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Watching is her husband, Ulrich, who has a heart-rending decision: to leave his wife of 41 years in this facility 9000 kilometres (5 600 miles) from home, or to bring her back to Switzerland.
Their homeland treats the elderly as well as any nation on Earth, but Ulrich Kuratli says the care here in northern Thailand is not only less expensive but more personal. In Switzerland, "You have a cold, old lady who gives you pills and tells you to go to bed," he says.
Read: Caregivers: Dementia
Kuratli and his three grown children 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, each with three caretakers working in rotation to provide personal around-the-clock care. The monthly $3 800 cost is a third of what basic institutional care would come to in Switzerland.
Rising costs for Alzheimer's care
Kuratli is not yet sure how he'll care for Susanna, who used to produce a popular annual calendar of her paintings. But he's leaning toward keeping her 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."
Spouses and 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.
Read: Alzheimers patients demand better careDifferent locations is already becoming a trend
Germany is already sending
several thousand sufferers, as well as the aged and otherwise ill, to Eastern
Europe, Spain, Greece and Ukraine. Patients are even moving from Switzerland,
which was ranked No. 1 in health care for the elderly this year.
The Philippines is offering
Americans care for $1 500 to $3 500 a month — as compared to $6 900 the
American Elder Care Research Organisation says is the average monthly bill for
a private room in a skilled nursing US facility. About 100 Americans are
currently seeking care in the Philippines but more facilities are being built.
Facilities in Thailand also
are preparing to attract more Alzheimer's sufferers. In Chiang Mai, a pleasant
city ringed by mountains, Baan Kamlangchay will be followed by a $10 million,
holiday-like home scheduled to open before mid-2014. Also on the way is a small
Alzheimer's unit within a retirement community set on the grounds of a former
four-star resort.
Read: Caring for someone with Alzheimer's disease
Medical tourism
The number of people over 60 worldwide is set to more than triple between 2000 and 2050 to 2 billion, according to the World Health Organisation. And more are opting for retirement in lower-cost countries.
"Medical tourism" has become a booming industry, with roughly 8 million people a year seeking treatment abroad, according to the group Patients Beyond Borders.
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 $203 billion this year and soar to $1.2 trillion by 2050.
Read more:
Principles for Alzheimer’s care
The bond between an Alzheimer's patient and their caregiver may slow decline
