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Nestled in Mexico’s highlands, Aguascalientes charms visitors with colonial architecture, clean streets, wide sidewalks, shade trees, and a warm community spirit. About 1.5 million residents live at 6,194 feet above sea level, an easy drive on the highway from Jalisco (three hours from Guadalajara). Known for its safety and relative tranquility, Aguascalientes surprised this newcomer. During my three-day stay persistent winds became an unexpected part of the city’s personality.

Founded in 1575 by royal decree of King Phillip II of Spain, the city’s original name was Villa de Nuestra Señora de la Asunción de las Aguas Calientes (Village of Our Lady of the Assumption of the Hot Waters). Citizens are amusingly referred to as hidrocalidos or hydrothermal people.

Mini-park in central Aguascalientes:

Immaculate street with residences and shops in central Aguascalientes:

Aguascalientes is an industrial city. Major companies present are GM, Honda, Mazda and Nissan. Other notable companies manufacture medical equipment, electronics, car parts, and textiles. Years ago, Aguascalientes built trains. The original station still stands as a museum and there are restored train cars to see.

Not surprisingly, among the expat population estimated around 1,000, there are several Japanese. Trip Advisor lists 34 Japanese restaurants (not all Japanese owned).

A glimpse of what I experienced related to older adult activities, care, hospitals, and end of life:

Older Adult Socialization in Community

Club de la Tercera Edad is a public center for older adults run by CONACYT, the national counsel studying science and technology. When I arrived, there was a danzon class. Danzon is a Cuban music and slow dance tradition, immensely popular in Mexico and other parts of Latin America.

DIF and INAPAM Older Adult Activity Centers Both DIF (Desarrollo Integral de la Familia) and INAPAM (Instituto Nacional de las Personas Adultas Mayores) are government run centers offering activities. They are separate entities but sometimes collaborate. DIF addresses entire family needs and is more about social protection of vulnerable populations. It offers adult daycare centers, psychosocial support, food programs, medical attention, recreational activities, and more. INAPAM is focused on older adult legal rights, transportation discounts, medical and cultural services.

On another trip I hope to meet Aguascalientes DIF director Aurora Jimenez Esquivel, known for her innovative initiatives including a popular travel program to visit nearby states known as “Gigantes Viajeros”. If you have access to Facebook, there are charming photos with older adults from Aguascalientes enjoying a trip at the FB page of Aurora Jimenez Esquivel. The link would not post when I loaded it here.

Señor Sebastian As I made my way to the Panteón de los Ángeles y La Cruz, thirst led me to a sunlit corner store not far from the cemetery gates. There I met the venerable octogenarian you see in the photo whose warmth seemed to animate the whole neighborhood. With his son by his side, he presides over the store like a sage, sharing stories about local elders and aging in place. He graciously pointed me to the entrance of the cemetery. After wandering the peaceful grounds among small and large gravestones, I returned to thank him —feeling, in that moment, not just like a visitor, but welcomed to Aguascalientes. Memorable encounter.

Photos of the cemetery may be seen on an Aguascalientes Facebook page at: https://www.facebook.com/VivaAguascalientes/posts/pante%C3%B3n-de-los-%C3%A1ngeles-y-la-cruzaguascalientes-ofrece-una-gran-historia-en-relac/2168728129814822/

Assisted Living/Memory Care Residences

According to INEGI (the Mexican government statistics bureau) and Google, there are about 14 long-term care residences. (In Mexico long-term care is, with some exceptions, all in one – assisted living/memory care/nursing).

I focused on homes in the city center and visited seven to get a feeling for environment, providers, residents, and care.

Three assisted living/memory care homes had closed, one during COVID. Most places were basic, clean, modest, and dark, yet each with devoted caregivers. Residents in some homes seemed thrilled to have a visitor.

I was warmly welcomed at clean, efficient, light-filled Residencia de la Roble which houses 33 older adults including Mexican-Americans who prefer to age in their native Aguascalientes. Care costs are about $700/month USD (13,000 pesos/month) for shared rooms (there were two single rooms). Included in the fee: nutrition with customized diets, television and activities, laundry, medical care by the owner, a geriatrician, and most of all what appeared to be loving, energetic care by devoted nursing assistants. Note: Many Mexicans are accustomed to sharing space. The concept of privacy and your own room is often found with families who are well-off.

Here are photos showing a shared room with pristine, well-organized clothing and linen storage:

There is no website for Residencia de la Roble but you may find several photos of its high energy, activities, and sweet residents and caregivers on Facebook at Residencia para adulto mayor “El Roble”. https://www.facebook.com/profile.php?id=100064126566555

On my next visit I wish to tour Estancia Geriatrica Villas Juan Pablo as I had originally planned. It is a privileged residence in a park-like setting, also with lots of light, a few miles north of the city center. You will find photos at https://estanciageriatricavjp.com/ The environment reminds me of countryside care homes outside Quito, Ecuador – wood cabinetry, vistas of green meadows, tranquility. Under “instalaciones” there are photos of private rooms. The monthly prices at Villas Juan Pablo would be double, or more than double, the costs at Residencia de la Roble.

Note: prices for long-term care in the state of Aguascalientes are less than in the state of Jalisco (home to Guadalajara, Lake Chapala, and Puerto Vallarta). The Aguascalientes homes cater to local Mexican families.

Hospitals and Dental Care

Aguascalientes has an impressive medical infrastructure with hospitals both public and private. Hospital MAC (there are two, one in the north the other in city center), Centro Hospitalario de Aguascalientes, Star Medica, Centro Medico la Salud, Hospital Cardiologica de Aguascalientes, Medica San Juan de Aguascalientes, Hospital Fundación Medica México Franco Brasileña plus a plethora of other options for specialized medical care as well as dentistry.

Emergency Care at Hospital MAC

The third night of my visit I awakened around 10-10:30 p.m. feeling tingling down my right side and leg. My first thought, oh no, not a TIA/stroke!! But I was able to speak. The sweet elderly man on night duty at the hotel suggested a taxi to the Red Cross. I wished for a hospital. I was super weak and dizzy yet decided to slowly walk to a nearby hotel. The night duty clerk there suggested Hospital MAC, a few blocks away.

There are about 30 MAC hospitals in the country. I had visited others and felt confident. I was especially encouraged because I could see the hospital tower from the front door of the hotel. I walked slowly but surely about four short blocks and made it to the emergency room. A nurse promptly greeted me, took my name, invited me to a room, took my vitals. I was then escorted to meet Dra Nancy originally from Mexico City and a graduate of UNAM. She was amazing – attentive, kind, professional. A thorough assessment of eyes, strength in arms and legs, heart, walking etc. Thankfully I was going to be okay. I was dehydrated (first time ever and quite a lesson) and had a bit of heat stroke from walking in the sun from early morning to sundown. The hospital experience was a gift, and I remain grateful to all who assisted and cared for me at the hotel as well.

Palliative Care and End-of-Life Care

Pain relief for life-limiting illness is offered by 14 anesthesiologists with palliative care credentials at hospitals and clinics. Two of the physicians drive from Guadalajara. According to a list of medical providers, there are 20 geriatricians. In-home pain relief for end-of-life is offered by at least two geriatricians.

All assisted living/nursing homes attend to end-of-life.

One residence, Hogar del Abuelo Maty, was founded with supportive end-of-life care in mind. It is in the countryside one hour to the northeast of Aguascalientes.

The home, opened in 1981, is named in remembrance of Matilde (Maty) Dubroy de Villanueva who was accompanied at end of life by her daughter Carolina Villanueva de Garcia. The profound experience inspired Señora Carolina to build the hogar where every elder could have a dignified death with compassionate, personalized care.

The current administrator of the non-profit is the founder’s son, Carlos Garcia Villanueva. Care is provided by nurse nuns of St. Vincent de Paul. The nuns have a long and rich history of companioning the infirm and those at end-of-life. The website with photos and videos reveals more: https://www.hogardelabuelomaty.org/

While I did not encounter any modern-day end-of-life doulas in Aguascalientes, Mexico, non-medical, psychosocial spiritual support has been a community tradition for centuries. Local women known as “parteras” assist not only with birth but have a significant role supporting families and individuals during the dying process.

Funeral Home Arriaga

Toward the end of each day, I passed Funeraria Arriaga on the way to my hotel. Families waited inside where there are four viewing rooms and a place to sit and sip coffee or tea. Or, they waited in front of the building. There is a florist across the street.

Most Mexicans choose burial in a coffin. For those who choose cremation, the cost with this funeral home is between 9,000 and 20,000 pesos ($470 to $1000 USD) depending on whether there is a memorial service. According to Funeraria Arriaga there is no refrigeration in Aguascalientes but there is embalming. (Refrigeration is possible in Jalisco to create time for family members arriving from far away to view the deceased). The Boinita Group advertises green spaces for cremains (ashes) in Aguascalientes as well as Cancun, Hermosillo, Merida, and San Luis Potosi. https://boinita.com/en/green-niches-of-funerary-forests-in-mexico/

National Museum of Death

The museum, which opened in 2007, exhibits death-related artifacts from pre-Hispanic times to the present from the personal collection of Octavio Bajonero Gil. The 2,000 or so items include sacred religious paintings, sculptures, objects d’arte, and more. They are displayed in three connected buildings of a restored 17^th century convent that once housed Franciscan monks. The property is now owned by the University of Aguascalientes.

My experience was not of the macabre. Some items show the unique Mexican sense of humor.

