What is life like in Thailand for very old expats?

[thaibeachlovers]

2 hours ago, NancyL said:

I'm involved with Lanna Care Net and sadly, we encounter someone like the man in the above post about once a month.  However, often it's the foreigner himself who is refusing medical treatment and insisting he just wants to be left alone to die in his room, of a condition that could have been treated if he'd had health insurance or adequate funds to seek medical treatment.  Usually it's a friend of the foreigner or the owner of the property, or a neighbor who contact us.  Sometimes the consul or embassy.  Sometimes the family in the home country who has lost contact with the person.

 

(Actually, the guy in the photo looks like he's being kept clean and is probably hydrated and fed regularly.  I just hope he's moved regularly to prevent bedsores.  I've seen, much much worse.)

 

It's essential that older people plan ahead and not just for having someone to take care of their physical needs, but also for having someone to do "the thinking" for them as they age.  As you can see from that photo, once someone gets to be in their mid-70s, it just takes one fall or illness for things to go downhill in a real hurry.

Have you considered that being left to die was a choice? If I was that bad I wouldn't want to be "rescued" to suffer old age even longer. I am a supporter of voluntary euthanasia, and hope that when I get old enough it is a choice. Without legal euthanasia it's either suicide or let nature take its course, neither of which is a great choice.

[thaibeachlovers]

On ‎10‎.‎10‎.‎2016 at 5:33 AM, retoohs said:

I met an old girl aged in he late 70's in an Aussie bar at Jomtiem. She had just packed up to move back to Australia after living the past 40 years in Thailand without ever returning home once. She was worried as hadn't kept touch with family or friends and now knew nobody back in Oz. I clearly remember her saying that if she was a man she would be staying as she saw Thailand as a paradise for men but found it very hard to live a satisfying life as an elderly single woman in the Kingdom.  I guess after 40 years she understands the Thai life for an expat better than most but is she right?

Seriously, if she has no one back home, IMO better offing herself when it gets too bad. Being stuck in a rest home is a fate I do not wish to experience.

[NancyL]

11 minutes ago, thaibeachlovers said:

Have you considered that being left to die was a choice? If I was that bad I wouldn't want to be "rescued" to suffer old age even longer. I am a supporter of voluntary euthanasia, and hope that when I get old enough it is a choice. Without legal euthanasia it's either suicide or let nature take its course, neither of which is a great choice.

 

You don't understand what the end-of-life process is like.  Someone cannot be "left alone to die" alone, without being left in conditions of unbelievable squalor, lying in their own filth, unable to get water or food if they are still interested in eating.  When faced with a terminal diagnosis and someone decides to retreat to their room and "let nature take it's course", they don't understand how long the process is or how weak and incapable they'll become while still clinging to life, in pain, miserable pain.  Made all the more miserable because of the conditions they're in.  Often a single Thai caregiver is unable to help in these situations also, especially if the foreigner is large and the caregiver small.

 

I'm not advocating "rescuing" someone to force treatment on them to prolong life, but rather rescuing them so they can be in a situation where "nature can take its course" where they are cared for, their pain in managed and they are treated with dignity.  We're fortunate to have such a place in Chiang Mai, McKean Rehabilitation Center, where someone can go for end-of-life and their wishes for non-intervention are respected.  Also Vivo Bene Village in Chiang Mai has helped others with more resources at the end-of-life too, where they can have five star care during their final weeks.

[thaibeachlovers]

21 minutes ago, NancyL said:

 

You don't understand what the end-of-life process is like.  Someone cannot be "left alone to die" alone, without being left in conditions of unbelievable squalor, lying in their own filth, unable to get water or food if they are still interested in eating.  When faced with a terminal diagnosis and someone decides to retreat to their room and "let nature take it's course", they don't understand how long the process is or how weak and incapable they'll become while still clinging to life, in pain, miserable pain.  Made all the more miserable because of the conditions they're in.  Often a single Thai caregiver is unable to help in these situations also, especially if the foreigner is large and the caregiver small.

 

I'm not advocating "rescuing" someone to force treatment on them to prolong life, but rather rescuing them so they can be in a situation where "nature can take its course" where they are cared for, their pain in managed and they are treated with dignity.  We're fortunate to have such a place in Chiang Mai, McKean Rehabilitation Center, where someone can go for end-of-life and their wishes for non-intervention are respected.  Also Vivo Bene Village in Chiang Mai has helped others with more resources at the end-of-life too, where they can have five star care during their final weeks.

Fair enough. I'm happy to hear of that option.

 

However, I very much understand the end of life process. I was a ward nurse for many years and cared for many terminal patients.

In the west, the medical and care home industry has a vested financial interest in keeping aged people alive as long as possible, regardless as to the daily trauma such people are being forced to live through. The propaganda presented by the anti voluntary euthanasia cabal sicken me, to be frank.

I won't say more as it upsets me too much.

[NancyL]

You have to remember that we have chosen to live in a Buddhist country where the hospitals will do everything possible to keep someone alive, out of respect for life.  Voluntary euthanasia isn't a legal option here.  Once a life prolonging option, like a respirator, is started in a hospital, they will not stop it.  They will not "pull the plug".

