Care overseas

[canary]

@Scarlet Lady - I think that everyone on here had similar concerns to mine. If you are a long way away from your person with dementia who is in a care home it is difficult to know exactly what is happening and if something goes wrong it can become very problematic - doubly so if they are in a different country.

I dont think anyone was holding up the UK system as the gold standard as we have all come across the problems here and know what can go wrong. I think everyone wanted to make sure that the OP had thought of all the possible problems that may occur - you do not want to suddenly discover that there are huge problems just a time when the person with dementia has become too frail to repatriate.

 

[Davidb1973]

It sounds to me as though you have considered this very carefully and I am considerably heartened to hear that you will be moving there permanently - although a lot can happen in 18 months. I had a horrible feeling that you intended to move her there and simply trust that they would look after her.

If you do go ahead with this please, please can you feed back to let us know how it went and what happened. We have had a couple of people come on here saying that they are thinking of doing this, but then never came back to let us know if they did, and if so, what happened.

Will do, thanks for the positive reply. We are thinking about October/November as this is the coolest time in Thailand in order to help her get acclimatised. Again, no decisions have been made yet, and again my biggest fear is being unable to make a decision.

 

[Davidb1973]

Hi, @Davidb1973. You clearly know more than most of us about life in Thailand. Most of the questions that have been asked of you on the forum have been slanted towards life within the care system in the U.K, because that’s what most of us know. However, perhaps we need to understand that we most certainly do not hold the gold standard for care and it’s utterly presumptuous of us to assume we can do better than other countries. It may well be that the Thai care home you’ve been looking at will fulfil your mum‘s needs far better than the U.K. could.
All you can do is try, if that’s the decision you make. If so, as Canary has said, please let us know how it goes.

Will do. Again thanks for the positive message, which is much appreciated

 

[Davidb1973]

I just wanted to add something. Thailand is like the UK some 100 years ago, in the Cinema people stand for the national anthem, they respect the king, they have a respect for teachers, they respect each other, they also have a great deal of respect for the elderly. Do you remember tales from your grandparents where doors were left unlocked, this is Thailand in Chiang Mai today. Long may it continue.

 

[sdmhred]

I’ve been following this thread and indeed a difficult decision for you. My SIL is Asian (Malay) and I was wondering what the culture is in Thailand for the elderly. she is shocked here about how uncaring society is for the elderly….as well as the poor provision for all types of care. I had wondered whether that might be influencing your decision. I have to say we live in a block - there are 3 Asian families. They give my mum great respect when they see her coming in and out etc. Also I seem to get it too for looking after her. I have to say I do like that.

 

[Yankeeabroad]

Hi @Davidb1973
just see this thread — not going to add to the general themes. And I can totally understand the desire and benefits of sunshine!

I will say it’s not imperative that you are right around the corner to your mom in a care home. I live in Europe and my mom was in a home in the US. Yes, I spent some extended periods there not just for visiting — once when moving her in but mainly after hospitalisations.
You will need a full list of facility and individual telephone numbers though and hours they work.

Please ask how many care conferences you can expect and with whom - we had 1x month for the first months then moved to 1x quarter with the full care team (dr rep, caregiver rep, nursing and physio).

Is there a doctor on call and physio? (I bet you’ve already checked this). And what is your access to the doctor and input into the care plan? Will you be a part of doctors visits remotely? Same for hospital stays. Will they communicate electronically (a great help with time differences).

Do they facilitate phone and video/internet calls (very important as PWD often lose the ability to work technology or phone is removed to avoid excessive calling) and at what time of day.

Can you easily arrange food/good/clothing deliveries; particularly of any ”home” or western items and brands she might miss?

Do they have a plan in place for natural disasters — flooding, cyclones, fire, etc — both evacuation and rehousing if needed.

Finances: What are their past finances and current budget. You don’t want to be caught short because the place has gone bankrupt or can’t pay the bills. Is there a maximum fee increase per year? What about the place being sold?
Are you expected to tip, is it forbidden, or is there a tipping fund that is distributed proportionally between employees?
what happens if she runs out of money (hospitalisations can add up and there is always currency risk) — is there a benevolent fund? How will she be treated if she must be repatriated (where would she go in the UK if she has not been resident? And how long a wait to be placed)

and very interested in hearing your decision and outcome. maybe it’s an option for me in the future!
best of luck with making the decision.