At the entrance of the museum is a gift shop where you pay an entrance fee of 20 pesos ($1 USD). It takes 45 minutes to an hour for a self-guided tour. If you are lucky you will have university student Antonio accompany you to the basement to see reconstructed gravesite remains. The photo below was taken in the basement:

Later, multi-lingual Jesus from Mexico City who delighted me with his Italian might lead you through the floors and buildings.

The Instagram video at this link shows more items displayed in the museum: https://www.instagram.com/reel/C-Ag-HsgAFv/

The museum produces 200 or so events per year including the October/November Day of the Dead Celebrations. At the writing of this post the calendar of events for the 2025 Annual Festival de Calaveras (skeletons) has yet to be posted.

Museo Posada This museum is dedicated to the collected works of Aguascalientes native Jose Guadalupe Posada (2 February 1852 – 20 January 1913), a political satirist/caricaturist, engraver, and printmaker known throughout Mexico as the father of La Calavera Garbancera/La Catrina, a female skeleton dressed to the nines that is seen each year at Dia de los Muertos/Day of the Dead ceremonies. During the presidencies of Portfirio Diaz (1876-1911) Posada introduced skulls and bones as political and cultural critique. La Catrina indicates death comes to all, including politicians and the super wealthy. Here below is a Catrina from the Museum of Death:

Photos of the museum and its contents may be seen at this link: https://ags.gob.mx/turismo/conocemas/museoposada/index.html

Wendy Jane Carrel, MA, is a trusted older adult advocate and consultant who has many years of hands-on experience with healthcare systems, retirement options, senior living and wellness programs in Mexico, Ecuador, Italy, the U.S., and beyond. She provides culturally sensitive transition guidance and curated options for families and elders domestically and internationally. Wendy’s web site is https://www.WellnessShepherd.com

Resources

https://en.wikipedia.org/wiki/List_of_states_of_Mexico

https://en.wikipedia.org/wiki/Aguascalientes_(city)

https://en.wikipedia.org/wiki/Jos%C3%A9_Guadalupe_Posada

https://www.hospitalesmac.com/ MAC Sur, Aguasacalientes, República de Perú 102, Las Américas, 20230 Aguascalientes, Ags., Mexico Open 24 hours

https://www.atlasobscura.com/places/national-museum-of-death

Mexico’s Museum of Death in Aguascalientes

https://www.youtube.com/watch?v=01-n8TduhkM Mariana Lange’s Mexico Relocation Guide

https://roadtrippers.com/magazine/10-macabre-museums/

Aging in Place Mexico, Assisted Living Mexico, Death in Mexico, Older Adults Calvillo Mexico

Mexican Pueblo Magico (Magical Town) Aging in Place/Aging in Community, Calvillo, Aguascalientes

June 8, 2025December 1, 2025 bigpondlittlegirl

It is a gift to travel.

In Mexico I have enjoyed exploring Pueblos Magicos (magical towns) from Alamos (Sonora in the north) to Izamal (Yucatan in the south), learning about Aging in Place/Aging in Community (which most Mexicans do), healthcare, and end of this life traditions.

Magical towns are designated by the Mexican government SECTUR (Mexican Tourism Board) as part of “Mexico desconocido” or unknown Mexico – towns or villages representing the cultural diversity of the country.

Below is a photo along the malecon adjacent to Rio Calvillo (the river) near the entrance to Calvillo a pueblo magico in the state of Aguascalientes.

I recently had the pleasure of visiting Calvillo, Mexico’s leading producer of guavas. There is far more to meet the eye than guavas, and, there was that feeling of magic.

What immediately struck me on arrival at the bus station was how clean the streets are (no trash, no stains), how flat the city is (mostly), how safe and flat the sidewalks are, how immediately friendly the people were, and how unpolluted the air seemed. It was a breezy, sunny weekday.

Just a few minutes away, down Calle Jesus Gomez Portugal to the left of the hallway exit, I stopped outside a space flooded with light and inviting aromas. A local restaurant, Gorditas Jenny. Smiling ladies beckoned me to enter for a look see. Fresh, unadulterated breakfast food in an immaculate setting served from 8:30 a.m. to 1 p.m. Yes, I tried it and wish to return! Thank you, ladies!!

The Casa del Abuelo (grandparent’s home), a DIF (government) day center for older adults which opened in January 2024, was the next stop. In the link below you will see a photo of the entrance: https://www.elclarinete.com.mx/inauguran-la-casa-del-abuelo-en-calvillo/

Again, a warm and welcoming reception on arrival. The center offers painting (part of a program called “pintemos la magia de Calvillo” – let’s paint the magic of Calvillo), tai chi, chair exercises, handicrafts, carpentry, meals, trips, and resources for aging. In the following short you will hear precious elder Salomé Salas, a 94-year-old, joyfully share in Spanish why he loves the center, and you’ll get a glimpse of some of the activities. https://www.facebook.com/reel/3714970688791551

Asilo San José (originally Asilo de Los Ancianos Señor San José) is the only assisted living/nursing home in Calvillo. It was founded by the Catholic church and a group of locals and continues to be supported by the church, the locals, and a group of Mexican/Mexican-Americans from Santa Paula, Ventura County, CA, “citrus capital of the world.” As with many Mexicans who emigrate to the U.S., folks from Calvillo and surroundings send funds or return home to support the local community. Those who were born here often prefer to return to die or be buried.

Front of the Asilo San Jose Assisted Living/Nursing Home in Calvillo below.

Over 50 residents, men and women, reside on the spacious campus with three sections of housing. Most rooms are shared, two to a room. When I arrived, elders in wheelchairs were accompanied from mass at the chapel back to their rooms or recreation hall. I met with lovely assistant administrator Maria who graciously showed me the living quarters, the perfectly organized laundry and wardrobe area, the dining area, the meds room, and the offices. We agreed I would not take any photos. I was grateful to feel a sense of attention and care from her and the support staff as they looked after their charges. Without spending more time, or talking to community members, it is difficult to assess more. What was clear, however, is that the residence was welcoming and the residents clean, smiling, and mostly disabled, one severely disabled/bed-confined with an attendant. Each required round-the-clock care perhaps not possible in their homes. Below is a link to a video filmed 10 years ago which offers an idea of the environment, now re-painted and more lively.

https://www.youtube.com/watch?v=x0dbLLBaQ4g

Medical care

There are three small hospitals in town: Hospital General de Calvillo, IMSS Unidad de Medicina Familiar, and the Clinca del Valle. I was unable to manage site visits, but I understood from locals that for more serious medical challenges some folks go to Aguascalientes an hour away by car or bus. I noticed medical and dental offices in the city center.

Parrochia del Señor del Salitre

The beautiful baroque parish church has three magnificent domes adorned with frescoes. It is dedicated to the patron saint of the city, Lord of the Saltpeter. According to city legend a group of older adults saw a miraculous appearance of the Lord on the parish spot before the church was built around 200 years ago. The colors inside are gold, light pink, and light blue.

The people of Calvillo appear to be deeply religious.

It was a remarkable synchronicity that I arrived at the church in time to attend mass for a beloved older woman. The church was full. I stood in the back. Mariachis waited at the exit. After the mass they accompanied the woman’s casket to a waiting car.

The woman’s family sat in the van behind the white hearse. Music played for blocks around the church and down Avenida Revolucion to the Cemeterio Señor del Salitre about a mile away.

The gentle words of the priest at mass, the reverence and grief of the attendees, the mariachis, and the atmosphere were deeply moving. I was simply a bystander. My eyes and heart welled up with tears off and on. A blessed experience. I am thankful to the fellows from Funeraria Carrillo who shared some of the details.

National Museum of Magical Towns It was a nice surprise to walk down Avenida Benito Juarez in the afternoon and discover this beautiful museum which I did not know existed until I walked by!!

There are 177 magical towns in Mexico’s 32 states. The museum showcases folklore, cuisine, handicrafts, and traditions from eight regions. You may learn more about the museum at this link: https://magicaltowns.mx/atractivos/museo-nacional-de-pueblos-magicos/

The photo below features a piece in the museum from Morelos, Mexico, representing the creation of man, community, and the universe.

Conclusion:

Magical town Cavillo, with a population of around 60,000, is clean, inviting, and well-organized and worth a weekday visit. It is apparently crowded on weekends and on festival days.

Its streets are flat, its sidewalks comfortable for walking. In a few places there are hills. It sits alongside the Rio Calvillo.

Aging in Place/Aging in Community seems a lot easier in Calvillo than in larger Mexican cities, especially if you are not of high income. There is local social support and love energy.

Resources:

https://www.lugaresturisticosenmexico.com/en/calvillo-aguascalientes-mx/

https://www.lugaresturisticosenmexico.com/en/pueblos-magicos-magical-towns-by-state/

https://www.instagram.com/p/C2nT344Re1v/ inauguration day at Casa del Abuelo, Calvillo, Aguascalientes

Wendy Jane Carrel, MA, is an older adult health care advocate, advisor, and care coordinator from California. She has conducted due diligence for senior living and retirement on five continents and is dedicated to supporting families and their elders. She provides informed, attentive, compassionate guidance and curated options for aging in Ecuador, Mexico, and other destinations both domestic and abroad. She is a speaker and published author on subjects related to senior well-being. Wendy’s web site is https://www.WellnessShepherd.com

Aging in Community, West Hollywood, CACA, Aging in Place, West Hollywood, CA, Older Adult Accessibility, Older Adult Advisory Board, West Hollywood, CA, Solo Ager West Hollywood, CA

West Hollywood Celebrates Aging in Place During Older Adults Month May 2025

May 30, 2025July 5, 2025 bigpondlittlegirl

City streets were abloom with jacaranda and magnolia trees, and sidewalk gardens featured roses, brugmansia, and honeysuckle as the City of West Hollywood, California celebrated Older Adults Month in May 2025.