 

However, Living Wills, or Advance Directives are legal here.  So, if is imperative that we all discuss our final wishes with those around us, those most likely to be called upon to make those decisions.  Better yet, actually have an Advance Directive in place.  I've been involved in the execution of about 50 Advance Directives in Chiang Mai and in most cases doctors are relieved to see them presented.  

 

 

[thaibeachlovers]

4 hours ago, NancyL said:

You have to remember that we have chosen to live in a Buddhist country where the hospitals will do everything possible to keep someone alive, out of respect for life.  Voluntary euthanasia isn't a legal option here.  Once a life prolonging option, like a respirator, is started in a hospital, they will not stop it.  They will not "pull the plug".

 

However, Living Wills, or Advance Directives are legal here.  So, if is imperative that we all discuss our final wishes with those around us, those most likely to be called upon to make those decisions.  Better yet, actually have an Advance Directive in place.  I've been involved in the execution of about 50 Advance Directives in Chiang Mai and in most cases doctors are relieved to see them presented.  

 

 

I understand that, and voluntary euthanasia isn't an option back home either, so it has always been a death causing event or the other for me, but I shouldn't have to even consider the other. Anyway, that's getting somewhat off topic.

 

I have done the advance directive thing with everyone I know, verbally, but is there a more legal way to do it? I'm not aware if there is and neither is my ( ex ) wife.

 

BTW, what would the situation be in a Thai hospital if the ventilated patient has no money and no family to pay ( or won't pay )? Who pays in that situation? Would they really keep treating the penniless patient at their own expense, perhaps for months or longer?

[NancyL]

2 hours ago, thaibeachlovers said:

I understand that, and voluntary euthanasia isn't an option back home either, so it has always been a death causing event or the other for me, but I shouldn't have to even consider the other. Anyway, that's getting somewhat off topic.

 

I have done the advance directive thing with everyone I know, verbally, but is there a more legal way to do it? I'm not aware if there is and neither is my ( ex ) wife.

 

BTW, what would the situation be in a Thai hospital if the ventilated patient has no money and no family to pay ( or won't pay )? Who pays in that situation? Would they really keep treating the penniless patient at their own expense, perhaps for months or longer?

 

There are many options for having a written Advance Directives.  Some hospitals have their own form, like Bumrungrad and Bangkok Hospital.  You can download something from the internet and if witnessed, it will be probably be accepted, even in English, you can go to a Thai lawyer and have one drawn up.  

 

In a Thai hospital, once they start a life-saving procedure, like a ventilator, they won't stop until the person dies.  It doesn't matter about the ability to pay.  However, they may start a new procedure if there is no money and no one around to make decisions.  Again, you have to understand the process of death.  The body shuts down over time.  Often someone is put on a ventilator and after a while their kidneys start to fail, so a decision has to be made about whether to start dialysis.  If the prognosis is poor, if there is no family, if no one is paying the bills, they may very well not start dialysis.  But, if the decision is made to start dialysis, they won't stop.  Next decision that has to be made is whether to restart the heart if it fails.  

 

But yes, I've known of cases where someone is fairly stable and on a ventilator for months, at the expense of the Thai people in a gov't hospital.  Meanwhile, the hospital is in contact with their embassy who is trying to contact their family, etc, etc.  

[thaibeachlovers]

On ‎26‎.‎10‎.‎2016 at 4:11 PM, NancyL said:

 

There are many options for having a written Advance Directives.  Some hospitals have their own form, like Bumrungrad and Bangkok Hospital.  You can download something from the internet and if witnessed, it will be probably be accepted, even in English, you can go to a Thai lawyer and have one drawn up.  

 

In a Thai hospital, once they start a life-saving procedure, like a ventilator, they won't stop until the person dies.  It doesn't matter about the ability to pay.  However, they may start a new procedure if there is no money and no one around to make decisions.  Again, you have to understand the process of death.  The body shuts down over time.  Often someone is put on a ventilator and after a while their kidneys start to fail, so a decision has to be made about whether to start dialysis.  If the prognosis is poor, if there is no family, if no one is paying the bills, they may very well not start dialysis.  But, if the decision is made to start dialysis, they won't stop.  Next decision that has to be made is whether to restart the heart if it fails.  

 

But yes, I've known of cases where someone is fairly stable and on a ventilator for months, at the expense of the Thai people in a gov't hospital.  Meanwhile, the hospital is in contact with their embassy who is trying to contact their family, etc, etc.  

I would hope that if I was unfortunate enough to end up ventilated in a Thai hospital that my family would refuse to pay anything and could not be forced to pay ( unlikely as they are not in LOS ). It seems as if that would be the only way to be allowed to die.

I have told everyone that I am not to be resuscitated or ventilated, but obviously if it happened in LOS they aren't around to object before that happened. Far as I know back home, if consent for treatment is not given or withdrawn, they can't do anything to prolong life unnecessarily.

