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At first glance it looks like any other holiday resort. But the guests at this beautiful retreat in northern Thailand aren’t here for a typical holiday.
Known as a cultural centre and base for trekking, the mountain town of Chiang Mai has a growing reputation as a destination that excels in resort-style care for international Alzheimer’s patients.
As the cost of care in the West rises, patients and their families are increasingly looking to Asia for a quality care at an affordable rate.
And the trend is raising confronting issues, dividing medical experts and leaving family members to grapple with what’s best for their loved one.
Her husband, Ulrich Kuratli says the care in northern Thailand is not only less expensive but more personal than back home in Switzerland.
“(In Switzerland) you have a cold, old lady who gives you pills and tells you to go to bed,” he says.
Patients live in individual houses within a Thai community, are taken to markets, temples and restaurants, each with three caretakers working in rotation to provide personal around-the-clock care.
The monthly $US3800 ($A4277.59) cost is a third of what basic institutional care would come to in Switzerland.
He and his three grown children have given themselves six months to decide while the retired software developer lives alongside his 65-year-old wife.
He’s leaning toward keeping Susanna in Thailand, possibly for the rest of her life.
“Sometimes I am jealous. My wife won’t take my hand but when her Thai carer takes it, she is calm. She seems to be happy,” he says.
“When she sees me she starts to cry. Maybe she remembers how we were and understands, but can no longer find the words.”
Part of the family’
The pioneering Baan Kamlangchay was established by Martin Woodtli, a Swiss who spent four years in Thailand with the aid group Doctors Without Borders before returning home to care for his Alzheimer’s-diagnosed mother.
Wanting to return to Thailand and knowing that Thais traditionally regard the elderly with great respect, he brought his mother to Chiang Mai, where she became the home’s first “guest”. He never uses the word “patient”.
Over the next 10 years, the 52-year-old psychologist and social worker purchased or rented eight two-storey houses where 13 Swiss and German guests now stay.
Breakfast and lunch are eaten together and on most afternoons, the group gathers to swim, snack and relax on deck chairs.
Regular outside activities are organised because he believes these stimuli help delay degeneration.
“Movement is important. Tensions are also relieved if they have freedom to move. Our carers allow our guests a lot of space as long as it does not pose a danger to them,” Dr Woodtli says.
“In Switzerland we don’t have opportunity for such care.”
He says he thinks his guests “feel part of a family, a community”.
‘A resort, not a hospital’
Baan Kamlangchay led the way for other care-resorts to follow suit in Chiang Mai. A new, $10 million holiday-like home is set to open in the coming months. There are also plans for a small Alzheimer’s unit within a retirement community set on the grounds of a former four-star resort.
Those who end up staying at a facility being built in the outlying Chiang Mai district of Doi Saket will have amenities that would be tough for its European counterparts to match, including a clubhouse with a massage room and beauty parlour, a restaurant, Swiss bakery and pavilions with soaring ceilings and skylights.
“The idea is that this is a resort, not a hospital,” says Marc H. Dumur, a veteran hotelier who will manage the Swiss-owned, 3.5ha facility.
Going up are 72 patient rooms in six spacious pavilions, plus villas for visiting family members. Around-the-clock care will be provided by a staff of 150, including a Swiss head nurse and at least one licensed Thai nurse for each pavilion.
Care at the Doi Saket home will cost about $6000 a month.
Meanwhile, in the Philippines, about 100 Americans are currently receiving care, but more facilities are being built and a marketing campaign will be launched this year.
There, the cost of care is between $1500 and $3500 a month – compared with an average monthly bill of $6900 for a private room in a skilled nursing US facility.
Care vs community
There’s also uneasiness over the idea of sending ailing elderly people abroad: the German press has branded it “gerontological colonialism”.
Sabine Jansen, head of Germany’s Alzheimer Society, says while some with Alzheimer’s may adjust to an alien place, most find it difficult because they live in a world of earlier memories.
“People with dementia should stay in their familiar environment as long as possible. They are better oriented in their own living places and communities,” she says.
“Friends, family members, neighbours can visit them. Also because of language and cultural reasons, it is best for most to stay in their home country.”
Angela Lunde of the US-based Mayo Clinic says the afflicted generally do better in a familiar environment, but over time, even those with advanced stages of the disease can adjust well.
Dr Woodtli agrees that moving to a country like Thailand is not the answer for everyone with Alzheimer’s, but those who have travelled widely and are accustomed to change can probably adapt.
The UK-based Alzheimer’s Disease International says there are more than 44 million Alzheimer’s patients globally, and the figure is projected to triple to 135 million by 2050. The Alzheimer’s Association estimates that in the US alone, the disease will cost $US203 billion this year and soar to $US1.2 trillion by 2050.