Aging in Place/Aging in Community resources and services were highlighted, and the city honored a senior who has made a difference in the community.

Since 2016, the Aging in Place/Aging in Community Strategic Plan created to accommodate the anticipated silver tsunami (the worldwide phenomenon of older adults living longer) has been a stand-out initiative. The goal: offer quality-of-life and a sense of control for aging where you live with an extensive array of easy access support services. According to the 2020 census the population of West Hollywood is around 36,000 with older adults 65+ representing 20% of residents (7,200).

A recent West Hollywood Aging in Place success story:

A 92-year-old solo ager was hospitalized after breaking a hip and femur bone. From the time she entered an in-patient rehab she knew she wanted to be at home. Any other place? She felt her life might unravel. The challenge? How to access the only bathroom located upstairs in her one-bedroom apartment. With the good offices of a Jewish Family Services social worker, the woman’s health care advocate who lives almost an hour away, and the non-profit DCRC (Disability Community Resource Center) which serves the disabled, a stairlift was installed so she could continue to enjoy her home of over 50 years. Her health and her spirits improved greatly over a period of months. So greatly that she was able to give a poetry reading from her recently published book at a southern California library the last week of May. She continues to use a walker. The stairlift allows her comfort for healing and self-sufficiency.

Note: In 2022, the City of West Hollywood received the SCAN Foundation Innovation Award for “embracing aging” in one’s home throughout a person’s lifespan.

On May 14 at 2:00 p.m. at the televised Older Adult Advisory Board (OAAB) meeting, Richard (Ritch) Colbert a chaplain at Cedars-Sinai Medical Center and 39+ year counselor for the recovery and LGBTQ communities received the Senior of the Year Service Award with a proclamation presented by Mayor Chelsea Byers and OAAB Vice-Chairman RJ Holguin. Story plus photos at this link: https://wehotimes.com/west-hollywood-honors-richard-colbert-at-20th-annual-older-adults-service-awards/

Older Adult Advisory Board Chairman John Allendorfer deftly guided the televised meeting. During Public Comments Disability Advisory Board member Rick Watts and Human Services Commission member Karen Eyres spoke movingly about current concerns, mainly proposed Medicaid cuts which would harm children, the disabled, and older adults. Medicaid, known as Medi-Cal in California, currently provides essential health care coverage including support for vulnerable older adults for long-term care in nursing homes.

West Hollywood Older Adult Advisory Board members at the 20th Annual Older Adult Health Fair on May 8, 2025 in the photo below. Missing are members Nadia Sutton and A. Lee Walkup.

On May 8 several hundred seniors convened at Plummer Park for the 20^th Annual Older Adult Health Fair co-sponsored by Cedars-Sinai Medical Center and Jewish Family Services. Attendees learned about and/or applied for assistance with an array of non-profits:

Access LA transportation services for the disabled

Bez Tezek Free Legal Services

City of West Hollywood Rent Stabilization Department “Know Your Rights” Workshop

One Generation’s program registration for utility assistance and energy conservation

Jewish Family Services social worker support

Jewish Family Services nutrition education and meals at centers around the community

Jewish Family Services exercise and crafts classes, a social engagement monthly meeting, classes in digital education

Maple Counseling mental health support

Project Angel Food’s medically tailored home-delivered meals

The California Hearing Center, a family business, offered free hearing assessment tests

Others

Most of these programs/services are free or donation based.

Not present at the fair in 2025 but present last year was Metro.net the LA County bus and rail transportation system which continues to offer West Hollywood older adults $20/month complimentary travel on Metro. Seniors TAP cards are reloaded with the city.

According to Rent Café, approximately 80% of West Hollywood residents are renters. West Hollywood’s Rent Stabilization Department gave a presentation at the fair. Grassroots community organization Coalition for Economic Survival (CES), focused on supporting tenant’s rights since 1973, was also present.

Cedars-Sinai Medical Center offered:

blood pressure readings, blood glucose readings

cholesterol readings, heart rate reports

consultations with an MD

participation for those interested in a Cedars-Sinai free genetic testing research project

The Care Team, active in West Hollywood since the fall of 2023, and at the fair for the first time, offers mobile behavioral health support in partnership with www.sycamores.org. A two-person team cum phone coordinator 24/7, holidays included, mans each shift. They work in tandem with the County Fire Department’s Station 7 & 8 in West Hollywood, and the West Hollywood Sheriff’s station to respond to crisis situations, especially assisting the unhoused and other vulnerable populations “in an atmosphere that empowers”. The team also conducts follow-up care and wellness checks for all who call. The Care Team number is (323)540-6392. Also see www.weho.org/careteam.

Preparing for the West Hollywood 20th Annual Senior Health Fair on May 8 in the photo below are Older Adult Advisory Board Member Pat Dixon (on the left), honored with the 2025 LA County Older Adult Service Award, and Francisco Gomez, Acting Strategic Initiatives Supervisor, City of West Hollywood currently dedicated to the Holloway Interim Housing Program.

A community Aging in Place plan is a privilege. Nationwide surveys reveal 90% of the older adult population prefers to age in place.

West Hollywood is a small, young city of about two square miles sitting on the unceded land of the Gabrieleño Tongva and Gabrieleño Kizh peoples. It is surrounded by the City of Los Angeles. Los Angeles, founded in 1781, has an estimated population of around 3.8 million. Two older adults from Culver City (20-30 minutes away) who attended the health fair last year and this year shared how they wish they could move to West Hollywood. Other older adults who live in Los Angeles county and neighboring Los Angeles have shared similar thoughts with this writer after witnessing and comparing services. (Yes, a smaller population creates a more tenable situation).

Photos by City of West Hollywood photographer Joshua Barash of Older Adult Month May events may be found online at https://www.flickr.com/photos/weho/albums/

Conclusion:

In its 40 years as a city, West Hollywood has created a strong bank of social service resources for all citizens, not only seniors. Its Aging in Place/Aging in Community plan won the SCAN Foundation’s Innovation award.

Other age-friendly cities actively developing notable services for health, housing, participation, security, transportation, and more are Rochester, NY; Grand Rapids, MI; Madison, WI; Provo, Utah and others. On the This Old House survey (see resource section below), West Hollywood is listed as number seven out of 10, mostly because the cost of living in California is higher compared to the rest of the cities on the list.

Honoring contributions of older adults each year and addressing their needs in aging officially started by federal government decree in 1963. At that time 17 million older adults were 65 or older, one third lived in poverty, and few programs existed to meet their needs. Today there are approximately 60 million older adults in the U.S., nine million in the State of California.

Disclaimer: The author has lived in West Hollywood, CA since graduate school and has a bias for a community she appreciates living in.

Wendy Jane Carrel, MA, is an older adult health care advocate, advisor, and care coordinator from California. She has conducted due diligence for senior living and retirement on five continents and is passionate about supporting families and their elders. She provides informed, attentive, compassionate guidance and curated options for aging in Ecuador, Mexico, and other destinations both domestic and abroad. She is a speaker and published author on subjects related to senior well-being. Wendy’s web site is https://www.WellnessShepherd.com

Resources:

https://acl.gov/oam/history# Administration for Community Living website (formerly Administration on Aging website)

https://www.democratandchronicle.com/story/news/2024/12/05/rochester-ny-named-best-in-the-u-s-for-aging-in-place-heres-why/76733432007/ This Old House’s 10 best cities for aging

Survey names best and worst cities for aging in place, finds 90% desire to remain in home

https://scag.ca.gov/sites/default/files/old/file-attachments/west-hollywood-he-0421.pdf West Hollywood renter statistics from the Southern California Area of Government

https://www.weho.org/Home/Components/News/News/10603/23 Scan Foundation Award news

https://en.wikipedia.org/wiki/West_Hollywood,_California

Advance Health Care Planning Mexico, Death in Mexico, Dying in Mexico, Health & Wellness Mexico, La ley de voluntad anticipada Mexico

Why Creating an Advance Health Care Directive in Mexico (and Latin America) Makes Sense If You Are an Expat

April 25, 2025December 1, 2025 bigpondlittlegirl

If you live in Mexico or Latin America, have you created a plan for what to do in case of an accident, natural disaster, or healthcare emergency?

Who is going to show up for you?! What if you are no longer able to speak and make decisions for yourself?

If you wish to save your family and other loved ones considerable grief and time, it is important to understand what is involved when a foreigner becomes ill or dies in Mexico or other Latin American nation.

Last month I had the pleasure of joining patient advocate and educator colleague Deborah Bickel of Be Well San Miguel to share with expats why it is wise to create a Mexican declaracion jurada (living will) and/or voluntad anticipada (advance healthcare directive). The voluntad anticipada is incorporated into the declaracion jurada in many sates. My role in the meeting was to give an overview of palliative care and hospice and how to find end-of-life support in Mexico.

We have each invested 14 years or more sharing with expats (Deborah in Mexico, Guatemala, and Nicaragua – me in Mexico and Ecuador) why planning is important no matter your age but especially if you are 55+.

Short list of reasons:

Mexican law is civil law

British, Canadian, and U.S. law is common law.

There are major differences.

If you arrive with an Advance Healthcare Directive or Five Wishes or other document legal in your native country, it will not be legal in Latin America unless you get lucky. In Mexico, you must create a declaracion jurada and/or voluntad anticipada if you want your wishes to be honored. Some attorneys and notaries will incorporate your home country wishes for you. These documents must be created BEFORE any accident, illness, or demise. As of this date only 14 of Mexico’s 32 states offer a voluntad anticipada. The purpose of the voluntad, sometimes referred to as a directriz, is to avoid legal, medical, and bioethical problems that could complicate the situation for you the patient or your family.

