Is this the future for dementia care?

The tsunami of dementia sufferers worldwide is heaping pressure on residential facilities and personal carers. The result is that families are looking overseas for cheaper and better care and adding a new dimension to the medical tourism industry.

British and Swiss families in particular have been sending elderly relatives with dementia to Thailand in a small but growing trend, The Guardian reports.

It says there is a rapidly growing number of private care homes in Chiang Mai in northern Thailand offering care for dementia sufferers because available facilities in western countries are expensive and many lack suitably qualified staff.

“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 in England.

“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.”

Someone in the world develops dementia every three seconds, according to the World Alzheimer’s Report 2015. There were an estimated 46.8 million people worldwide living with dementia in 2015 and that number is expected to almost double every 20 years, reaching 75 million in 2030 and 131.5 million in 2050.

In Australia, dementia is the second leading cause of death overall, and the leading cause for women.

The ongoing aged care royal commission has shone a spotlight on the quality of residential aged care generally and how problems are magnified when residents have dementia.

The Guardian reports that in the UK, local authority residential care for dementia sufferers costs up to $1155, with private care around $1700. As is currently the situation in Australia, there are no prescribed staff-to-guest ratios and the adequacy of staff training is questioned.

In Thailand, 24-hour, one-on-one residential care with fully qualified staff – in facilities that equate to four-star hotels – costs about $1300 per week.

Dr Johnston spent nine weeks in Thailand 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,” he said.

“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: “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.”

An interim report from Australia’s aged royal commission, titled Neglect, was released on 31 October. It called for a fundamental overhaul of the aged care system and the way it is designed, funded and regulated.

The federal government’s Mid-Year Economic and Fiscal Outlook (MYEFO) 2019–20 responded with a four-year $537 million package that included $10 million to increase dementia training and support for aged care workers.

It was quickly labelled by many in the sector as inadequate.

Aged care provider groups said at the time that the lack of new aged care investments in MYEFO meant the risk of an aged care emergency remained and that some residential providers would find it almost impossible to continue delivering quality care.

The Guardian tells the story of UK citizen Peter Brown. 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.”

Would you consider moving a loved one with dementia to Thailand so that he or she received good care?

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Written by Janelle Ward

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