 

[Davidb1973]

I’ve been following this thread and indeed a difficult decision for you. My SIL is Asian (Malay) and I was wondering what the culture is in Thailand for the elderly. she is shocked here about how uncaring society is for the elderly….as well as the poor provision for all types of care. I had wondered whether that might be influencing your decision. I have to say we live in a block - there are 3 Asian families. They give my mum great respect when they see her coming in and out etc. Also I seem to get it too for looking after her. I have to say I do like that.

The culture in Thailand and embodied from birth, is to respect your elders, respect your teachers respect your religion. I have experienced it in my many years over there. On a recent trip an older tourist boarded and sat down on a bus with no mask on, the conductor came over saying mask, mask and gestured towards the face, within seconds another passenger came over and gave him a face mask and. all was well. Its just a small example. I actually got married in Thailand and a friend of my Wife's (she's Thai) joined us when my parents visited, she essentially escorted my Mum and Dad everywhere, holding their arms and guiding them safely across the road...... it really was lovely to see and it was not just because she was a friend. There are of course bad eggs everywhere, but just to add there is a general respect for foreigners also

 

[Davidb1973]

Hi @Davidb1973
just see this thread — not going to add to the general themes. And I can totally understand the desire and benefits of sunshine!

I will say it’s not imperative that you are right around the corner to your mom in a care home. I live in Europe and my mom was in a home in the US. Yes, I spent some extended periods there not just for visiting — once when moving her in but mainly after hospitalisations.
You will need a full list of facility and individual telephone numbers though and hours they work.

Please ask how many care conferences you can expect and with whom - we had 1x month for the first months then moved to 1x quarter with the full care team (dr rep, caregiver rep, nursing and physio).

Is there a doctor on call and physio? (I bet you’ve already checked this). And what is your access to the doctor and input into the care plan? Will you be a part of doctors visits remotely? Same for hospital stays. Will they communicate electronically (a great help with time differences).

Do they facilitate phone and video/internet calls (very important as PWD often lose the ability to work technology or phone is removed to avoid excessive calling) and at what time of day.

Can you easily arrange food/good/clothing deliveries; particularly of any ”home” or western items and brands she might miss?

Do they have a plan in place for natural disasters — flooding, cyclones, fire, etc — both evacuation and rehousing if needed.

Finances: What are their past finances and current budget. You don’t want to be caught short because the place has gone bankrupt or can’t pay the bills. Is there a maximum fee increase per year? What about the place being sold?
Are you expected to tip, is it forbidden, or is there a tipping fund that is distributed proportionally between employees?
what happens if she runs out of money (hospitalisations can add up and there is always currency risk) — is there a benevolent fund? How will she be treated if she must be repatriated (where would she go in the UK if she has not been resident? And how long a wait to be placed)

and very interested in hearing your decision and outcome. maybe it’s an option for me in the future!
best of luck with making the decision.

Thank you for your response. Some of what you have raised has already been considered, some not and I certainly appreciate what you have raised and the points I have not already covered will be raised with the home. Funnily enough my Wife said to me we will go there when we are older!!

 

[Davidb1973]

I started the thread and feel obliged to provide an update. Mum went out on her own for a walk a few days ago, she (I assume) got confused and knocked on the neighbours door, they are aware of the situation and walked her back home and called me.
We do still believe Thailand is the best option and are still expecting to go in October. Given the above we are actively looking for another carer to visit every evening until Mum goes to bed in the hope the above won't happen again.
I am not a financial advisor but I am quite savvy financially. I realised Mums capital was earning a pittance, I am scared of the negative consequences of my decision, but more scared of doing nothing, the same applies financially. I selected some shares and invested £47k of her money, to date this has increased in value by £19k. Doing nothing can be easier than doing something, everything has a risk including doing nothing, I only hope my decision re Thailand will be the right one as were the investments on her behalf.
My point? If you are here you most likely have your loved ones best interest at heart, so don't be afraid of not following the norm
Thank you

 

[canary]

Hi @Davidb1973 , thanks for your update.

This new development is rather disturbing, though. My mum used to do this and once she had started it during the day it was only a very short time (just a few weeks) before she started going out at night (still in her nightwear), getting lost and knocking on random peoples doors. I do hope this doesnt happen to your mum, but please do be aware of the possibility.

 

[Lawson58]

I just wanted to add something. Thailand is like the UK some 100 years ago, in the Cinema people stand for the national anthem, they respect the king, they have a respect for teachers, they respect each other, they also have a great deal of respect for the elderly. Do you remember tales from your grandparents where doors were left unlocked, this is Thailand in Chiang Mai today. Long may it continue.

I don’t wish to sound disagreeable or to cause offence but I find that generalisations such as above very concerning. This is looking through rose coloured glasses.

I have never lived in Thailand but have visited several times and I have travelled extensively throughout Asia. I understand that Thailand has a very poor reputation regarding corruption in spite of various agencies set up to try and combat the problem. You don’t have to live in Thailand to have had some experience with corruption and the problems with drugs and sex (particularly underage sex and slavery) are very well known and indeed ‘in your face’.

I also lived for quite sometime in a country where corruption was rampant and saw first hand the way it impacts on society, families and frequently the most vulnerable. This includes the elderly and it appears from reports in the Bangkok Post that elder abuse is well and truly on the increase. I believe that recent elections revealed a lot of discontent on the part of the population with their current system and that they are not so fond of having a king as they used to be.

I have a friend who has lived in Thailand as a doctor for over thirty years and he loves it. But he is also a realist and recognises that Thailand has many problems and he has to deal with the fallout on many occasions.

 

[Davidb1973]

As promised I would like to give an update. We are now in Thailand and have been here for one week so far. Mum is getting along very well with the carers and the change. The daily exercise sessions and activities are being enjoyed and the food is very good (fish and chips last night). We are struggling with really knowing how often we should be with her, the daily activities stat at 10 and generally finish at 2, but we have arranged 1:1 care from 8 until 8, so we tend to leave her to it until about 4. We have been taking her to a shopping centre every other day where we all have a Starbucks and a bite to eat and she seems to love that. Yesterday was the first time we didn't visit so will see how she coped later today. That's about it for now, but in summary, despite all of my concerns all seems to be going well, and importantly she seems happy. Thanks all

 

[canary]

Thank you for your update @Davidb1973

Im glad the move went well and you managed to get her there safely. So far, its all sounding very positive.

A week is still very early days, though - it usually takes a good couple of months for them to settle, so it would be nice to have further updates please.

 

[Davidb1973]

Thank you for your update @Davidb1973

Im glad the move went well and you managed to get her there safely. So far, its all sounding very positive.

A week is still very early days, though - it usually takes a good couple of months for them to settle, so it would be nice to have further updates please.

Will do, and as it happens another member of the forum over a relation to Thailand about the same time and they are equally impressed. Thanks

 

[Hermann]

As someone with over thirty years’ experience of the language, culture and people of a politically monolithic country in the far east with very poor human rights and rule of law, I would echo Lawson58’s cautionary words about Thailand from July.

Be aware that people standing up for the national anthem and respecting elders do not mean there aren’t certain harsh realities about life in Thailand:

Thailand: Freedom in the World 2023 Country Report | Freedom House

See the Freedom in the World 2023 score and learn about democracy and freedom in Thailand.

freedomhouse.org

 

[Davidb1973]

I agree its not a simplistic as standing for the anthem, however it is indicative of a respectful society. people get murdered, there is corruption and if you are earning minimum wage and get unfairly sacked don't expect to much help in Thailand, similarly the gig economy in the West isn't really doing the participants too many favours. Rule of law is not perfect here, far from it, but we in the UK do not live in anywhere close to a perfect model, a glance at the newspapers and recent news (Andrew Malkinson) shows examples of justice gone wrong and regularly doing so, There is a lot of dirty money in the UK (Transparency international),political influence is for sales and money talks and with a highly paid barrister on your payroll, you are more likely to get off a police charge or win a case than Mr &Mrs average will with a high st solicitor. At roughly £2,500 pm residential homes in Thailand are not that cheap but there are people making a great deal of money from running the homes and I would expect an owner would want the home to be squeaky clean because any bad publicity could easily close a very profitable business down. Thailand is a developing country and is probably as free (if not more free) as the UK was at is comparative time of development.