Mexico is a country with predominantly Catholic traditions. These traditions influence choices. If you are Catholic, the system may seem familiar, such as burial over cremation. If you had chosen to live in Buddhist or Hindu Asia, cremation would be a relatively easy matter involving fewer steps as cremation is common practice. Or, you could have opted for a Tibetan sky burial. If you wish to be cremated, you will need a notarized document stating this wish.

Latin Americans have large family systems. If something happens to you as a Latin American, a family member will show up and know what to do. Most expats live in Latin America alone or as a couple, sometimes with children.

The Mexican culture, language, and way of thinking are unique. Most of all, procedures may be unfamiliar and complex. Attitudes and response to accidents, illness, and death are different.

Non-Spanish speaking expats often need bilingual advocates to negotiate the system. At least three people are recommended to advocate for your wishes, and/or serve as your healthcare proxies. If one is not available, perhaps another will be.

April 16 is National Healthcare Decisions Day in the U.S. If you do not yet have a plan, every day is a good day to work on one no matter where you are.

Aileen Gerhardt, a fellow patient advocate and educator in Boston writes “decide, document, designate, and discuss!!” Good advice.

Deborah’s extensive advance healthcare directive service for Guanajuato state Mexico may be found at https://bewellsanmiguel.com/medical-directives/ :

Medical Directives

Wendy Jane Carrel, MA, is a Spanish-speaking senior care advocate from California. She has travelled Mexico for several years researching health systems, senior care, and end-of-life care to connect Americans, Canadians, and Europeans with healing options for loved ones. She is a compassionate companion and palliative care liaison, legacy writer, co-founder of Café Mortality Ajijic/now Death Café Ajijic and founding member/speaker of the Beautiful Dying Expo (USA). She is a trauma-informed, gentle End-of-Life Doula (National End-of-Life Doula Alliance proficient), and a speaker and published author on subjects related to senior well-being. Wendy’s web site is https://www.WellnessShepherd.com

Death and Dying, Grief Care, Grief Choir, Holiday Grief, Seasonal Grief, Somatic Grieving

Grief Choir: A Surprisingly Poignant Experience During the Holidays

December 31, 2024January 1, 2025 bigpondlittlegirl

The holiday season for many in the northern hemisphere is sometimes fraught with sadness, sorrow, and a sense of loss. Thankfully, there is an invitation for comfort and a unique panacea of sorts… a Grief Choir.

What is a Grief Choir and how did I end up attending one?

Elizabeth Gill Lui, the thoughtful leader of Death Café at the Los Angeles Philosophical Research Society, has a mailing list. I am thankfully on it. Her interests and friendships are deep and wide from experiences as a fine arts photographer, author, educator, end-of-life doula, and more.

I read about the gathering and felt compelled to attend.

So, on December 22, at the time of the solstice (shortest and darkest day of the year, but also the birth of light), I found my way to the First Congregational Church of Los Angeles to listen to a choir. I was curious.

Here is what happened:

I arrived late, by minutes.

About 30 folks were gathered quietly on chairs in a circle.

The Resonance Collective hosts, Artistic Director Fahad Siadat and clinical psychotherapist Cynthia Siadat smiled in my direction and welcomed me warmly. Someone added a chair so I could join the circle. Lovely.

The leaders shared…they created the concept of Grief Choir out of “a desire to hold space outside a particular religious context during times of loss.” The gathering was intended as a ritual “to sit with the darkness of grief and the growing light of the community with whom it is shared.” A special event, free, to sing and heal. No experience required.

Cynthia passed around a basket with pens and white cards. She asked attendees to write three words for why they came. The cards were collected in the basket and passed around again. This time each of us picked a card from the basket. Then we read aloud from the card we picked. Many reasons were remembrances – names of persons (or pets) who had passed. Do not know for certain as do not know who wrote the names or why. Touching to listen to, especially since none of us knew each other, and a way to feel connected to the community of 30.

Below is a photo of the First Congregational Church of Los Angeles meeting room. For reasons of privacy, no photos of the gathering on the other side of the bridge table.

Fahad then introduced the East Indian wooden shruti box, akin to a harmonium, sitting on his lap.

If interested, you may read about the shruti box here:

https://en.wikipedia.org/wiki/Shruti_box

The box has bellows. Fahad slowly opened and closed the box like an accordion. There was no melody, but a drone sound with each movement. And then Fahad would hum and guide a sound meditation. The group was invited to respond and hum with him. A call to grief if you will. The sounds defied description.

This was quite a surprise for me as I thought I had attended to listen to a choir. As it was then apparent, the choir consisted of all who attended, me included.

The humming at times took on the sound of gentle, tender, almost-wailing. Difficult to describe, intangible, something one must experience. Perhaps a bit of the ululations (zagrouta in Arabic), bouncing from lament to joy but not exactly that. Most of all, a feeling of support from others in the circle. Eyes were closed or open. Fahad and Cynthia had created a safe space. Mellow feelings at the end of the hour.

Fahad (imagine a modern-day Sufi or Rumi) has been described by the LA Times as a “fanciful and downright utopian artist and thinker”. His bio states he “explores sound as spiritual practice, creating interdisciplinary pieces as a vehicle for unveiling the mystery of our interconnected world.” An apt description.

I am pleased to have attended. Unique and memorable. For those who are in Los Angeles and interested, the next Grief Choir is scheduled for the Summer Solstice somewhere around June 20, 2025. The announcement will be made on the Resonance Collective website.

For information about the Resonance Collective and Fahad Siadat see:

https://www.resonancecollective.org/fahadsiadat.html

For information about Cynthia Siadat see:

https://www.iamlivingfully.com/bio

For more about Elizabeth Gill Lui see:

https://en.wikipedia.org/wiki/Elizabeth_Gill_Lui

Wendy Jane Carrel, MA, is a Spanish-speaking senior care advocate from California. She has travelled Mexico (and Latin America) for several years researching health systems, senior care, and end-of-life care to connect Americans, Canadians, and Europeans with healing options for loved ones. She is a compassionate companion and palliative care liaison, legacy writer, co-founder of Café Mortality Ajijic/now Death Café Ajijic and founding member/speaker of the Beautiful Dying Expo (USA). She is a trauma-informed, gentle End-of-Life Doula (National End-of-Life Doula Alliance proficient), a speaker and published author on subjects related to senior well-being, and serves on the City of West Hollywood’s Older Adult Advisory Board. Wendy’s web site is https://www.WellnessShepherd.com

Death and Dying Education, End Well Conference, End-of-Life Care, Multi-Cultural Grief, Time to Pause (grief care)

Time to Pause Multi-Cultural Grief Gathering Follows End Well 2024 in Los Angeles

November 30, 2024December 2, 2024 bigpondlittlegirl

The day after the annual End Well conference in Los Angeles, End Well presenter Alica Forneret, Executive Director of Time to Pause, hosted the non-profit’s first-ever Resource Fair focused on grief in multi-cultural communities. An ideal segue.

The fair was held at Our House, a non-profit grief support center in West Los Angeles. As the program noted, it was produced “by People of Color for People of Color.”

Alica personally welcomed all attendees at the entrance. A fine, warm beginning for what became a meaningful, memorable afternoon among the many who, according to Canadian sacred deathcare practitioner and teacher Sarah Kerr, PhD, “are called to transform how our culture(s) meet death and loss.”

First stop, one-hour with poet/writer Nicholas Reiner who offered reading and writing tools to navigate whatever stage of grief you may find yourself in. Nick lost his Los Angeles County Fireman and First Responder father in the line of duty. Nick was 9 years old at the time. Moving to hear his story, moving to hear Nick read his eloquent poem about this father in both English and Spanish, moving to hear letters of loss from others we read aloud. We were sent home with 10 pages of prompts, ideas, and other writings to ponder. Wonderful gift.

Next stop, the Book Nook with some current (and past) titles relating to death, dying, and grief by authors of color.

I was excited to continue to a glassed-in room where San Francisco Bay Area doulas Tida Beattie and Soyeon Davis had created a labyrinth of marigolds, pine cones, and plant branches from local flora. They had also created a labyrinth for the End Well conference the day before.

Tida and Soyeon provided directions about setting an intention before entering the labyrinth with suggestions for how to focus on your breath and feelings. They also provided a thoughtful sheet about the rich and diverse history of labyrinths.

I am a huge fan of these precious ladies from a Reimagine on-line meeting years ago and subsequent on-line gatherings about death, dying, and grief in Asian communities. Here below you may see and feel their open, receiving energy. Soyeon is on the left, Tida on the right:

Tida was on the mid-afternoon panel discussion. She spoke movingly and authentically about how difficult it is to navigate the subject of dying in an Asian family. Also on the panel were African-American cancer survivor Sonya Jackson, and Our House Latina social worker Jenny Rivera-Cruz with Alica Forneret as the moderator. Each of their experiences about navigating serious illness, death, and grief were compelling to listen to and at moments surprisingly humorous.

Photo below of Sonya, Tida, and Jenny on the Time to Pause afternoon panel:

Photo below of Executive Director Alica Forneret (blue and white blouse) as panel moderator with some of the audience:

The AC Care Alliance, a non-profit “faith and health caring community” focuses on the African-American experience yet serves all others. They received me graciously, just as they were packing up. My thanks to Regional Director Trevino Cochran for offering me a well-conceived, well-written Care Planning Workbook for Advanced Illness Care.

Jasmine Godinez-Gomez had a table with her Art for Grievers.

Mangda Sengvanhpheng, a Laotian-American, shared with me about her culture of care as a death doula since 2019. Her first name translates to light of the full moon. Her name fits her low key, calm and present with you manner.

A short film entitled Curating Grief by London-based filmmaker Jamie Max Lee, shot on location in Lisbon, was screened. Attendee Charlene Lam of http://www.curatinggrief.com is featured in the film. I look forward to viewing the film at another time. A trailer for the film is on Charlene’s website.

Bella Vida Hospice of Signal Hill, CA had a table. They focus on serving the Latino community.

There were many other participants to meet and appreciate.

About 200 authors, chaplains, nurses, caregivers, end-of-life doulas, poets, psychologists, social workers, and anyone interested or involved with cultural differences in end-of-life and grief attended the free event. The atmosphere was healing and supportive, and the fair well-organized and produced.

Several folks who attended End Well stopped by – National End-of-Life Doula Alliance President and Compassion & Choices African American Leadership Council member (AALC) Ashley Johnson from Orlando, Florida; Author/End-of-Life Doula Trainer/End Well speaker Alua Arthur of Los Angeles; SFO Bay Area Author/Hospice Nurse Gabrielle Elise Jimenez, Sarah Chavez of the Order of the Good Death whom I would have liked to have seen again (last time was in 2019) and many others.

If this gathering returns next year, and I hope it does, I have a prayer for possible Native American participation.

Many thanks to Alica and her equally passionate and engaging Time to Pause team for their attention to details and care. For more info on Alica and Time to Pause please see:

About PAUSE Leadership — PAUSE

Note: The End Well conference, produced since 2019 with immense heart and soul by Dr. Shoshana Ungerleider of San Francisco, is devoted to “making the end of life a part of life.” The conference has included diverse voices since inception. If interested, an edited 5-hour recording of this year’s End Well may be viewed on line at: https://endwellproject.org/live/ .

Assisted Living Mexico, Ecuador Senior Care, Eldercare Abroad, Ex-pats in Mexico, Health & Wellness Mexico, International Retirement, Nursing Homes Mexico, Senior Care Abroad

Finding Eldercare/Senior Care Abroad – Assisted Living, Nursing Care, Memory Care

September 4, 2024August 9, 2026 bigpondlittlegirl

We live in an aging universe, a universe where older adults live longer than ever before and the need for care is growing.

For centuries we have protected and provided for loved ones from cradle to grave. These acts of reverence, respect, and love still exist and are seen in traditions around the world.

But modern life has shifted from relative stability to burden for many – out-of-the-blue expensive healthcare conditions, a growing number of older adults with chronic diseases/co-morbidities requiring long-term care, fewer folks to work as caregivers, multiple stressors for families overwhelmed with work and caregiving, financial loss, climate change, pandemics, war, forced migration.

Sadly, the reality of aging in the U.S. if you are not independently wealthy requires extra effort, planning, and sacrifice. No matter how much exercise, living with a positive attitude, and attention to healthful lifestyles, you may find yourself with difficult choices due to an unanticipated surprise – do you adjust where you are or imagine alternatives? Staying home is understandably preferable.

Older adults around the globe prefer to Age in Place and make their end-of-life transitions in a community they know and love. Quality of life that is comfortable and familiar is the main objective. This is generally translated to, NOT in a foreign country or anywhere else.

If you have exhausted all avenues of community support at home or in adjacent counties, states, or provinces, and realize care may not be affordable or you may outlive your funds, what are your choices? What if you are a solo ager with no family, spouse, or fallback? What if you must continue to work to support a family and are uncomfortable with the idea of sending mom or dad away for care?

Choosing to move could be a disheartening task. It is a leap into the unknown, no matter how adventurous one is.

One option is to seek care in another country.

There are seven continents on our planet. All but one (Antarctica) provide a form of care for older adults. From Albania to Samoa, unless loved ones are cared for by family, there are in-home support services or residences offering various forms of independent living, assisted living, memory care, nursing care, and/or end-of-life support.

According to Grand View Research, “the global long-term care market size was valued at USD 1.11 trillion in 2023 and is expected to grow at a compound annual growth rate (CAGR) of 6.68% from 2024 to 2030.”

The area with the largest anticipated growth is memory care. Alzheimer’s Disease International reports there are more than 44 million Alzheimer’s patients globally. The number is expected to triple to 135 million by 2050. “If ‘dementia’ was a country it would be the world’s 17^th largest economy.” Costs for memory care are exorbitant, especially if the anticipated lifetime of care is 12 years or more.

How do you choose where to go?

Somewhere around 2003 it became evident to me as a person dedicated to older adult healthcare that the future for American boomers, Gen-Xers, Millenials, and their parents would be affected by the rising cost of aging care. With the benefit of a lifetime of travel, foreign study, and work on five continents, it became apparent Americans might begin to seek care in another state or abroad if they could not afford the cost of care at home.

In the last 15 years I have witnessed and assisted more and more Americans, as well as Canadians and some Europeans take a leap of faith and choose south of the U.S. border for retirement and care for reasons of proximity (not for Europeans), weather, cost, and a reputation for thoughtful providers.

According to Lottie, a UK research organization and placement advisor, the best countries for senior care named in order are Norway, Sweden, Switzerland, Germany, Canada, and the U.S. You would need to have residency, be a national, or have funds to pay for care. Factors included in the study were pensions, healthcare systems, care services (assisted living, nursing), social support, and government grants.

The best countries for senior care by continent named by Lottie are:

Africa – South Africa

Asia – Taiwan

Europe – France

Oceania – Australia

North and Central America – Mexico

South America – Ecuador

The Lottie report did not include parameters for the above assessment. France as the best in Europe contradicts the previous Lottie report that Norway leads in senior care.

The below review is based on my research and experience.

What countries do Americans and other nationalities consider for retirement and senior care if looking internationally?

Americans and Canadians favor the Caribbean or Mexico by virtue of proximity, and often for weather. Other places in Latin America are considered, mainly Costa Rica, Ecuador, and Panama. In the last 15 years, the Philippines and Thailand have also been chosen based on cost, weather, and a reputation for attentive care. Malaysia, a new face of senior care in Asia since legislation in 2018, attracts some Americans but mostly Australians, Brits, and folks from other Asian nations. Ireland is sometimes considered when qualifying for Irish citizenship or residency. If you are an EU citizen, you have certain residency rights in Ireland.

Frida mural in expat enclave Ajijic, Jalisco, Mexico

If you have the blessing of universal healthcare (Americans do not) and are a national in Norway or Sweden, you are cared for from birth to burial no matter the level of care you require. Norway, as mentioned above, is considered the best country for older adults by virtue of its healthcare system and life expectancy. I can attest to Sweden based on attending graduate school in Stockholm and experiencing the healthcare system.

If you live in the UK, Portugal or Greece look like warmer options by virtue of proximity and favorable tax breaks, but the situation may be more of a challenge post-Brexit depending on your financial status and language considerations. Many American older adults are finding their way to Portugal, and to Greece if they have Greek heritage. Brits as we know have considered India for retirement and medical care (shades of the film about middle class retirees in The Best Exotic Marigold Hotel), or a British base in the Caribbean.

Since the end of the 19^th Century Italians (and some French) looking for affordable options have been traveling to Tunisia, not so far from home. Historically, Tunisia was a Roman imperial colony. Vibrant Italian colonies are found in Tunis, Bizerte, and Sfax. On a recent trip to Italy, I learned some Italians are now traveling to Croatia for lower costs, which is interesting as several “badante” or caregivers in Italy are from Croatia. Here is my post about aging in Italy a favored country for retirement, healthcare, and senior care by Americans of Italian descent and others:

Aging in Place & Senior Care in Italy – A Snapshot from Tuscany

In the Arab world, Kuwait, Oman, and Zanzibar (on the Trucial Coast of Africa but formerly the Sultanate of Oman and an important Arab trading center), countries I know, taking care of your elders is a religious and traditional obligation. Home health caregivers and nurses are de rigueur. There are now palliative care and hospice services.

What countries have dignified elder care at a price point less than that of the U.S.?

As of 2024 more affordable price points may be found in Costa Rica, Cuba (not an option for U.S. citizens), some Caribbean nations, Ecuador, India, Mexico, Panama, the Philippines, and Thailand. Note: prices for care are rising worldwide.

In every country of the world there is quality, supportive elder care and there is sub-standard, disengaged “care”.

Quick overview of points to ponder:

Determine country. Easiest to do when you have travelled to far flung places before. Be advised that dream vacations are not the same as living long periods of time in a new place. A preliminary, exploratory trip is always recommended. In expat destinations there are often introductory seminars for how to navigate the place you have chosen. If your heritage is Irish, Italian, Polish, or other, and you qualify for residency and a second passport, countries of heritage may be in mind.

Healthcare beyond in-home care and assisted living. Access to physicians, hospitals. Learn how the healthcare system works in the country that beckons you. Medical care may cost less and yet be of similar quality or better. Vet your medical team as you would in your own country. What is the role of the assisted living residence if any? Is the residence hands on or does it expect family members to participate in your hospital and rehab care from a distance? If you are a solo ager, consider locating a healthcare coordinator/advocate to keep an eye on your care. Review factors that affect health – weather, elevation, pollution, availability of fresh water and food. Will you be in a flat place safe from falls? What is the standard of care?

Residency requirements. Every country provides information on how to qualify for and achieve residency. Will you be able to live there in the future on your income as prices rise? Embassy and consulate websites plus expat forums on-line provide guidance for navigating residency. Expect a lot of effort on your part. If you do not speak the language, consider hiring a facilitator.

