CHIANG MAI, Thailand — Residents of this 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 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 said 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 said.
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 $3,800 cost is a third of what basic institutional care would come to in Switzerland.
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.
“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 said. “When she sees me she starts to cry. Maybe she remembers how we were and understands, but can no longer find the words.”
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 said uprooting people with Alzheimer’s will add to their sense of displacement and anxiety, though others said 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 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.
Patients are even moving from Switzerland, which was ranked No. 1 in health care for the elderly this year in an index compiled by the elderly advocacy group HelpAge International and the U.N. Population Fund.
The Philippines is offering Americans care for $1,500 to $3,500 a month, well below U.S. rates. About 100 Americans are currently seeking care in the Philippines, said J.J. Reyes, who is planning a retirement community near Manila.
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, holidaylike home scheduled to open before mid-2014.
The U.K.-based Alzheimer’s Disease International said there are more than 44 million Alzheimer’s patients globally, and the figure is projected to triple to 135 million by 2050.
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 her to Chiang Mai, where she became the home’s first “guest.” Woodtli never uses the word “patient.”
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.
Sabine Jansen, head of Germany’s Alzheimer Society, said 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.
“They are better oriented in their own living places and communities,” she said. “Friends, family members, neighbors can visit them. Also because of language and cultural reasons, it is best for most to stay in their home country.”
Angela Lunde of the U.S.-based Mayo Clinic said generally the afflicted do better in a familiar environment, but over time, even those with advanced stages of the disease can adjust well.
“I think a positive transition has less to do with the move itself and more with the way in which the staff and new environment accommodates the person living with dementia,” she said.
Woodtli said people who traveled widely and are accustomed to change can probably adapt.
“One of our guests sometimes wakes up in the morning and says, ‘Where am I?’ But she would do the same if she was in a care center in Switzerland,” he said. “One guest thinks she is in a schoolhouse at Lake Lucerne.”