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Dick Crank

Too old for Thailand?

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If you look at NancyL's numbers above it could be about US $2000 per month to have round-the-clock professional nurse assistance. Do you realize what that would cost in the USA?

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10 minutes ago, JLCrab said:

If you look at NancyL's numbers above it could be about US $2000 per month to have round-the-clock professional nurse assistance. Do you realize what that would cost in the USA?

 

Where you get your usd 2000 a month? If I need 24 hours help, I will jump to if I can climb over that f fence. 

 

It should not be more than 18 000,- bath a month for normal daycare help. She have to pay me 4000,- back for the room to, 

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As I said from NancyL's numbers 

 

"The primary two are paid at least 10,000 baht/month, actually as high as 15,000 baht/month and get free food when they're working." ... and then I would be willing to pay maybe more than the going rate.

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5 hours ago, NancyL said:

 

There would be no way to get good quality care here in Chiang Mai for the 450-500 baht/day number given by Colinneil.

Ever calculated how much 30 times 500 is? And by per day I would assume that mean a normal day shift.

 

5 hours ago, NancyL said:

The primary two are paid at least 10,000 baht/month, actually as high as 15,000 baht/month and get free food when they're working.  

 

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9 hours ago, OJAS said:

I am the same age as you and with similar mobility problems to yours. I agree with you that the UK is more disabled-friendly than Thailand. But, in addition to mobility v. boredom, I think that another key issue relates to the availability of support mechanisms. Here in Thailand, I have my wife and her family who, I hope, will take care of me in my advancing years, in accordance with the Thai tradition of the younger family members looking after their elders. But no such tradition exists in the UK, of course, and, in any event, I no longer have any close family members living there. So, were I to relocate back to the UK, I could eventually find myself having to shell out a fortune for so-called "professional" care, just like my parents had to do in their final years.

That is my concern as we'll, being that returning Thailand now when I'm much older I may not have the time to marry and/or have the relationships in place formed over time which would enable me to rely on care from an extended family there.

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2 hours ago, Dick Crank said:

That is my concern as we'll, being that returning Thailand now when I'm much older I may not have the time to marry and/or have the relationships in place formed over time which would enable me to rely on care from an extended family there.

How romantic.

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6 hours ago, janclaes47 said:

Ever calculated how much 30 times 500 is? And by per day I would assume that mean a normal day shift.

 

 

I believe Nancy quoted a monthly salary of THB10,000/15,000 per person rather than a total for the pair, both working 12 hour shifts, which seems like a sensible salary.

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3 hours ago, simoh1490 said:

I believe Nancy quoted a monthly salary of THB10,000/15,000 per person rather than a total for the pair, both working 12 hour shifts, which seems like a sensible salary.

Yes, I'm quoting 10,000/15,000 per person, for two full time people with an additional third person needed part-time for the main staff's days off.   This is a reasonable rate for someone who is a certified nursing assistant and knows how to do things like beyond just spoon-feeding a patient or helping them dress.  As people age, they often need more advanced care for things like changing dressings on bedsores or other wounds, administering tube feeding (including reinserting the tube if the patient pulls it out), suctioning a respirator, having a bed-bath, etc. 

 

You may think you're "healthy and active" now, but that has a way of changing and it can change fairly quickly for people beyond age 75.  If someone makes it to that age, then they rarely die suddenly from something like a stroke or heart attack.  Instead, they experience years of declining mobility and increasing frailty and have a multitude of little health problems that take their toll.  You should plan for several years of needing this type of care, especially if you're older and have a healthy lifestyle, so you've dodged the bullet on getting cancer or having a stroke in your 60s.

 

Another concern is people who maintain good physical health but develop dementia.  These folks can be VERY difficult to care for because they want to wander and stay active.  The solution there is to keep them busy with physical therapy including activities that will challenge their bodies and make it easier for them to sleep -- like water exercises, treadmills, stationary bikes or even long walks with a caregiver watching, sometimes from a distance, out of sight of the person, if they resent always having someone around.  It takes a special kind of caregiver, trained not to do it the Thai way of hovering over a elderly person and expecting them to be still.  Someone who is able to work alongside the elderly patient to keep them physically active.  

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15 hours ago, NancyL said:

I know people who have set up good 24/7 care situations in their homes, but it requires employing three people.  At least two working 12 hour shifts and a third working part-time to give the other two some time off.  The primary two are paid at least 10,000 baht/month, actually as high as 15,000 baht/month and get free food when they're working.  

