87 yr old in desperate need of medical help

[KayCee]

To start - I don't know this person, but a friend of mine does, and has been trying to help her over several months and is now desperate for some help and advice.

 

This woman has lived legally in Thailand for around 40 years, but around 5 years ago lost all her money to a scam of some sort, and is now on overstay - this obvious complicates getting her medical help now that she badly needs it.

 

She is desperately poor, living in a room with no A/C, badly dehydrated, not eating or drinking well because she's weak and so is in a bad and rapidly deteriorating state.  She's a dual national from two European countries, and advice from the embassies is they can help her get home if she showed up at their doors, but she will refuse to go, and in any event is not in any condition to travel.  She has no relatives anywhere, never married, no kids, no siblings.  

 

It seems like what's really needed first is to find a doctor that would make a house call and get her some fluids and help evaluate the situation from a medical point of view.  Even if she's dying, and perhaps she is not, she deserves some care and attention.

 

Does anyone have any advice?  My friend and others are willing to help with funds, and with time, but really as fairly new expats have no earthly idea where to turn to get her the help that she desperately needs.  It's heartbreaking to see someone of that age alone and so desperate for help.  It's an upsetting situation, and while obviously this woman made some mistakes at an already advanced age, it won't help too much to go on about those now.  I'd be so grateful for any advice that I could pass along.

 

[1FinickyOne]

Hi Kaycee - nice of you to care, but the question I would have would be whether she wants help.. you say she is in desperate need, and that sounds correct. But has she asked for assistance? Does she want any? 

 

I hate to say this but not eating and drinking is a sign that she might be on the way out and it might be of her choosing... Does the eating and drinking cause her discomfort? She also refuses help to get home from her embassy. 

[ubonjoe]

A inflammatory troll post has been removed.

[KayCee]

Thank you Ken (and thank you Ubonjoe for your moderating).  
I don't know this woman, so all I know is what my friend has told me.  It sounds as if she is eating and drinking, but given the heat, and her weakness she has not been doing enough of either.  Her toilet requires her to go up stairs, and with her deteriorating physical state, that has been hard, and so she is not wanting to drink too much, etc., etc.  She will accept help, and she will eat and drink.  She just doesn't want to leave her home.  I would completely respect that, as my father very much felt the same way before he passed away (in my home country) and we made sure he was able to stay in his home and get appropriate medical care until that day came.  So the question is how to respect her wishes, but also not refuse her help to be comfortable and to live as long as possible in the way in which she chooses.  The initial thought was a doctor that could visit at home, assess the situation, possibly prescribe some medication or some IV fluids, and her friends help her with potty chairs, shopping, and perhaps a home health aid or nurse to look in.  But these are only thoughts - things are happening fairly quickly from what had been a stable situation until this last heat wave and some diarrhea and weakness from that and dehydration.  It's always hard to know how best to help while respecting someone's wishes, and all her friends were asking for was some advice on resources that might be available.  

Thanks so much for the advice and concern, in advance.

Edited April 29, 2017 by KayCee

[tomwct]

Notify one or both of her embassies. They will need to attend to her needs before and after something happens. 87 is a good time to meet your maker!

[CharlieH]

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[simon43]

Quote

 

87 is a good time to meet your maker!
 

 

 

The lady in question may not agree with you....

 

Also, other posters have said that maybe she doesn't want any help.  But is she Compos mentis (lucid and able to make common-sense decisions)?  If not, then decisions need to be made for her, and that probably needs more direct involvement from her embassy.

Edited April 29, 2017 by simon43

[Jingthing]

Definitely a very sad situation. It can happen when in your home country as well, but complicated by living abroad, and also illegally. 

I am quite curious about one thing about this.

If her overstay situation came to the attention of the authorities, would they treat a pitiful case like that like anyone else? In other words, send her to immigration detention prison? 

[Sheryl]

You indicate you have already contacted her embassies and they are willing to help but she refuses to go to them.

 

No doctor is going to provide free care to her at home and most won't make house calls regardless.

 

The best thing to do is take her to the nearest large government hospital (you did not say where she lives, but it should be at least a provincial level hospital, not small community hospital) and let them deal with her. usually hospitals do not call Immigration, they look at passports only for proof of ID. But even if they should that might actually be for the best as it would get her departed back to a home country where she would have help available (presumably) from state services.

 

If she refuses to go to a hospital then 2 choices and needs to depend on how rational she is and also  how sick

 

1- call 1669 (emergency medical services) report that there is a an irrational/disturbed woman in need of medical care. This will work if she is really in bad shape that will be evident to them and if she is likely either to be obviously unfit to make an informed decision or else too weak to likely overrule them when they want to take her to hospital. If she is likely to be able to forcefully refuse in a manner that appears rational, probably useless.

 

2. Wait it out until she becomes to sick to effectively resits - or so obviously irrational that they will ignore her protests - and then revert to the above.

 

Once she is in a hospital inform her embassy.

 

Make sure she goes only to a government hospital as there will be big problems over bill payment at a private one. Government will also expect to be paid but costs will be much less and they will not usually not go to the same extremes a private hospital will to get payment (e.g. confiscating clothes and passport, refusing to discharge).

 

There is however a risk of her being hospitalized just a short time, enough to et her back on her feet, and then sent home where the cycle will repeat itself.

 

And some possibility of her overstay being discovered along the way, actually that has to happen sooner or later and she has to accept deportation (which is also likely in her best interests) but you want to avoid risk of her being taken to an immigration detention facility when in need of medical care. While that would probably not happen , it could.  More likely they'd take her to a hospital, notify her embassy, and issue a deportation notice but you can't be sure.

 

It is very unlikely that she has absolutely no relatives, she likely has some but not close. Still worth someone tracking down whomever there may be e,.g. cousins and the like if possible.

 

You do not mention just what it is this woman wants to have happen and also (related issue) how rational she is. If she is refusing medical care and refusing food and staying at home, and has no plan for dealing with her overstay problem, her rationality is open to question and a return trip to the Embassy to explain that she is ill and irrational  (and on overstay) is in order, Embassy can help interface with Immigration to allow her ti get medical care first and then turn herself in to pay the overstay fine and be deported (assuming the overstay is long enough to warrant that). They can also arrange to have her met on arrival at her home country by approrpriate social services.

 

If she is by any chance in the Chiang Mai/ChiangRai area, contact Lanna Care

 

http://www.lannacarenet.org/

 

They have experience with situations like this.

 

She is going to have to pay -- or someone else is going to have to pay for her - the overstay fine and medical bills.  Possible her Embassy will pay for her return travel home, depends on the Embassy.

 

[Pacificperson]

If she has been in Thailand for 40 years, I doubt that she wants to be deported and put in an European nursing home. I would guess that the local authorities are turning a blind eye to her visa situation and will continue to do so as long as their hands are not forced. I would also guess that she has some limited local assistance - either from local expats or Thais.

 

From my experience with my 88 year old mother who lives with me, I would also guess that the main problem stems from the stairs. Either they are getting to be too much physically for her or they terrify her or both. You could try getting her a portable potty, but that means that you will have to arrange for someone to empty it at least daily. This done, you may find her willing to eat and drink sufficiently to maintain her health.

[KayCee]

appreciate all the advice, and Sheryl particularly from you as I know you're quite knowledgable.  She has been completely lucid as I understand it - just determined to stay in Bangkok, stay in her home of 40 years, and not to go back to Europe where she knows no one.  Her mental facilities may be a bit slipping with dehydration and illness the last few days, but before then, I've been told that she was sharp as a tack and very clear on her wishes.  Her local friends - most of fairly advanced age and with their own medical and other concerns - have collected enough funds that a short hospital stay would be manageable, not sure about overstay fines, but I'm sure someone would help.  Heck, I don't even know her, and I would help if necessary to get her the care she needs.  

 

I think the stairs and the bath are the biggest challenge, combined with the unbearable heat of late.  I sent along the shower chair we used for my mother-in-law, and suggested a porta-potty as well.  I hope perhaps she can be convinced to visit a local hospital, and will get an update tonight from my friend who went to see her today to try.  

 

Thank you again for your input.  It's difficult to see someone vulnerable in need of help, and seemingly with little resources, financial or human, to help.  (As I understand it, she may have a cousin still in her home country, but if so he'd be in his 90s and she lost contact decades ago - her life has been here.)

 

[KayCee]

18 minutes ago, Pacificperson said:

If she has been in Thailand for 40 years, I doubt that she wants to be deported and put in an European nursing home. I would guess that the local authorities are turning a blind eye to her visa situation and will continue to do so as long as their hands are not forced. I would also guess that she has some limited local assistance - either from local expats or Thais.

 

From my experience with my 88 year old mother who lives with me, I would also guess that the main problem stems from the stairs. Either they are getting to be too much physically for her or they terrify her or both. You could try getting her a portable potty, but that means that you will have to arrange for someone to empty it at least daily. This done, you may find her willing to eat and drink sufficiently to maintain her health.

yes to everything you wrote.   My 90 year old mother in law who lives with us, and my father who passed away recently both had similar problems with physical mobility and need for help, and both had very clear ideas about where they wanted to spend whatever time was  left to them, and as they were both rational adults, it seemed that was their right, as challenging as that can be to help. 

Edited April 29, 2017 by KayCee

[Rc2702]

Forgive me but how many of these cases cam there be? Only 6 months ago a very similar plea for help was posted but on that occasion the lady in question was a UK national living in CM.

 

 

 

 

[Sheryl]

There are unfortunately quite a lot and more to come.

 

An awful lot of expats settle in Thailand without adequate provision for themselves in case of illness and without adequate provision for their old age.

 

As she is in Bangkok, St Louis Hospital on Sathorn has -- or used to have - a free clinic one or two evenings a week. You'll have to call to confirm they still do and find out the hours. they will not make a house call, and the free clinic is only for outpatient care, but could at least get her evaluated and treated for any illness she may have. From what you say it really is not clear if she is ill or just weak and failing due to age and not eating/drinking enough.

 

If she needs inpatient care, St Louis does have a foundation that assist with people who can;t meet their hospital bills, office is on the first floor but I don't know how they would respond to a farang - no harm in asking though.  Otherwise -- government hospital.