Dementia This article is more than 4 years oldFamilies sending relatives with dementia to Thailand for care
This article is more than 4 years oldBritish people with disease sent abroad over inadequate and expensive care at home
British families are sending elderly relatives with dementia overseas to Thailand in a small but growing trend.
Researchers visiting private care homes in Chiang Mai have found eight homes where guests from the UK are living thousands of miles away from their families, because suitable care in their home country was impossible to find or afford.
“Thailand already has a long history of medical tourism and it’s now setting itself up as an international hub for dementia care,” said Dr Caleb Johnston, a senior lecturer in human geography at Newcastle University.
Some of the facilities are British-run; some are Thai-run but with substantial investment from British citizens; and some are Swiss-run. All have the backing and support of the Thai government. “The government and private investors are very active in cultivating this as part of their economic development,” Johnston added.
There are an estimated 850,000 people living with dementia in the UK. Local authority residential care costs up to £700 a week, with private care around £1,000. There are no prescribed staff-to-guest ratios in the UK but, with annual staff turnover exceeding 30% and 122,000 job vacancies, levels in state and private facilities tend to be around 1:6.
In Thailand, in contrast, 1:1 around-the-clock residential care with fully-qualified staff – in award-winning facilities that look like four-star hotels – costs around £750 a week.
Johnston spent nine weeks in Thailand along with Prof Geraldine Pratt, head of geography at the University of British Columbia, interviewing families and staff in residential care homes.
“There aren’t yet any official numbers as to how many people are moving out to Thailand to receive care,” said Johnston. “Relative to the total number of people living with dementia, it is a low number. But with the number of people with dementia set to increase, and the cost of looking after them also getting higher, it is likely to be an option that more and more people consider.”
Paul Edwards, the director of clinical services at Dementia UK, said: “I can well understand people choosing this option, given the state of anxiety about care in the UK.
“It’s an emerging market that I can see becoming more popular because our failing and ailing system – which no politician is even trying to find a solution for – causes fear for those whose loved ones have to use it.”
Nonetheless, those who take their loved ones abroad talk of the distress in having to choose between the physical, emotional and financial hardships of caring for them in the UK and outsourcing their care to the other side of the world.
Annie (not her real name) has moved her husband into Vivobene Village, a Swiss-run home near Chiang Mai. She initially tried finding care close to her home in the south of England, but was forced to move to Yorkshire. “There was care for him there but there was no one for me to turn to there,” she said.
“So then we moved again to the north of England. But then I needed respite. The home we were recommended for my husband cost £900 a week and one afternoon, my son-in-law went to take [my husband] out and he wasn’t dressed or shaved. He was just looking out of the window. We bought him home and a few months later, I put him into another care home and the same thing happened again.”
Shortly afterwards, the couple flew out to see their daughter in Bangkok and heard about the care home. “He’s never left here since that day. We just said, ‘this is perfect’,” said Annie, in an interview with Johnston and Pratt.
Annie now visits her husband three times a year, staying for two to three months at a time.
“I think he’s very happy here,” she said. “The people around him are so nice and he reacts to that. For him, I think his life is as good as it could be. It’s worse for me than it is for him.”
Peter Brown moved to Thailand from the UK and opened a four-star hotel resort in Chiang Mai 11 years ago. He founded the Care Resort Chiang Mai six years ago, after becoming unhappy with the quality of care his mother was receiving in her British care home.
“I don’t believe there are any relatives in the world who want to export their mother and father to a different country,” he said. “What they want is care for their mother and father that they are entitled to and unfortunately, their local city is incapable of giving them.
“They don’t want their mother and father locked away for 23 hours a day, sat in a corridor for one hour then put back into their room, so they start to look around for alternative options. There are plenty of options in a separate country, so how can you blame them for taking it?
“You should find the solution at home. But the solutions aren’t good enough or affordable in the UK. Dementia sufferers need a lot of time and that doesn’t fit in with the western lifestyle any more. The advantage with somewhere like Thailand is that the staff are a lot cheaper and the strong family culture here. People respect the elderly as a norm. In the west, we don’t respect the elderly any more.
“The British state does need to do more because the best place for people to be looked after is where they are now.”
There have been recent reports of people with Alzheimer’s disease being forced from Thailand because of changes to immigration rules, but for Allan Sims, from the south of England, his experience is “as close to perfection as you can imagine”.
Sims and his wife had been going on holiday to Thailand for years, and when she developed Alzheimer’s disease four years ago, the couple moved to Ko Samui and lived in a four-star hotel.
When his wife’s condition worsened, their daughter found a Chiang Mai care home on the internet. “We have three to four carers for every dementia guest here and my wife’s caregivers are my close friends now,” Sims said.
“I’m so impressed. My wife needs someone with her 24/7. When I get overwhelmed and my daughter takes me away for a break, a carer doesn’t just care for my wife but shares the bed with her [because she tends to get up and walk around].
“If I was in the UK, we might get a carer for 15 minutes in the morning and 15 minutes in the evening, or some ridiculous thing,” he said. “I despair about the care in the UK.”
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