 

The key to making this arrangement work is to have someone "in charge" who can act when one of the caregivers doesn't show up and who is handling bill payment, scheduling medical appointments, supervising meds, etc.  Often this can be a wife, but not always.  

 

There would be no way to get good quality care here in Chiang Mai for the 450-500 baht/day number given by Colinneil.  You can maybe hire a full-time maid for that, but not someone who has skills needed to take care of a handicapped person.  Maybe in KhonKaew, but as he pointed out someone working at that low a wage isn't very reliable.

Nancy i do not understand you saying that 500 baht a day is any diffrerent to your posts.

As 500 baht a day over 25 days is 12500 baht a month exactly in the middle of your estimate.

 

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9 minutes ago, colinneil said:

Nancy i do not understand you saying that 500 baht a day is any diffrerent to your posts.

As 500 baht a day over 25 days is 12500 baht a month exactly in the middle of your estimate.

 

Nancy is quoting a PER PERSON cost, for the second time!

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1 minute ago, simoh1490 said:

Nancy is quoting a PER PERSON cost, for the second time!

So am i

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7 minutes ago, colinneil said:

So am i

With all due respect to your carers I doubt that at that price you have fully trained and qualified staff, I suspect location may also determine rates to some degree with cities being more expensive. Also, are your rates factoring in 2 x 12 hour shifts?

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16 hours ago, colinneil said:

How do i cope?

Well mate i am fortunate that after my accident we had a bedroom/ bathroom/ kitchen built downstairs, with everything suited to wheelchair height.

I had a carer for nearly 2 years, but she was very unreliable, worked a few weeks, stopped for few weeks.

Now in our area near khonkaen it is around 450/500 baht per day for a helper.

Colin, this is the first post of yours where you did not mention your dual duty, hard working, great caring wife. I always enjoy reading your tributes to this fine Thai woman.

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I am not interested in the numbers game but the options available to me and some of the arrangements I have made tentatively or otherwise in Thailand for long-term care can astound persons in the USA who are knowledgeable of how things work there.

 

... and while it is nice to know that a family or significant others can help with your long-term care, it's also nice to know that they can do so at THEIR choice and that you are not solely dependent on them.

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18 minutes ago, JLCrab said:

I am not interested in the numbers game but the options available to me and some of the arrangements I have made tentatively or otherwise in Thailand for long-term care can astound persons in the USA who are knowledgeable of know how things work there.

Yes, as I pointed out you can arrange 24/7 care from certified nursing assistants for about $2500 per month.  The labor cost is cheap, but you also have to factor the cost of specialized equipment and this can get expensive here.  For example, a manual patient hoist that sells  $700 - 1000 in the U.S., with free delivery, will run 50,000 - 70,000 baht here because of import duty.  Same thing with hospital beds.

 

But, if someone is anticipated to need long-term care, it can be arranged for less than half the cost of what you'd pay in the U.S.  Remember, too, that the assisted living centers in Chiang Mai are a very good bargain compared with the U.S.  The most popular Dok Kaew Gardens, part of McKean Rehab Center, is 32,000 baht/month for someone who still has some independence and 45,000 baht/month for higher care, as for those with dementia. The high-end assisted living center here is Vivo Bene, like staying in a five star resort.  The cost there ranges from 80,000 -100,000 baht/month.  Less than $4000.  Ten years ago my father was in a facility in the U.S. that cost $5000 per month and was nowhere near as nice as Vivo Bene, maybe more like Dok Kaew.  That was ten years ago; I shutter to think what it costs now. 

 

If someone is bedbound and needs tube feeding, daily dressing changes and other regular nursing services, they can live at McKean Rehab Center.  I've assisted one man who had high care needs and was in a very nice, private room at McKean.  His monthly bills were about 80,000 baht/month for daily wound changes, daily physical therapy, bedbaths, and other attention needed because he couldn't leave the bed.   Less than $3000, about 1/3 what this level of service would have cost in the U.S. and chances are it would have been given by disinterested caregivers.  At McKean, the nurses are sweet and kind and have a nice rapport with the patients.

 

Yet for many expats, especially those living pension-check-to-pension-check just on a gov't pension, these numbers seem astronomical.  There are many retirees here getting by on 30,000 - 40,000 per month.  This is not a realistic income to support assisted care here and people in this situation should have a plan in place to return to their home countries when the time comes so they can avail themselves of public assistance.

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