Seeking Residential Care in Another Nation for Loved Ones with Alzheimer's
When faced with the hard decision about placing a loved one who has Alzheimer’s into a residential facility, most people want to find one that feels like a loving community and provides individualized attention to its residents. We seek out places that offer a home-like feel, believing it is in the next best thing to actually having a loved one at home. But would you do if the best facility you’ve found is actually in another nation?
It turns out that many people around the world are finding living options for their loved ones that are well outside their national borders. These facilities are offering less expensive care than can be found in the home country. And in many cases, the families feel that these facilities may actually offer better and more compassionate care that what their loved ones can get in the Alzheimer's facility in the cities where they live.
A recent Associated Press story shares the story of Susanna and Ulrich Kuratli, who live in Switzerland. Susanna, 65, has been diagnosed with Alzheimer’s and Ulrich, her husband of 41 years, is trying to decide whether to place her in an Alzheimer’s facility in Thailand or bring her back to Switzerland.
It turns out that this is proving to be a tough decision. He has found that the facility in Thailand has two really big selling points. First of all, at $3,800 a month, the Thai facility is a third of what the cost of basic institutional care in Switzerland, which ranks first in health care for the elderly in some indexes. Secondly – and equally important – his wife is getting more personalized care in the Thai facility. In Switzerland, he told the Associated Press reporter, “You have a cold, old lady who gives you pills and tells you to go to bed.” Susanna's care in Thailand is much more interactive and engaging, and also offers a feeling of being part of a family.
The story also points out that family members in other countries are seeking out similar arrangements in other nations. For instance, Germans are sending their elderly and their ill to Eastern Europe, Spain, Greece and Ukraine. And Americans are looking at options in other nations as well. For instance, the Philippines can provide care for between $1,500 and $3,500 a month. In comparison, the Alzheimer’s Association points out that the U.S. national average for basic services in an assisted living facility is $41,724 per year (or $3,477 a month). Furthermore, the average cost for a semi-private room in a nursing home is $78,110 (or $6,509 a month) while the cost of a private room in this type of a facility averages around $87,235 (or $7,270 a month).
So is this a good option? I’m not one to tell families what they should do and I think that all options should be explored. So here are my thoughts, based on my own caregiving experiences:
- If you are considering placing a loved one who has dementia in a facility in another country, definitely spend some time there with the loved one to get the lay of the land. Ulrich Kuratli is doing this, spending six months with his wife to determine if the facility they are considering is really up to par.
- Ideally, a family member or close friend would either living in the country or would relocate to the country. However, if you decide to make this type of placement and you’re not going to remain in the country with your loved one, you really need to develop a “team” that will be in charge of your loved one’s care in that country. That team needs to include a medical doctor, any medical specialists for specific conditions, and an “advocate” for the loved one. The advocate needs to be regularly visible at the care facility to ensure the loved one receives quality care and also should serve as the family’s coordination point in the country when medical issues arise.
- Finally, before placement, you need to thoroughly investigate all the financial and legal ramifications of placing a loved one in another country. Your exploration should include key health care issues, such as the loved one’s wishes if artificial means are needed to prolong life and who will make those decisions.
Personally, I wouldn’t have made this type of placement with my mother since I wanted to have more control of her caregiving, especially since she had advanced chronic obstructive pulmonary disease. However, I wouldn’t discourage families from exploring these options. Just make sure you do the due diligence to ensure that your loved one really will get quality care if they move to a facility in another nation.
Primary Sources for This Sharepost:
Alzheimer’s Association. (ND). Residential care.
Washington Post. (2013). Some with Alzheimer’s find care in far-off nations.