Consider the distance and cost of travel, keeping in mind cost to return home should life change. The longer the distance the harder it is to travel with elder loved ones. Will family be able to visit? On a recent Viva Aerobus flight between Los Angeles and Guadalajara a precious senior in obvious pain was traveling with her mindful son. The flight was three hours. The son held her close. She never complained but you could feel it was not easy.

Corporate or Home-Like Environments. What would be the most compatible environment and style for you or your loved one? What is the owner/administrator’s philosophy of care? Do they have a mission to care for elders? Is income the only objective? Will the residence remain in existence for the life of the resident? Search the Internet and AI. You will read about places, mostly those that are corporate, and not necessarily discover smaller places with no budget for outreach. Consider smaller places, some are gems.

Garden at small assisted living home in Mexico

Consider family moves. I have had the privilege of assisting families who moved with their loved ones. The sons and daughters work digitally and visit mom or dad. For those who are unable to move with loved ones, most homes provide Face Time, Google Meets, or Zoom visits.

Safety and happiness. Is the residence secure? How will the residence assist with the transition? Any move is stressful, especially for older adults. It takes three to six months to adapt to a new environment. Not everyone transitions well, some not at all. In my experience, a well-traveled person who has an affinity for adventure or a certain culture, has as easier time. If the loved one has dementia, places in nature with gardens, room to walk, the energy of light, and a high level of activity and engagement encourage positive outcomes. What will the level of socialization be? Are there other expats who would be compatible company? Some expat havens and faith communities have volunteers, usually retirees, who visit homes and keep track of brethren. Is the food fresh, does the home offer diets suitable for diabetes or other illnesses? What are the standards of care? How is staff trained, how many staff per resident?

Quality of life and engagement lead to comfort, better health, and general contentedness.

Local culture. How are older adults viewed by the society and government? Is English a second language and is there experienced, trained staff who speak some English? Will you or your loved one be comfortable living among locals or being examined by a doctor who may not speak English? What is the country like compared to what is familiar to you? What might be missing? Some countries group residents who only have physical disabilities with those who have dementia.

Palliative care and hospice. Will the residence and local doctors accept and respect your wishes? What are local procedures/traditions for treating pain? How is end of life treated? Is there 24/7 attention and vigiling? If you feel close to death, will you be able to return to your home country to die if that is your wish?

Expat forums. There are innumerable expat forums on the Internet, some offer basic guidance about what to expect in the country of choice. Be advised, however, that even with good intentions, information may contain other cultural biases and not necessarily be in alignment with your personal needs, perceptions, and standards.

Summary:

If aging and healthcare options at home become limited, or you realize you may outlive your funds, one option is to look abroad.

Seeking eldercare beyond your own borders is a daunting task and may feel painful. If you have had the privilege of international travel, languages, and on-the-ground experiences that provide you with a level of psychological as well as financial safety and comfort, you may do well. There are also many who have chosen care abroad, never travelled far before, who end up feeling pampered and content. Choosing care near an expat retirement community may bring peace of mind and could provide back-up support and socialization.

Exploring and planning ahead make a difference in your outcomes.

Mission based care (not meant to be interpreted as religious) in smaller residences is often appealing, especially when administrators and staff demonstrate compassionate care daily. Large corporate facilities often require an extra layer of vigilance on the part of families in all countries, so providing an advocate/weekly visitor is helpful if affordable.

There is no perfect place, but there is excellent care to be found in every country.

Research well, make lists, assess your needs, and locate a place that aligns with your preferences.

Abundant blessings for whatever journey you or your loved ones choose.

Wendy Jane Carrel, MA, is an older adult health care advocate, advisor, and consultant from California. She has conducted due diligence for senior living and retirement on five continents and is passionate about supporting families and their elders with solutions. She provides informed, attentive, compassionate guidance and curated options for Ecuador, Mexico, and other destinations both domestic and abroad. She is a speaker and published author on subjects related to older adult well-being. Wendy’s web site is https://www.WellnessShepherd.com

Resources:

Long-Term Care Market Size, Share & Growth Report, 2030 (grandviewresearch.com)

https://www.alzint.org/about/dementia-facts-figures

https://lottie.org/care-guides/which-country-has-the-best-elderly-care/

Best Countries for Seniors & End-of-Life Care

https://www.youtube.com/watch?v=l4vUGKcASUU PBS program How Long-Term Care is Burdening Middle Class Americans

https://myhometouch.com/articles/caring-for-an-elderly-parent-from-abroad – wise advice for sons and daughters of parents who live abroad

https://ceoworld.biz/2024/04/08/worlds-best-and-worst-countries-for-older-people-to-live-in-2024/

Death and Dying, Death Cafe Los Angeles, Family Caregiving, Heather Fink, Long-Term Illness

Catastrophic Long-Term Illness, Death and Love – An Immersive Evening About Caregiving with Comedienne/Filmmaker Heather Fink’s Quicksand

June 16, 2024June 16, 2024 bigpondlittlegirl

Place: LA’s Fringe Festival, June 2024

Heather Fink is a comedienne/filmmaker/storyteller who bravely shares her thoughts and feelings about long-term illness, caregiving, death, loss (income, career, family), and love in a live performance.

The title Quicksand telegraphs Heather’s theme, most of all its weight. She offers an authentic, energetic, engaging, and quirky memoir with relatable universal situations.

The well-paced performance (with backdrop slide show of photos, a stuffed dummy father, and surprise pop-up) entertains and reels us in as we relate to the family crisis – her father’s stroke – the toll on her father unable to speak but four words, the exhaustion of her self-sacrificing Dutch mother, and loss for Heather’s efforts to advance her career. Heather shares, “we lived with a constant sea of emergencies.” Thirteen years of emergencies.

Meet Heather introducing her show on TikTok at:

@quicksandshow
My 1st ever tiktok! Whew I feel like a geezer! Please come see Quicksand at Hollywood Fringe! I promise to improve my tiktoking with each new vid 🙏#HFF24 #firstvideo #firsttiktokever #hollywoodfringefestival #HollywoodFringe #latheatre #caregiver #caregiversoftiktok #death #midlifecrisis #filmmaker #soloshow #losangeles #quicksand #dola #creative #eldercare #eldercaregiver #strokesurvivor #strokeawareness #strokerecovery @hollywoodfringe
♬ original sound – Heather Fink

The material is fresh and raw. Heather’s father Stephen passed away exactly a year ago around the time she celebrated another birthday.

Heather’s journey is one of endurance and faith.

A fine audience experience demonstrating the value of everyday love and remembrance.

Quicksand messages:

Family illness and ultimately death affect the life trajectory of all involved.

Learn how to recognize a stroke!! (outlined on the show’s program)

There are 53 million unpaid caregivers in the U.S., they represent the backbone of long-term care. Most families, such as Heather’s, cannot afford to hire in-home caregivers.

Heather’s Angst and Outcome:

“I’m 43 and I have nothing to show for it” she cries. As we learn, though she may not yet see, she has everything to show for it – being present for both parents with love and support, plus the experience of a dark night of the soul that ultimately led to her current mission – meaningful discussions about caregiving, illness, and death.

Heather is now an advocate for stroke awareness, advance care planning, and talking about death, especially at Death Cafes.

Notes:

The Hollywood Fringe Festival, a community arts event, is held over three weekends every June at various small theaters in LA. It was founded in 2010 with 130 shows. The term originated with the first Edinburgh Fringe Festival which featured unique, non-traditional performances in 1947.

Death Café. Bernard Crettaz, a Swiss sociologist, created the first Café Mortels. His concept of meeting over tea and cake revolutionized how we speak about death and dying. Jon Underwood, who founded Death Café in the UK, made a trip to meet his inspiration Bernard Crettaz. Underwood attended the last Café Mortels in Lausanne, October 31, 2014. Jon died suddenly in 2017 at the age of 43. His mother and sister, plus two women in the U.S., keep the project going. There are more than 18,000 Death Cafes in 90 countries around the world.

There is a thoughtful Death Café in Los Angeles hosted by Elizabeth Gill Lui, a photographer/artist/author and death doula, at LA’s Philosophical Research Society.

A June 12, 2024 article in the Los Angeles Times features Elizabeth’s Death Café. The photo includes the author of this post (wearing a mask) and to her right and the reader’s left, charming Heather Fink who created the solo piece Quicksand. Link to article is in the Resources section below.

Resources:

https://www.caregiver.org/resource/caregiver-statistics-demographics/ .

https://www.aarp.org/caregiving/financial-legal/info-2023/unpaid-caregivers-provide-billions-in-care.html

https://deathcafe.com Death Café

https://www.prs.org/events.html Philosophical Research Society, LA

https://www.latimes.com/lifestyle/story/2024-06-12/death-cafes-los-angeles-grieving-discussion-group# Sorry, there is a paywall

Abode Contemplative Care Texas, Community Hospice, Death and Dying, End-of-Life Care, End-of-Life Doula Certification, Hospice, Social Hospice

Support for Dying via Social Hospice – A Snapshot from Abode Home, Texas

April 19, 2024June 11, 2026 bigpondlittlegirl

What is social hospice?

In the U.S. a social model of hospice (SMHh as written in academic and medical journals) is described as a dedicated home with 24/7 non-medical personalized care for end-of-life when dying at home becomes unmanageable. It is a non-profit service, often at no cost, in collaboration with support from a medical hospice service (usually the Medicare hospice benefit). It is sustained by community philanthropy, usually with a large base of volunteers devoted to comfort care and the gentlest passage possible.

In other words, end-of-life support by the people for the people.

