Thousands of miles away from the depths of the murky British winter, the view from the patio of Mary Inman’s villa in Thailand is beautiful indeed.
Luscious gardens replete with fragrant flowers and birdsong, two glistening swimming pools; anyone watching the 83-year-old sitting outside in the evening sunshine might think she was enjoying a five-star holiday.
But Mary, who has severe dementia and needs round-the-clock care, is one of a small but growing number of elderly Britons being sent halfway around the world by families who have turned their backs on the UK’s beleaguered, expensive care system and embraced the care ‘resorts’ that have sprung up across Thailand.
John Higgins at the Care Resort Chiang Mai in northern Thailand; a British-run facility which caters for hotel guests as well as the elderly
While the decision to send a loved one so far from home might be regarded as drastic, relatives say Thailand, with its warm climate and lower cost of living, offers unbeatable standards of care — beyond anything most could afford in the UK, where around one care home place in three is privately funded.
Some compare the Thai resorts to hit film The Best Exotic Marigold Hotel, in which a group of pensioners travel to India to see out their twilight days.
At Care Resort Chiang Mai, a British-run facility in northern Thailand which caters for hotel guests as well as the elderly, widowed mother-of-three Mary is looked after, one-to-one, by a team of Thai carers, while her days are filled with walks around the 12-acre grounds and lake, painting and music, pool sessions, spa treatments and trips to the local elephant farm and butterfly park.
‘The care our mum has is way beyond anything we could find in the UK,’ says Mary’s 54-year-old son Michael.
‘Care for the elderly is a huge part of the Thai culture. She has four wonderful young Thai women looking after her.
‘They treat her with love and respect. It’s impossible for homes to offer this level of care in the UK — it’s just too expensive.’
There are about 920,000 dementia sufferers in the UK but, with the nation’s social care system in crisis, their families struggle to find affordable good-quality care.
The average UK residential nursing home costs nearly £50,000 a year — but with staff shortages and no prescribed staff-to-resident ratios, carers often look after several residents at the same time.
The cost of one-to-one care, 24 hours a day, is about £120,000 a year.
Residents with savings over the Government’s £23,250 threshold have to ‘self-fund’ their places.
Rates at Care Resort Chiang Mai, which has 32 ‘guests’ and 48 full-time carers, start at about £1,100 a month.
After dementia sufferer Debbie Carlton, pictured, was taken to the Swiss-run VivoCare Residence, another Chiang Mai care facility, two years ago, one family friend even accused her husband Neil of kidnapping her
Former army officer’s wife Mary, from Chislehurst in Kent, pays £3,500 a month — £42,000 a year — for her luxury 800 sq ft two-bedroom, two-bathroom villa, which has a private patio garden. She is looked after by four carers working eight-hour shifts in rotation and is never alone.
The price she pays — at the highest end of the scale because of her care needs — is all-inclusive and covers individually tailored food, medical care, daily activities, spa treatments, laundry and day trips.
It’s not much more, says Michael, than the £35,000 a year the family was paying for 40-hours-a-week care in Britain.
The business consultant from Bristol heard of Thai ‘care resorts’ on the radio in 2017, at a time when he and his wife had realised Mary could no longer remain at home.
Put off by the sterile, hospitalised care homes they visited in the UK, they flew to Thailand in April 2017 and after ‘falling in love with the place’ took Mary there two months later, staying in a nearby hotel while they settled her in and furnished her villa to make her feel at home.
‘We were nervous about the trip but she was relaxed and excited, as if she was going on holiday,’ he says.
‘She is right next to the spa and gets massages every couple of days and her hair done. It’s very moving to see how loving the carers are with her. They kneel at her side to feed her by hand at mealtimes.
‘It was a big decision to make but I have never regretted it. We believe she is having the best care possible.
‘I know there are people here who are devoted carers and do a great job but you just can’t match what’s on offer in Thailand.’
Care Resort Chiang Mai is run by Peter Brown, a businessman from Manchester who decided to adapt his hotel resort to offer care for the elderly after removing his elderly mother from her UK care home.
There, he said, he found that staff were checking in on her via a tannoy system and he found several days’ meals still covered in cling film.
‘I knew I could do better,’ he says. ‘I wanted to create something that wouldn’t look, feel or smell like a care home. I don’t have patients, I have guests. My focus is to keep people safe and happy.’
His resort is one of several that have sprung up in the mountainous north of Thailand, most catering for elderly Europeans and Americans, sometimes along with their healthy partners, and offering high-quality care with high staff-to-guest ratios.
The UK government website lists 24 Thai care facilities, including Peter’s, that claim to meet standards set by the Care Quality Commission.
Pensioners wishing to relocate to one must obtain an annual ‘retirement’ visa from the Thai government and either provide proof of income or deposit 800,000 baht — around £18,000 — in a Thai bank account.
The biggest issue facing those considering care in Thailand is the distance. With his mother living 6,000 miles away, regular trips are impossible for Michael. But while he admits leaving his mother was ‘a wrench’, he believes he did the very best for her.
Mary Inman, who has severe dementia and needs round-the-clock care, is one of a small but growing number of elderly Britons being sent halfway around the world by families who have turned their backs on the UK’s beleaguered care system
Mary, he says, no longer recognises her family, so she doesn’t miss them. There is no point in FaceTiming her, as ‘she wouldn’t know what’s going on’. Instead, her carers share pictures and videos of her several times a week via social media.
‘It’s sad for us because she doesn’t know who we are any more,’ says Michael. ‘My job is to make sure she’s healthy, safe and well and ensure she has enjoyable moments.
She can have more of those in Thailand than in the UK — a little walk with her carer to see the flowering bush by her villa, or visiting an animal park, or being in the pool and feeling the sun on her face.’
But inevitably, those who send their relatives to Thailand can face scrutiny from friends and family.
After dementia sufferer Debbie Carlton was taken to the Swiss-run VivoCare Residence, another Chiang Mai care facility, two years ago, one family friend even accused her husband Neil of kidnapping her.
‘Most of our mutual friends turned their backs on me,’ says the 66-year-old entrepreneur and film historian from North London, who pays £2,800 a month for his wife’s care.
‘Dementia creates judgment in people but I have no doubt I made the right decision.’
Debbie has a large hotel-style room with ensuite bathroom and views of the mountains. During the day she has access, with a carer, to two outdoor pools and a Jacuzzi, as well as acres of gardens with lakes and a trout pond, a Swiss-style bakery and and five a la carte restaurants.
She spends her days taking short walks around the grounds, playing number games or filling in colouring books.
‘The care in Thailand is unbelievably good,’ says Neil. ‘There is an abundance of love for the elderly. My wife may not know who I am but she is smiling and happy all the time.’
The 66-year-old, who used to run her own events management business, was diagnosed with dementia in 2015.
At first Neil looked after her at home with the help of a £15-an-hour carer working from 9am to 6pm. But as her condition deteriorated, he started looking at residential homes in the UK.
‘Even the top-of-the-range ones felt soulless,’ he says. ‘It wasn’t the life I wanted for her. In Thailand, as soon as Debbie wakes up, there is someone with her. The carers are always smiling, always tender. They can’t do enough for her. It’s like a Four Seasons hotel.’
Residents’ days are filled with walks around the 12-acre grounds and lake, painting and music, pool sessions, spa treatments and trips to the local elephant farm and butterfly park
He adds: ‘When Debbie first arrived, she didn’t know where she was but she was relaxed and happy. They bent over backwards to look after her. At the time, all she would eat was salmon, noodles and grapes — and they got everything fresh for her every day. You’d never get that in a UK care home.’
The pandemic has also separated Neil from his wife — although he points out that in the UK, families have also been unable to visit care homes. He recently booked flights to visit her later this year.
‘I keep in touch via FaceTime but she doesn’t recognise me. I get upset because the person I love has gone — but all I can do is care for the person she is now.’
Paul Edwards, director of clinical services at Dementia UK, says the fact that families are choosing care abroad is ‘a reflection of the crisis facing the UK’s social care system’.
He adds: ‘Families dealing with long-term conditions like dementia are challenged more and more by a system they see as lacking in choice and financially punitive.’
Eileen Chubb, who runs the charity Compassion in Care, says that while the Thai model may work for some, such care facilities should be open to outside scrutiny.
‘I don’t judge people for choosing that option,’ she says, ‘but really we need to address the care system in the UK.’
Peter Brown, of Care Resort Chiang Mai, says that until recently there was no care home inspection system in Thailand because the concept was not part of the culture. Recently, however, Thai government policy has changed and he is in the process of obtaining a licence for his resort.
And clearly, despite concerns, for many the advantages of Thailand are all too evident. Even the healthy and able-bodied are choosing to go there.
John Higgins, an 81-year-old retired university lecturer who is still in good health, moved to Care Resort Chiang Mai last summer after the death of his wife Muriel from cancer in November 2020.
‘I didn’t want to be rattling around a house in Dorset on my own,’ he says. ‘Basically, I’m now living in a lovely hotel.’
John, who has a £1,700-a-month pension and £100,000 in savings, pays around £1,200 a month for his semi-detached villa. That covers food, laundry, housekeeping and excursions. While he doesn’t need care, a nurse checks his blood pressure three times a week and weighs him once a month.
‘It’s so much cheaper here and the climate is wonderful,’ says John, who lived in Thailand in the 1960s while working for the British Council.
‘I can see myself staying here for the rest of my life. It doesn’t feel anything like a care home. There are morning exercise classes by the lake and excursions to Chiang Mai, where there is a Marks & Spencer.
‘There’s a library with 500 large-print books. I can swim lengths in the pool. There’s even a bar here. I can sit on my terrace with a glass of wine in the evening and chat to my daughter in London on the phone.’
Dr Caleb Johnston, a senior lecturer in human geography at Newcastle University who has visited several of the Chiang Mai care facilities, says Thailand has a history of medical tourism stretching back to the 1960s that is backed by government investment.
‘The country is evolving as an international hub for dementia care,’ he says. ‘The care system in the UK is broken and each successive government is failing to fix it.’
With the number of dementia sufferers in the UK predicted to rise to 1.6 million by 2040, the dilemma of how best to care for the nation’s vulnerable elderly is clearly not going away.