MacMillan type nurses in Thailand

[Sigurris]

I have a few months left to live (if I am lucky) and am currently being treated at the BKK-PYA hosptal for out patient and palliative care. M friends and GF are fantastic in their support but at the moment I can do pretty much everthing my self.

But there is going to come a time when I can't (if I se it that far: No judements on that please).

I don't want to be kept alive in an expensive hospital room nor do I want to sweat out my last days in a general ward at a Goverrnment hospital (no reflection).

What I am wondering is if anone has knowledge of for hire cancer nurses or a company that does this, so I can die in my own bed.

Edited November 12, 2014 by Sigurris

[Sheryl]

You can get nurses through the hospital, but it will be costly. A less expensive alternative is to just put the word out yourself, especially at local government hospital.

However your big problem is going to be pain management and overall unfamiliarity with the principles of hospice care. Unlike in the West, IV opiates are not given in the home, even with a registered nurse in attendance. So once you are unable to swallow, it will be hard to avoid being admitted to hospital. Fentanyl patches and sublingual administration iof oral opiates are one option but if they fail, you may have to accept being admitted.

In addition, nurses in Thailand are not trained in palliative care and there is nothing like the home hospice care programs that exist in the West. Which means that any nurse you get is likely to have trouble with the concept of no life prolonging treatments. There probably are some exceptions out there but I've yet to come across them.

It is very unfortunate, but Thailand is seriously behind the times in this area of medicine.

The best I can advice, assuming you are unwilling to leave Thailand, is that you get under the care of one of the few doctors in Thailand specializing in palliative care/pain management. AFAIK there are none in Pattaya (there aren't many nationwide) but there is a good one at Bangkok Hosp in Bangkok:

Dr. Laksamee Chanvej

Schedule Monday, Wed and Thurs 08:00 - 12:00; Tues and Fri 1 - 3 PM

She trained in palliative care in Australia

Go see her (now, while you are still mobile enough) and discuss your wishes with her and see what she suggests. It may be possible to have her oversee your care at BPH from a distance, if so this will help a lot. In that case you are probably best off with nurses from the hospital as that will ensure a smooth chain of command from her to them.

If you have not already, be sure to fill out the hospital's "living will" form.

[infinity11]

important topic

thanks OP and Sheryl