 

The hope for the future is that because of the rising number of elderly and decreasing resources to pay for elder care, voluntary euthanasia will come in as a necessity. Can't come soon enough for many of us.

I'd like to be in front of one of those that would seek to make me suffer unnecessarily and give them a verbal roasting. Who do they think they are?

[NancyL]

They are Buddhists and believe in the sanctity of life.  We are guests in their country and must understand their value system.  Many of the health care professionals consider "pulling the plug" to be murder.

 

 

[SaintLouisBlues]

6 minutes ago, NancyL said:

They are Buddhists and believe in the sanctity of life.  We are guests in their country and must understand their value system.  Many of the health care professionals consider "pulling the plug" to be murder.

Whether they are Buddhists or not is a moot point. It's a bit like saying medieval Christians buying Indulgences from monks (similar to Thais buying lucky lottery numbers from monks) are "Christian". I'd say they're animists rather than Buddhists. As for their value system and healthcare, a number of Thais have told me that their religion forbids organ donation. Others say that statement is incorrect. I'm not at all convinced that it's possible to make generalisations that suggest that the health care professionals who won't switch off life support to be a particularly Buddhist or even Thai 

[NancyL]

I'm merely repeating what I've been told numerous times by health care professionals when they've been asked to discontinue ventilation or other life-saving treatments by Next-of-Kin or authorized Heath Care Representatives.  It's not my role to question the sincerity of their religious beliefs.

[jayceenik]

I am a senior in good health and spirit.

I have a Living Will with my much younger TGF as executor.

She is also the sole inheritor of my bank accounts so I have hammered in her that if some very bad health or accident happened to me the more she would let me vegetate on ventilation and other life-saving treatments with no hope to get back to a normal life and at great cost by a greedy hospital the less she would get from my bank account when I go.

I have also bought a new house in her name which is going to be my "senior home".

We can live reasonably comfortably on my pension so she has no immediate benefit in terminating soon her ATM's life !! 

She'll get all the money anyway when I die.

 

 

[Spaniel]

Seems your original question, "What is life like in Thailand for very old expats" has gotten way off topic.    Just read a few of the replies above.   Why don't these people start their own thread instead of hijacking someone else's?     To answer your question, at least from my expierence my life here has been pretty good.   I'm 72 and first arrived here in 1967 but left several times for employment in other countries.    I finally retired here when I was 54 and have lived in Bangkok ever since although we have a small condo in Pattaya  we use a couple times a month.   Wife and I have been together about 28 years and we have 1 son, 26 y/o, who lives in the USA.      Health has bee pretty good, I exercise daily, watch what I eat,   stopped drinking and smoking years ago.    We travel around Thailand by car several times a year mostly up North, enjoy camping but not beach people so give south beaches and islands a miss although have been to most but not recently.    So if you consider 72 very old then that's what life is like for us.

[tailspin]

3 hours ago, Spaniel said:

Seems your original question, "What is life like in Thailand for very old expats" has gotten way off topic.    Just read a few of the replies above.   Why don't these people start their own thread instead of hijacking someone else's?   

This is nonsense.....when you start a thread, you do not own it....people can make whatever comments they want within the forum rules.....you do not have to read so-called "hijacked" comments

 

[Spaniel]

10 hours ago, tailspin said:

This is nonsense.....when you start a thread, you do not own it....people can make whatever comments they want within the forum rules.....you do not have to read so-called "hijacked" comments

 

Well, that's your opinion, not mine.      I think posters should stay on topic as to the question asked, although I must admit I have been guilty at times of adding additional info not always pertinent to the question asked.

[tailspin]

14 hours ago, Spaniel said:

Well, that's your opinion, not mine.      I think posters should stay on topic as to the question asked, although I must admit I have been guilty at times of adding additional info not always pertinent to the question asked.

This a tautological statement....of course it is my opinion since I wrote it....how could it be yours?  Sorry I am getting off topic...

[Johnniey]

On 29/10/2016 at 1:12 PM, jayceenik said:

I am a senior in good health and spirit.

I have a Living Will with my much younger TGF as executor.

She is also the sole inheritor of my bank accounts so I have hammered in her that if some very bad health or accident happened to me the more she would let me vegetate on ventilation and other life-saving treatments with no hope to get back to a normal life and at great cost by a greedy hospital the less she would get from my bank account when I go.

I have also bought a new house in her name which is going to be my "senior home".

We can live reasonably comfortably on my pension so she has no immediate benefit in terminating soon her ATM's life !! 

She'll get all the money anyway when I die.

 

 

Do you not have any kids? Any relative back in your home country? If so are they happy with this arrangement? They could say that you have gone insane!

I find this situation very sad - basically having a much younger woman staying with you purely for money.

[music065]

On 10/30/2016 at 9:51 AM, Johnniey said:

Do you not have any kids? Any relative back in your home country? If so are they happy with this arrangement? They could say that you have gone insane!

I find this situation very sad - basically having a much younger woman staying with you purely for money.

 

Where did he say she is staying with him purely for money?