They join Gerhart, 64, who is agitated and mumbling in broken German, a lively and youthful-looking Margrit and dozens of others. Guests and staff are playing ball, swimming and splashing around like a group a teenagers. The laughter is loud and the music cheerful. Caregivers are never too far from the elderly they look after – and there is a lot of touching.

“It’s all about giving them a warm feeling,” explains Martin Woodtli, the Swiss founder and director of the Baan Kamlangchay care home. “From my experience with Alzheimer’s disease, I learned that this is really what matters the most.”

Woodtli has received more than 100 patients in the 10 years his centre has been in operation and he has developed a unique method of treating them.

Unlike at most Alzheimer’s centres, the patients’ accommodation is scattered, having been spread across a working village, “so they have to travel to come to lunch or meet each other”. Guests live, therefore, amid shops, families and the usual minutiae of local life rather than in a sanitised centre.

The proper training of the carers, says Woodtli, is essential.

“We try to find people who work with their hearts. In Europe, oh yes, everything is very professional – but nobody holds your hand, which is actually most important for a person of that age.”

Woodtli’s story with Alzheimer’s began very close to home, when his own mother fell sick. His father, unable to cope with the situation, committed suicide.

“I tried to put her in different centres in Switzerland, but she was hardly receiving any care at all: in Europe, old people in care centres are left in their rooms by themselves, watching TV all day.”

So, in 2003, he decided to bring her with him when he returned to northern Thailand, where, in 1992, he had worked with Medecins Sans Frontieres in helping set up an HIV/Aids care centre.

“I was fascinated by the culture and mentality and I remembered how they took good care of elderly people,” says Woodtli. “My main intention was to provide home care for my mother.”

After a year – during which, he says, his mother received good care – Woodtli, who has a master’s degree in social work and had specialised as a gestalt therapist, a practitioner who focuses on relationships and environment, decided to open a facility of his own. His mother passed away seven years ago but Baan Kamlangchay – the home he built for her – lives on.

Following its success, several care homes for sufferers of Alzheimer’s and other forms of dementia have opened around Chiang Mai, some of which have taken a more business-oriented approach.

Northern Thailand has, over the years, earned a reputation for being a “Southeast Asian Florida”: British, French, American and Japanese pensioners have been flocking in by the thousands. Retirement homes and compounds have flourished and operators began facing a demand for facilities that could accommodate the needs of dementia-affected seniors.

Last year, Peter Brown, another expat with an Alzheimer’s-afflicted mother, opened a five-star facility located in the middle of beautiful rice fields. Care Resort was designed as a retirement centre for healthy senior citizens before it became apparent there was a demand for something more.

“We want our guests to know they can stay, until, well, the end,” says the Briton. “You have to be realistic; if you get 20 pensioners living here on a long-term stay, chances are that three or four of them will develop Alzheimer’s disease.”

As of last year, there were an estimated 44 million people with Alzheimer’s or related dementia worldwide, according to Alzheimer Disease International, mainly in Western Europe and the United States. One out of every three senior citizens in America dies with the disease, says the US Centres for Disease Control and Prevention.

Care Resort is aimed particularly at couples in which only one of the partners is sick.

“Alzheimer’s disease puts a strain on a marriage, on a family,” says Brown.

“Here, we offer both total care, 24 hours if needed, but also tourist attractions, spas, shopping …”

Companions can relax by the pool while trained nurses take care of their ailing spouse.

A few kilometres from Care Resort is Vivo Bene Village, which also accommodates healthy guests alongside dementia-affected relatives. The five-star, 400 million baht (HK$95 million) resort will be fully opened later this month, and the management expects “dozens of guests from Europe” to join the seven (three of whom have Alzheimer’s) already in residence. The resort features luxury pavilions and a spa, individual villas, a hairdressing and beauty salon, and a restaurant serving high-quality Western food. The village is fully equipped with wheelchair ramps, even in the swimming pool, and a strong focus will be placed on dementia-affected patients, dozens of specialised nurses having been recruited and the vast common room displaying “memory games” on its shelves.

Care Resort and Vivo Bene Village together should provide more than 400 jobs for locals.

Questions about the medical relevance of such projects are often asked: is it advisable, for instance, to uproot an Alzheimer’s patient and send him or her to another country, far from familiar landmarks and faces?

Medical opinion is split on the issue. For some sufferers, a radical change of environment may cause the loss of the last memories he or she had. Some medical professionals argue, though, that the more care a patient gets, the better, wherever that might be.

