An article recently published in the Guardian reports that British families are now sending elderly relatives with dementia overseas to Thailand in a small but growing trend. It would seem to be a sign of our times.
This would seem to be at odds with the criteria often used by many families when seeking a place for their relative in a care home, where the nearness of the location of the home is seen of paramount importance. Location has always been a major consideration because it enables people to visit more easily and keep in regular contact with the relative.
Private care homes in Thailand
It is surprising then that even in these turbulent times 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 a 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.
Research in Thailand
“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 will consider.”
Why are people moving their relatives to Thailand?
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.”
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.
“You should find the solution at home. But the solutions aren’t good enough or affordable in the UK. “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.”
The advantage with somewhere like Thailand is that the staff are a lot cheaper and the strong family culture here. However, 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”.
Seeking accommodation in a care home for your loved ones in Thailand would cause consternation to any family. The fact that it is taking place at all is surely down to anxiety and the state of many underfunded social care services in the UK.
We are continuing to learn about how we can provide quality and meaningful services for people with dementia and the support of families is crucial to social care services. While Paul Edwards says he can well understand people choosing this option, given the state of anxiety about care in the UK. Reports about people with dementia being forced out of Thailand because of migration issues are accurate, then this may impact on the decision of families to consider this option in the future.
Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy