Residents of a Thai facility for people with Alzheimer’s disease toss around a yellow ball and laugh under a cascade with their caregivers, in a swimming pool ringed by palm trees and wind chimes. Susanna Kuratli, once a painter of delicate oils, swims a lap and smiles.
Watching is her husband, Ulrich, who has a heart-rending decision: To leave his wife of 41 years in this facility 9,000km from home, or to bring her back to Switzerland.
Their homeland treats the elderly as well as any nation on Earth, but the care in northern Thailand is not only less expensive, but more personal, Ulrich Kuratli says.
In Switzerland, “you have a cold, old lady who gives you pills and tells you to go to bed,” he says.
Kuratli and his family have given themselves six months to decide while the retired software developer lives alongside his 65-year-old wife in Baan Kamlangchay — “Home for Care from the Heart.”
Patients live in individual houses within a Thai community, are taken to local markets, temples and restaurants, and receive personal around-the-clock care.
The monthly US$3,800 cost is a third of what basic institutional care would cost in Switzerland.
Kuratli is not yet sure how he will care for Susanna, who used to produce a popular annual calendar of her paintings. However, he is leaning toward keeping her in Thailand.
Relatives in Western nations are increasingly confronting Kuratli’s dilemma as the number of Alzheimer’s patients and costs rise, and the supply of qualified nurses and facilities struggles to keep up.
Faraway countries are offering cheaper, and to some minds better, care for those suffering from the irreversible loss of memory.
The nascent trend is unnerving to some experts who say uprooting people with Alzheimer’s will add to their sense of displacement and anxiety, though others say quality of care is more important than location.
There’s also some general uneasiness over the idea of sending ailing elderly people abroad: The German press has branded it “gerontological colonialism.”
Germany is already sending several thousand sufferers, as well as the aged and otherwise ill, to Eastern Europe, Spain, Greece and Ukraine.
The Philippines is offering Americans care for US$1,500 to US$3,500 a month, well below US rates.
Facilities in Thailand are also preparing to attract more Alzheimer’s sufferers.
In Chiang Mai, a pleasant city ringed by mountains, Baan Kamlangchay will be followed by a US$10 million, holiday-like home scheduled to open before the middle of this year.
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.
A number of European countries have generous national health insurance, but these generally do not cover treatment abroad.
Kuratli says the Swiss government would cover two-thirds of the bill for his wife’s care if she stays in Switzerland, but since high-end private clinics there can cost US$15,000 or more per month, he could still end up paying more there than he would in Thailand.
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.
He brought his mother to Chiang Mai, where she became the home’s first “guest.”
Over the next 10 years, the 52-year-old psychologist and social worker purchased or rented eight two-story houses where 13 Swiss and German patients now reside.
On most afternoons, the group gathers at a private, walled park to swim, snack and relax on deck chairs. Regular outside activities are organized because Woodtli believes these stimuli may help delay degeneration.
Germany’s Alzheimer Society director Sabine Jansen says that while some with Alzheimer’s may adjust to an alien place, most find it difficult because they live in a world of earlier memories.
Angela Lunde of the US-based Mayo Clinic says that generally the afflicted do better in a familiar environment, but over time, even those with advanced stages of the disease can adjust well.
Woodtli says people who have traveled widely and are accustomed to change can probably adapt.