The Midlife Conundrum


Caring for the elderly is a daunting task. It’s different and difficult for every family. Much like other American social institutions, such as healthcare and education, assisted-living facilities and nursing homes work if you have money.

The journey to care for my mother, a less-mobile stroke victim, hasn’t many good options. The following is a look at ’em, where the best-of-the-worse wins.

The Options

Note 1: I’ve neglected healthcare as a factor, because American and private Thai hospitals are on-par with one another. They operate similarly with insurance, doctors, specialists, and prescription drugs.

OPTION 1: Hotel California

Mom lives in the States with me. A caregiver visits a few days per week.

An assisted-living facility is not an option. Prices in the Bay Area range from $3000-5000. There’s also the fear of dealing with a business-first service. Mom also doesn’t like Western food.

  • Close and personal, 1-on-1 care from the immediate family and caregiver.
  • Medicare health insurance covers most everything.
  • Overall, meals, laundry, bathing, attention, and other household chores increase.
  • Expensive caregiver pay: ~$20/hour, approximately $160/day. At 5 days per week, that totals $3600/month.
  • Without the caregiver, looking after Mom is a full-time duty.

OPTION 2: Totally Thailand

Mom lives in Thailand at an assisted-living facility. I live in Thailand—in long-term hotels and AirBnBs.

I could generate revenue by renting out the townhouse. But, that is another can of worms.

  • Caregiving at the assisted-living facility: ~$1250/month including misc. expenses.
  • Personal, 1-on-1 care from me and the extended family.
  • Multiple nurses available to help with day-to-day meals, laundry, bathing, etc.
  • Caregivers speak mom’s native tongue.
  • NO private health insurance. The services are less expensive, while the prescription drugs are pricey without insurance.
  • Living out of a suitcase is tiring. Homesickness for the United States.
  • The hot weather, air pollution, and mosquitoes.
  • As a friend put it, “there’s a sense of aimlessness.”
  • Working in Thailand could alleviate boredom. Though, in the States, I earn the same annual Thai salary in a few months.

OPTION 3: The Splits

Mom lives in Thailand at an assisted-living facility. Every three month period, I live in the States for 8 weeks, while visiting Thailand for 4 weeks.

  • As previously mentioned, smaller financial burden, ~$1250/month.
  • Weekly visits from the extended family.
  • As mentioned above, the help is good.
  • My independence and sanity is greater.
  • Anxiety over distance. Mom seems a little depressed without her immediate family. Frequent video chats do help.
  • Airline tickets, approximately $750-$1250 round trip. Jet lag.
  • Work options dwindle as a full-time job is harder to sustain.


After many sleepless nights, staring into the clouds, pondering the various scenarios, Option 3 seems the best of the meh.

Financially, it is less expensive in Thailand. With help, multiple caretakers are better than one to a few. Emotionally, the extended family really helps.

It’s all good. For now.