losing everyhting

In 2015, an estimated 5.3 million Americans will be diagnosed with Alzheimer's disease. This number is expected grow each year as the proportion of the US population above age 65 continues to rise.1 The global cost of dementia is now $600 billion per year and is expected to soar even further.2

The World Health Organization predicts that by 2050, the number of people who make it past their 80th birthday will almost quadruple to 395 million—and one in six will be living with dementia.

More than 80 percent of current care home residents have significant memory problems or full dementia.3 With younger family members footing the bill, the cost of a good residential home is out of reach for many, causing some families to consider options outside of their own national borders.

The Exorbitant Cost of Dementia Care

When you consider what it costs to provide full-time care to a family member with Alzheimer's or other dementia, it's easy to see why some families are considering what might be called radical options—such as care centers on the opposite side of the globe.

Like the US, the average cost of residential or nursing care in the UK ranges from $3,600 to more than $5,000 per month. In Switzerland, the price tag's even higher at $5,000 to $10,000 per month.4 The exception seems to be Thailand.

Thailand is known for medical tourism. There, the cost of nursing care is significantly lower, and yet care quality remains high, according to most reports.

Thai culture places a large emphasis on looking after its elderly, which has paved the way for a different approach to care. A basic residential care package in Thailand is closer to $3,000 per month—and that package is likely to be more comprehensive.

Two 'Dementia Resorts' in Chiang Mai, Thailand

The film features two dementia care centers in Thailand, both located in the northern city of Chiang Mai—and both are in stark contrast to a typical "nursing home" or long-term care facility.

The first center is Baan Kamlangchay,5 established by Martin Woodtli, a Swiss psychologist who previously worked for Doctors Without Borders.

According to Woodtli, patients at his center generally don't require drugs to stay calm or locked doors to keep them safe. Instead, they're never without an attendant, so they have the benefit of continuous human interaction and supervision.

He says his guests "cannot explain it, but I think they feel part of a family, a community, and that's very important."6

About a dozen patients live in individual houses within one Thai neighborhood and are accompanied to local markets, temples, and restaurants, and receive personal around-the-clock care—all for $3,800 per month.

The second care center,7 located about 30 minutes from Chiang Mai, is owned by Peter Brown, a British entrepreneur who converted it from a four-star tourist resort. Brown's goal is to give each guest as much independence as their individual condition allows.

Care Resort Chiang Mai sits on 11 acres of trees, gardens, fishponds, and a lake. There are different designs ranging from studios to one- and two-bedroom villas, each equipped with a full nursing care station. Sightseeing excursions and a spa are part of their treatment.

'Dementia Village' in Weesp, the Netherlands

Perhaps the most interesting place of all is located in the Netherlands. On the outskirts of Amsterdam in a small town called Weesp, is Hogeweyk, also known as Dementia Village.8 Since 2009, more than 150 dementia patients have called this village "home."

As this is typically a person's last residence, the goal at Hogeweyk is to provide the most normal life possible, reminiscent of each individual's formative years.

Dementia Village has the sort of manufactured reality depicted in the movie "The Truman Show," where Jim Carrey portrays a man who discovers his entire life is actually a reality TV show.

There is only one way in and one way out... all doors open automatically, except those to the outside world. This four-acre village was built with the specific needs of dementia patients in mind, designed around common and familiar social and cultural building blocks.

For example, residents with shared interests and backgrounds live together in "lifestyle-groups," with the design and decoration of the 23 homes tailored to each type of lifestyle. Together, the residents manage their own households, in terms of washing, cooking, etc., with the help of staff members playing various roles.

Within each house, residents have their own large bedroom and then share a living room, kitchen, and dining room with their housemates. They buy their groceries at the Hogeweyk supermarket and get their medical needs tended at the outpatient clinic.

The village has all sorts of amenities, including a cafe and parks with gardens and fountains along streets where the residents can freely roam.9 Village staff are everywhere, cleverly blending in as ordinary town folk. According to CNN:10

"Caretakers staff the restaurant, grocery store, hair salon, and theater -- although the residents don't always realize they are caretakers—and are also watching in the residents' living quarters."

The cost of Hogeweyk is $8,000 per month, but families never pay more than $3,600 per resident, thanks to government subsidization. At the time this special was made, Dementia Village had a waiting list of 82.

Families Must Make Heart-Wrenching Decisions

"The pain of this disease is often felt more by family who still hold the memories instead of those who've lost hem."

When considering whether or not to place a loved one in a care center far from home, the saddest part for the family is often leaving their loved one behind, not necessarily knowing if he or she is aware of what's happening or feels abandoned. This is, of course, a very personal decision with multiple factors weighing differently in every situation, and each patient is different.

The majority of dementia patients placed far away from home are in the most advanced stages of the disease. Experts report, while many people with early dementia would find it difficult to adjust to a foreign community where they're separated from their families, many in advanced stages adjust surprisingly well to a place with good care, because they "live in a world of earlier memories."

Continued efforts should be made at improving the quality of life and quality of care for people living with dementia, and this requires this type of "outside the box" thinking. Studies show that loneliness11—as opposed to living alone—is linked to the onset of Alzheimer's, as well as emotional stress. In the final hours of life, whether the person at your loved one's bedside is you or a caregiver thousands of miles away, it's important that they're not a "stranger" to the dying person and that they're being cared for with dignity and respect.