Social Hospice Model

Social models for the dying have been recorded since 3000 B.C. (ancient Egypt). Every continent has had and still has some form of community care for the dying.

In modern times, the term social hospice was part of an obscure movement following the “good death” or “death with dignity” efforts of the 1950’s and 60’s. The goal was to return the dying process and choices to the individual.

The first U.S. hospices of the 1970’s were non-profits. Their mission was to create a caring, supportive environment in a residence specifically devoted to end-of-life care. In the 1980’s, social hospice for HIV/AIDS came into existence. The model includes grief and bereavement support for families.

The current U.S. landscape is dominated more and more by for-profit hospices and conglomerates, often funded by Wall Street players and private equity focused on high profit margins.

There are not as many community-based offerings as there once were.

****This situation may reverse and evolve based on growth in preparation for dying education, the end-of-life doula movement, and more awareness about the benefits community models provide. Why? Because they provide an unmet need.

Where may you find a social model hospice in the U.S. and who is social hospice for?

The home I know best, as I have participated in their on-line educational gatherings, is Abode Contemplative Care for the Dying in San Antonio, Texas.

Abode Home is affiliated with the Omega Home Network (based in Tulsa, Oklahoma), the largest U.S. social hospice network promoting the development and expansion of community homes for the dying. There are currently 74 homes found in 27 states, others are in development. https://www.omegahomenetwork.org/

Omega Homes generally receive solo agers who do not have support for dying at home, the dying whose family no longer has personal or financial resources for 24/7 care, and the homeless.

Here is a bird’s eye view of Abode Contemplative Care Home in San Antonio. There are others just as precious. Photo below courtesy of Abode Home.

Even though I live in both California and Mexico focusing on services for senior care and end-of-life, I continue to follow how others create and sustain community care.

I wish such sustainable community care would be available in every country and to every individual.

As a solo boomer (no spouse, no children, no fallback) I have been contemplating my demise for more than 25 years – I believe in planning ahead when possible.

If I lived in Texas I might choose Abode’s sacred, supportive care based on the energy of light of the CEO, the Board of Directors, the staff, the End of Life Navigators, and the volunteers.

With great pleasure, I have participated in Abode Home’s on-line discussions hosted by CEO Mary Thorsby who welcomes all open-heartedly. She and her team send out meaningful, inviting newsletters, quarterly reports, and raise funds to sustain their generous service.

When I first learned of Abode Home I was attracted by the pastoral-looking watercolor rendering, photos of the garden, the words contemplative care, but most of all Abode’s transparency and community engagement.

The home is a sanctuary – a quiet dwelling surrounded by nature with an intimate atmosphere, light in each of the three rooms, and, an inclusive presence.

Abode Home collaborates with all the San Antonio medical model hospice providers who send physicians, nurses, and medications.

Comfort care is provided 24/7 at the residence by five full-time staff, four part-time navigators, and 70 volunteers (15 of whom are Board members) in eight hour shifts. “It’s a grass roots team effort different from the medical model, and, it’s a mission,” shares CEO Mary.

Abode Home is celebrating its 10^th year serving the public.

Here are some of Abode Home’s supportive activities for their end-of-life guests and the community-at-large:

Bedside yoga

Book Club – book study with End-of-Life titles

Caregiver guidance for supporting oneself through caregiving

Contemplative Drumming

Education via on-line Zoom meetings and gatherings at the home

Death Café second Saturdays of the month

Dementia series with speakers from the community

Dia de los Muertos celebrations each fall

EOL (end-of-life) Doula trainings and EOL Doula Certifications – teaching others how to be with dying and dispatching them to the community-at-large

Fundraisers – a yearly Spring Art Show & sale; a fall online BIG GIVE

Luminarias lit in paper bags on stone walls around the property every December

Meditation via Zoom

Pull Up A Chair Dinners – highlighting alternative therapies for End-of-Life comfort

Reading of Names on All Souls Day, November 2

Sound healings

Staff and volunteer training

Threshold choir

Yes, donations are welcomed and appreciated.

See www.abodehome.org/donate, write info@abodehome.org, or see their Facebook page at https://www.facebook.com/ABODEcontemplativecare

Note: According to the National Vital Statistics System, about 35% of Americans die in hospitals, down from 48% in the year 2000. Almost 30% die in nursing or hospice homes. (This statistic does not include dying from a sudden accident, cardiac arrest, or stroke).

Social model throughout the world:

The social model has existed for millennia in various forms following cultural preferences and traditions.

“Egyptians, Orientals, Greeks, and Romans all used churches or temples as refuge for the sick or for pilgrims. Care of the sick was the responsibility of those believed to have special talents as healers, those who felt it was a religious duty, or diploma physicians who learned their craft based on scientific knowledge at the time,” writes Cathy Siebold in The Hospice Movement: Easing Death’s Pains (Twayne Publishers, New York, 1992).

Buddhist Emperor Asoka of India, (273-233 B.C.) known for a humanitarian approach to governance, created 18 shelters for aging, disabled, ill, and poor pilgrims who came to die and be cremated on the Ganges River. As we know, such homes exist now though they are mainly used by Hindus.

According to Wikipedia, historians believe the first “hospices” originated in Malta around 1065 during the Crusades. They were run by nurse nuns.

Summary:

The social hospice mission is to enhance quality of life to the end of life with compassionate care in a sacred manner regardless of ability to pay.

Local, direct, loving acts of care during life and at end-of-life are the foundation for a flourishing community.

Resources:

https://www.omegahomenetwork.org/homes/ with a map of locations in the U.S. Scroll down to see the list plus website links to each.

https://www.youtube.com/watch?v=U7tHPCjEs7c Marty Bazelak, MD, palliative care physician hosts guests from Clare House, Tulsa, OK, founders of the Omega Home Network of social hospices.

https://journals.lww.com/jhpn/abstract/2021/10000/social_model_hospice_home__a_concept_analysis.13.aspx Social Model Hospice Home

https://journals.lww.com/jhpn/abstract/2023/10000/experiences_of_homeless_recipients_of_social_model.10.aspx

https://theprint.in/pageturner/excerpt/king-ashokas-hospitals-to-rural-health-mission-how-the-indian-medical-system-evolved/746649

https://history.stackexchange.com/questions/61776/did-the-emperor-ashoka-really-build-hospitals-or-is-that-a-myth

https://www.businessinsider.com/photos-varanasi-india-city-of-death-tourism-2023-6#the-city-is-dotted-with-ancient-temples-there-are-an-estimated-3600-in-total-5

https://en.wikipedia.org/wiki/Hospice

https://www.propublica.org/article/hospice-healthcare-aseracare-medicare “Endgame: How the Visionary Hospice Movement Became a For-Profit Hustle” …… plagued by exploitation. By Eva Kaufman, November 28, 2022.

Hospices Have Become Big Business for Private Equity Firms, Raising Concerns About End-of-Life Care

https://cepr.net/report/preying-on-the-dying-private-equity-gets-rich-in-hospice-care/

https://www.cdc.gov/mmwr/volumes/69/wr/mm6919a4.htm# government report on U.S. death statistics from 2018 (not including, obviously, COVID death)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9255424

https://www.reuters.com/article/idUSKBN1YF2Q5

https://caringheartandhands.org/social-model-hospice-homes-can-change-end-of-life-care/ excerpt from book by Karen Wyatt, MD, hospice physician

https://eolupodcast.com/tag/social-model-hospice/ Karen Wyatt, MD, hospice physician host

https://en.wikipedia.org/wiki/Saint_Fabiola

Aging in Place, Tuscany, Italy, Mexico Senior Living, Senior Care Italy, Senior Care Mexico

Aging in Place & Senior Care in Italy – A Snapshot from Tuscany

December 30, 2023January 3, 2024 bigpondlittlegirl

In October I spent three weeks in Italy celebrating the 90th birthday of “Super Silvana” the last living person of her generation who has witnessed my life since I was a teenager. Her nickname comes from her daughter and friends who have spent a lifetime watching her overcome obstacles. She was a child during WWII living in the countryside, and later, the sole support of her daughter and other relatives. My heartfelt thanks to Silvana and her daughter for permission to share. Here is what I observed:

Aging in Place

Silvana is aging in place with dignity and self-respect, her way, as much as possible.

From my point of view, it is not easy without unlimited resources and optimum health in Italy, nor almost anywhere else in Europe. Nordic countries and The Netherlands may be mini exceptions. (I have seen well-thought-out senior living and support in Stockholm and outside Amsterdam).

Silvana’s circumstances are what Americans would refer to as middle class. She worked her whole life, ran a small business, and owns a condominium in an attractive section of Florence a few hundred yards from the Arno River. She has been a widow for over 35 years.

She is aware of the importance of diet, buys the freshest food, and continues to create meals from scratch. She used to go to open-air markets but recently has found most produce at the Esselunga market behind the back gate of the condominium. Years ago, we drove to the Tuscan towns of Impruneta or Poggibonsi on weekends and returned with the best quality olive oil, chianti, cheeses, and more. Today this is accomplished by or with her super capable and loving daughter, her only child, who lives next door, and works full-time.

Here below is a photo taken by her daughter outside the Esselunga market under the hot (over 100 degrees) October sun.

Silvana’s home is immaculate – open any armoire and you will find the best quality linen, beautifully laundered and ironed. Ditto for her clothing. In the entrance hall she keeps a marble bowl of necklaces – pearls, Murano glass, and others on a sideboard. When she goes to the supermarket or for a café, she will (unless it is too hot) be wearing a necklace, earrings, and fine watch. Next to the sideboard is her walker for the street.