“Alzheimer’s patients need a kind of care that is much more personal, they need many more hours of care than what they get in our system,” writes Professor Martin Prince, of King’s College, London. Several studies of Latino communities in the US have shown family interaction and a “loving environment” are more important than medical follow-ups.

“The other day, one of our guests stopped in front of a Thai house,” Woodtli recounts, “and said, ‘Look, this is where I went to school as a little girl.’ The elderly travel with their memories. After a certain stage of the disease, it doesn’t really matter where they are.”

Thai caregivers seem to be better equipped culturally than most to provide the kind of personal care that is needed in such cases.

“We Thai people, when we take care of someone, we get really attached,” says Nong Faa, Margrit’s carer at Baan Kamlangchay. “We treat them like we would treat our own parents.”

In Theravada Buddhism, taking care of an elder gains one merit for the next life.

The training that nurses at Woodtli’s facility have received may be basic compared with that given to a graduate nurse in Europe, but they make more physical and eye contact, and are taught to smile and talk more.

“Whatever Victor tells me, I try to make him talk more about it,” Amporn says. “I never tell him he is wrong.”

Many Alzheimer’s patients, embarrassed about their disease, withdraw and stop talking, which can accelerate the degenerative process. In Thailand, though, there is a generally relaxed attitude towards dementia.

“Here, the decline of old people is considered normal,” says Woodtli, who last year published the German-language book Living with Alzheimer’s in the Land of Smiles. “The elderly are allowed to decline; there is nothing shameful or embarrassing about it, like it can be in Europe, which makes the situation more painful.”

One of the main reasons families choose to send their relatives to Thailand is cost. The monthly price of full-time care at Baan Kamlangchay is US$3,000, which includes three caregivers taking shifts to look after one patient around the clock. Complete medical care is included too, although that includes little medication.

“Most people used to take antidepressants or tranquillisers in Europe, but they don’t need them here,” Woodtli says.

Two patients share a comfortable house, where they are provided with three meals a day, physiotherapy and massage twice a week. They also have daily use of the swimming pool. In Europe, the same standard of care would cost about US$8,000 a month. Labour costs make all the difference: in Thailand, a trained nurse earns US$350 a month.

At Vivo Bene Village, costs start at US$3,500 a month for the basic hotel service and rise to US$6,000, with full-time care. Prices at Care Resort are more attractive, starting at about US$2,000 a month and rising to US$4,000 or more, depending on the amount of attention requested.

There is a problem, though. Despite strong interest – Brown says he receives 500 inquiries a year – the five-star resorts for senior citizens are proving difficult to fill.

Marianne Clark, a radiant 84-year-old Care Resort guest whose son November 2, 2014 Post Magazine 23 works in Hong Kong and visits on weekends, says, “I don’t understand why there aren’t more people coming. The place is so nice!”

Serge Gauthier, a French pensioner who lives independently on the outskirts of Chiang Mai, thinks it may be because “the healthy seniors don’t want to be mixed with the sick. It’s too depressing. If you need a holiday, then you go somewhere alone, far from your sick loved ones, to forget about it for a while.”

The economic crisis in Europe may be playing a role, too: with pensioners struggling to make ends meet, Europeans are becoming increasingly unable to afford five-star accommodation. So these resorts are now turning to the Asian market.

“Of course, if we are to receive Asian guests, it will require slight changes, like Asian dishes on the menu or steam baths for Japanese guests,” says Krisada Khuiaphai, Vivo Bene Village’s marketing manager.

That market, however, has yet to show any interest – are Asian families ready for this option?

Family structures are mutating in Asia, especially in Japan and China, because of ageing populations, increased workloads for women and cultural changes. In China, the one-child policy often places the burden of ageing parents on one person, leaving some elderly without the care they need. But even if retirement homes are a growing business in Asia, most families in the region remain incredibly reluctant to send ageing parents abroad. For Thais it would be unthinkable.

“We take care of them at home,” says Nong Faa. “It is our duty as children.”

“I don’t think sending your parent to Thailand is the best solution,” says Brown, somewhat surprisingly. “I even think it is pretty terrible. But it is certainly better than having them locked up in some inhumane facility in Europe. It all depends on what you can afford.”

Woodtli says he thinks Western governments should provide more choice: “You should be able to stay at home to take care of your parents when one of them is struck with dementia, like a kind of maternity leave, but for ageing parents. In Western countries, people don’t have time at all.”

“Thai people also have full-time jobs, everybody has to earn money,” counters Amporn, who has seen many relatives come to visit at Baan Kamlangchay. “The difference is in the culture; Western families are not knitted together like Thai ones. I think there is more individualism and need for privacy; people don’t want to live with their sick parents.”