you're old then it doesn't matter where you live - it's not going to be good. Your only hope would be that you treated your kids good !

No that's really not true. In most developed countries, there is a safety net for old people, often a fairly good one for people who were military veterans.

I've helped some nearly destitute elderly expats in Chiang Mai who were living on the edge to return to the U.S. after they encountered health problems here. Some have received treatment at places like Mayo Clinic, Cedar Sinai, Johns Hopkins, etc and they certainly aren't wealthy people. These facilities actually made an effort to find the cause of their conditions, rather than just treating their symptoms -- which was what the local amphur hospitals were doing because they were poor foreigners.

At least 40 U.S. veterans died while waiting for health care at the Phoenix VA, many of whom were placed on a secret waiting list, according to a CNN report.

The "elaborate scheme," implemented by top management, was an effort to hide that 1,400 to 1,600 sick veterans waited months to see a doctor, said CNN, citing a former Veterans Administration doctor and other agency staff. The secret list also gave the appearance of shorter appointment wait times, which were reported back to Washington, according to the story.

http://www.stripes.com/news/veterans/cnn-at-least-40-vets-died-while-waiting-for-care-at-phoenix-va-1.279589

Yes, the VA is a disgrace in some locations, but at least it is providing care in most and they are working to clean up the system. It is a safety net. Veterans who served just a few years can have access to its services if they are destitute -- in the U.S. They are not able to claim VA-reimbursement for medical services if destitute and outside the U.S.

Not true. Generally, as long as the service is medically necessary for the treatment of a VA rated service-connected condition, it will be covered.

http://www.benefits.va.gov/persona/veteran-abroad.asp

I don't think you are a VA rep. Contact VA for more information.

Or in the Philippines.

To be eligible for healthcare while in the Philippines, Veterans must have conditions or disabilities incurred in or aggravated by military service rated by the VA at 0% or greater. This includes outpatient care at the clinic, in-patient care, diagnostic tests/procedures and specialist referrals at various contract hospitals for service-connected conditions. Authorization is required for non-emergency outpatient care and hospitalization.

Find VA Philippines facility information on the Foreign Contact page.

Edited October 25, 2014 by thailiketoo

[cheeryble]

To be honest, the fact that palliative care here doesn't involve the use of morphine very much does affect my way of thinking.

True this could be important for a portion of us.

Heroin is widely used in the U.k to ease a nasty end now.

Ease the pain and ease the mind, just the job.

All that said, there's never been a better time to age.

With the internet revolution, with podcasts and downloads and Skype and so on one can live a pretty full and fulfilled life even confined to a house.

During an early very heavy crisis in my twenties, a life changing event, a great friend of mine said something I never forget:

"There's no such thing as absolute security".

So personally I'll muddle through.

Hoping to just pay for myself here and be careful with the funds as reasonable. If something very expensive maybe get back to UK and the dear old NHS (if mobile of course). If it doesn't work out it doesn't work out but be willing to adjust and hope for the best.

I push my niece to train as a physician later like two of her uncles and already I help her with an early start in English so hopefully I'll have my own doc haha.

Sent from my iPad using ThaiVisa app

Edited October 25, 2014 by cheeryble

[NancyL]

thailiketoo:

The Philippines is not in the U.S.

No I'm not a VA rep. I'm a caseworker with Lanna Care Net and we've helped U.S. vets with just a few years of service go back to the U.S. If they are over age 65 and their income is below a certain level and they are in need, in general, they will receive treatment in a VA hospital.

I know of several vets in Thailand who have gone to the Philippines thinking they will receive a similar level of treatment at the VA facility there. Not so. All one has to do is check out their website to see that isn't the case.

[thailiketoo]

thailiketoo:

The Philippines is not in the U.S.

No I'm not a VA rep. I'm a caseworker with Lanna Care Net and we've helped U.S. vets with just a few years of service go back to the U.S. If they are over age 65 and their income is below a certain level and they are in need, in general, they will receive treatment in a VA hospital.

I know of several vets in Thailand who have gone to the Philippines thinking they will receive a similar level of treatment at the VA facility there. Not so. All one has to do is check out their website to see that isn't the case.

You wrote, "They are not able to claim VA-reimbursement for medical services if destitute and outside the U.S." That is not true. I'm not talking about people in the Philippines. I am writing about people in Thailand. You should check your facts better. And no, I don't think this is the place to discuss the fine points of VA reimbursement for overseas vets but, generally, as long as the service is medically necessary for the treatment of a VA rated service-connected condition, it will be covered.

http://www.benefits....eran-abroad.asp

I think we are talking about two different things. I am talking about conditions of sickness that occurred as a result of a service connected injury and I believe you are talking about general medical care for men who happen to be vets.