Not meaning to turn this into an us versus them, however similar applies to the warehouse worker working for Amazon or the zero contract hours worker in a restaurant, neither would be granted an audience with a minister if they needed representation whereas the well connected and super wealthy in the West and East generally have contacts and influence

 

[Sonya1]

Having read through this thread, I think that if you have trusted friends there, and if you plan to settle your Mum in plus move to Thailand yourself in the forseeable future, it could be a very viable idea. For certain your Mums funds will last significantly longer paying for care in Thailand versus in the UK! We have a friend who has a Thai spouse and has spent significant time there over the last 20 years although they now live in UK ith their children. When their children were ill whilst visiting their Thai relatives, our friend says the standard of hospital care was way above and beyond anything in the UK. Many of the care staff in my Dad's nursing home are degree/masters students studying various health/care/medical and are from Nigeria and Nepal and I have to say that they knock spots off most of the UK carers! (no offense intended to any UK carers) Their gentle care and respect of my Dad is as good as we ourselves would provide. I would be very interested to hear how this works out for your Mum

 

[Lawson58]

I agree its not a simplistic as standing for the anthem, however it is indicative of a respectful society. people get murdered, there is corruption and if you are earning minimum wage and get unfairly sacked don't expect to much help in Thailand, similarly the gig economy in the West isn't really doing the participants too many favours. Rule of law is not perfect here, far from it, but we in the UK do not live in anywhere close to a perfect model, a glance at the newspapers and recent news (Andrew Malkinson) shows examples of justice gone wrong and regularly doing so, There is a lot of dirty money in the UK (Transparency international),political influence is for sales and money talks and with a highly paid barrister on your payroll, you are more likely to get off a police charge or win a case than Mr &Mrs average will with a high st solicitor. At roughly £2,500 pm residential homes in Thailand are not that cheap but there are people making a great deal of money from running the homes and I would expect an owner would want the home to be squeaky clean because any bad publicity could easily close a very profitable business down. Thailand is a developing country and is probably as free (if not more free) as the UK was at is comparative time of development.

Not meaning to turn this to an us versus them, however to state the little man in the paddy field in not politically well represented would be true, similar applies to the warehouse worker working for Amazon or the zero contract hours worker in a restaurant, neither would be granted an audience with a minister if they needed representation whereas the well connected and super wealthy in the West and East generally have contacts and influence

Corruption exists in all countries and we would be fools to say anything else. Corruption costs every economy loads and loads of money. However in developed countries, you don’t have to shell out to get a paper signed at the police station today instead of in three months time. You don’t have to pay a generous contribution to avoid being charged with speeding when you weren’t speeding simply because the policeman could fleece anyone when he wanted.

Corruption in under developed countries affects everyone, but mostly the people who can least afford it and it extends into areas most westerners don’t even think about or even want to know. It is involved in protection, organised crime and the black market.

As someone I knew once said, “At least with corruption, you can get things done when you need them done.”. People use the system because they have no other way of getting anything done. It stems out of poverty and lack of social welfare, whereas in developed countries we call it greed.

And the Amazon worker can still see his MP or write a letter and expect an answer.

 

[Hermann]

I can give you a good example of how differently rule of law works in the UK and in countries like Thailand.

Twenty years ago I was being driven along a motorway with only light traffic in the far eastern country I referred to earlier. My driver was doing around 80 mph in the inside lane. All of a sudden a huge black sedan with a small flag on the bonnet overtook us on the inside (i.e. on the hard shoulder) at around 100mph.

This might not have been so bad had it not been for the fact that a local villager working as a road sweeper was standing with her broom just inside the white line separating the hard shoulder from the inside lane. So when the driver of the sedan overtook us, the roadsweeper was briefly sandwiched on both sides between two very fast moving cars. She was in fact missed by inches by the sedan, whose driver may not have even seen her until the last minute. There was terror written all over her face.

I expressed my shock at what I'd seen to my driver and asked whether we should report the number plate of the sedan to the police. The driver told me there were senior army personnel in the black sedan, and that if we reported the incident to the police, it was us who would get in trouble not the senior army personnel in the sedan; the police would do the army chiefs' bidding, he said, and warn us off, with the threat of criminal charges of some kind if necessary, while the driver of the black sedan would be allowed to simply go his not so sweet way.

In Thailand specifically the case of Red Bull heir Vorayuth Yoovidhaya illustrates the impunity with which the rich and well connected can casually take ordinary people's lives in a similar fashion to the case I witnessed.

As for the matter of your dissatisfaction with rule of law in the UK, I am with you on that up to a point, not least because of the recent appalling curbs on access to legal aid people in the UK are now faced with. This is taking the country back to that very unequal society of past centuries when rank injustice could very well be your lot if you couldn't afford legal representation.

I might not be too complimentary about Thailand's rule of law, but you're certainly right that the UK has problems on that score too.

 

[ScaredyCat]

This thread seems to be veering away from dementia care.