Guess who cleans the condo, prepares meals, does the laundry, and makes certain all is in order. Silvana!

When you meet her, she exudes kindness, and love. She is an appreciator of life, always smiling and seeing the best in you and those whom she meets. She is a woman of immense energy, generosity, and intelligence. She worries about others and knows her neighbors and their stories. Every day she walks one flight up to check on another aging in place lady who is the caregiver for a severely disabled daughter. The lovely lady upstairs receives no respite or support from social services, neither does Silvana.

The precious little dog in the photo by her daughter below is Nina, Silvana’s companion during the day while her daughter works.

On Thursdays a hairdresser comes to coif Silvana’s hair. The hairdresser also attends to the ladies upstairs. This is Silvana’s investment in feeling better and “a posto” or okay.

Silvana’s attractive appearance defies what she is feeling almost 24/7 – unrelenting pain from rheumatoid arthritis, scoliosis, osteoarthritis, and other co-morbidities.

Nighttime Challenge

Nighttime is more difficult than daytime. Sleep is interrupted with shooting pain despite evening medication. When she gets up to use the bathroom, it is not easy. It takes a while to lift her body comfortably from the bed. (The bed she carefully chose gives best possible comfort and support for her condition). She is wise and focuses on remaining stable as she rises; it is a chore to walk the short distance. She does not use a walker in the house or to navigate at night. The lighting is good. But what if she falls?

Socialization

Silvana loves her independence, walking the local streets and around the condo compound every day. Unlike many disabled and ailing who are retired, she is supremely socialized, though it would be helpful to have visitors or a regular companion during the day other than neighbors who stop by outside her window. Game shows on TV are not of interest, the news is. She enjoys reading and crossword puzzles. Her mind is sharp.

Almost every day I was there we walked to the city center looking to replace my favorite Igi & Co. wedge walking shoes. Each time we went it was a charming adventure watching how she would dart ahead of me with her walker, so excited. She attracts folks like magnets on the street, in stores. It is fun to watch. As you may have surmised, she is super friendly and has a gift for storytelling.

We were late returning from the center one evening and decided to hop on a tram instead of walking back. As she enters the tram with her walker she is smiling and announcing how much she appreciates everyone’s help and she is sorry if she is disturbing anyone. Passengers smile broadly, transfixed by her charisma and warmth. I wish I had thought to make a video of the experience. It was such a pleasure to watch.

Assisted Living in Italy

Silvana has absolutely no interest in a senior living home even if she could afford the prices. There are a handful of “luxury” residences, homes run by nuns, and homes partially supported by the government in Tuscany known as RSA (Residenza Sanitaria Assistenziale – sanitary residence care).

The photo below is of a typical modern assisted living in Florence. The photo is only to show an example, not to recommend or endorse.

In Italy, there is private pay assisted living, and as in the U.S., you will be moved if you require nursing care. Prices range between 2500 and 4500 euros per month, depending on the city and the region. I visited four residences in Florence and two in Pistoia on this trip. My priority was to be with Silvana as much as possible, observe her health, and see if we could discover some surprise solution to ease her aging in place. My last trip was to see Silvana’s loving oldest sister before she passed away – fortunately, with good care paid for in part by the Italian government.

Home Health Aides (known as “badanti”)

Receiving help at home is not paid for or assisted by social services unless you are uncommonly poor and gravely disabled – blind, deaf, paralyzed, etc. Silvana might welcome a “badante”, a caregiver, though she might not readily admit this. She tries not to show it, but she is understandably tired. She is not a complainer. Keep in mind it is cultural to not discuss your woes outside your family, and just as important, is the desire to “fare una bella figura” an idiomatic way of saying always put your best foot forward.(Badante is from the Italian verb badare, to take care of).

There are agencies for a badante, male or female, in larger Italian cities. In Tuscany and other provinces there is also an underground market (or hidden job network) of migrant Peruvian, Moldavian, and Romanian badantes, some apparently without residency. I heard stories (not confirmed) about abuse or theft on occasion by caregivers who are not vetted or bonded. On the other side, there are stories of “modern servitude” by Italian families hiring badanti.

Below is a photo of a large agency on Via del Sansovino in Florence. There are three other agencies in city center.

According to a British study by Giuliana Costa the hiring of migrant badanti to relieve Italian families has been on-going since around 2000. The average price of a badante starts at about 800 euros/month (about $900 USD) and goes to 1500 euro (about $1600 USD) or 2000 euro per month ($2200 USD) not including room and board. The average gross monthly salary of middle-class Italians is currently 3650 euros, the current average middle class pension is 800-1200 euros/month or more). With prices rising around the world since COVID, the cost for a badante continues to increase.

The situation is challenging if you are caught in the middle. Italian families, the traditional caregivers, must now work or care for their own children as well as their parents.

Depending on which statistics you study, Italy has the second or third largest population of older adults in the world, following Germany or Japan. In Italy today, there is not enough support for the growing population of older adults.

Average Middle-Class Pension in Italy, Will It Pay for a Badante?

The average middle class pension in Italy is around $16,572.22 USD/year. Monthly, that comes to 1370 euros, but the pension is more likely 800 to 1000 euros per month. Even if your condo is owned, you are paying condo fees, water, gas, electricity, transportation, food, doctors, clothing, and miscellaneous expenses. Are you able to pay a badante who will need his or her own room + board? If you are lucky perhaps you may find someone for a few short hours at 10-12 euros per hour. But over time the expense may become prohibitive.

If you own a home and have a pension above the poverty line, it is a given that government social services will tacitly expect your family to care for you. This makes me wonder what happens if you are a solo ager with no support.

If you are above the poverty line in Tuscany, you must pay a fee to go to a senior center, a day care center, receive social worker support and other services. If the choice is paying utilities and eating, will you pay for day care? As far as I have learned from research, there is no organization such as Meals on Wheels in Florence for example, and even if there was, Silvana prefers choosing what food is most healthful for her. I was hoping to learn about a non-profit organization of volunteer companions that visit older adults. Florence does, however, have a volunteer service that drives extremely disabled older adults to doctor appointments.

The local government social services in Florence are housed in the ASL Ufficio di Assistenza (the Assistance Building) which includes the ISEE, the government entity which assesses your economic condition (Equivalent Economic Situation Indicator).

What happens if Silvana has a fall, a stroke, and needs serious care?

Government healthcare will kick in, but for some services, she may be paying in part. Her daughter sends good thoughts to the universe every day so that her mother will not have an accident, so do I.

The national health system in Italy includes state hospitals which are funded by taxes. If you are Italian, or a resident, you do not pay as a patient for the hospital. For scheduled surgery, a referral from a doctor is required. In acute situations, you can go to an emergency room (Pronto Soccorso) without a referral.

What works…

Italy has provided universal healthcare since 1978 through the Ministry of Health and its SSN Servizio Sanitario Nazionale. This service is available to all Italians and Italian residents. Until the last few years, according to many, it has been a positive experience. Recently, due to staff shortages, COVID, and fewer euros to support the system, it takes longer to receive attention. Fortunately, Silvana has an SSN geriatrician whom she is pleased with. SSN does not include dentistry and psychological support. There is also private pay medicine in Italy and private pay health insurance. Many Italians are now participating in both public and private insurance, the latter if they are able to afford it.

Conclusion

The review above is a snapshot. A proper evaluation would require several months or a year of due diligence and observation to understand the changing system of care for older adults in Italy.

Again, as with the U.S. and most “western” nations, much has changed in the last 10 or 20 years – mostly diminishing social services plus higher cost of living and cost of care prices.

My Italian trip made Mexico, (where I focus my energies coordinating senior care, senior housing, and end-of-life care), seem comparatively less complicated and more affordable for Americans, Canadians, or Europeans seeking to age in place outside their home country.

Through Mexico’s INAPAM and DIF, all nationals and residents may participate in programs and activities designed as poverty reduction strategies. Senior centers act as daycare centers with socialization (there are government centers in rural areas as well as metropolitan areas), seniors receive discounts for travel by bus locally and long distance, Mexican national seniors receive a small monthly amount for expenses, and DIF homes (not that many in the country), provide a roof over one’s head and care.

Wendy Jane Carrel, MA, is a Spanish-speaking (and still Italian-speaking) senior care advocate from California. She has travelled 13 states of Mexico for more than 20 years researching health systems, senior care, and end-of-life care. She provides housing and care solutions and guides transitions in/to Mexico for Americans, Canadians, and Europeans. She is a compassionate companion and palliative care liaison, legacy writer, a trauma-informed End-of-Life Doula (National End-of-Life Doula Alliance proficient), and a speaker and published author on subjects related to senior well-being. Wendy’s web site is https://www.WellnessShepherd.com

References:

https://journals.openedition.org/osb/1536 Private Assistants in the Italian Care System, Facts and Policies by Giuliana Costa

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5868556/ well-presented “badante” case study in the city of Verona from 2017.

https://cafebabel.com/en/article/badante-the-ghosts-of-italian-society-5ae00a19f723b35a145e5e21/ how migrant caregivers are often exploited in Italy

https://cafcisltoscana.it/isee Social Services in Tuscany, Italy Assistance for pregnancy, university tuition, older adults and more, if you qualify.

https://housinganywhere.com/Italy/average-salary-italy

https://en.wikipedia.org/wiki/Healthcare_in_Italy

https://www.yourcare.eu/press/assisted-living-boom-predicted-in-italian-cities/ average 2023 monthly salaries for in-home caregivers

https://www.gruppolameridiana.com/en/residenza-sanitaria-assistenziale-rsa-works/ RSA homes in Italy

Author: bigpondlittlegirl

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