Senior Health, Housing, Hospice Options in Mexico and Ecuador
Enthusiastic, knowledgeable wellness book shepherd. Wellness Shepherd for senior care, palliative care, hospice. Intl Health Journalism. Love exotic locations, foreign languages, norteno dancing, my friends, and the family I was lucky to have been born to. Blessings for all ;)
Corona Virus Mental Health – Healthflix.Onine Launches FREE Online Classes March 31, 2020 GMT with 100 World Thought Leaders Sharing Knowledge
My distinguished award-winning book clients, integrative psychiatrists Richard P. Brown, MD and PatriciaGerbarg, MD, join colleagues on-line to support the public during the current public health and mental health crisis.
Drs. Brown and Gerbarg, New York-based medical school professors known for their continuing trauma relief work at Ground Zero NYC, and with Syrian, Sudanese, Rwandan, and Rohingya refugees, have written innumerable articles and six noteworthy books.
See The Healing Power of the Breath from Shambhala Publications as welcome reading for these times.
Their participation in the Corona Virus Mental Health discussion begins March 31, 2020 Greenwich Time (London, UK) and continues for the next two weeks.
Details may be found in the press release I posted on the Internet at the following links:
Corona Virus is changing where we might be, what we are choosing to do, or what we are restricted from following through with in order to protect the health of others.
This is not a complaint. But it has come to signify postponing meaningful work or gatherings in person, especially with the vulnerable who depend on the presence of family and others who support them.
Circumstances have already created loss and a sense of abandonment for our elders worldwide. You may recall the sad circumstances of elders alone in ICU’s in Italy, as well as in assisted living homes in Georgia and Washington State in recent days where family members may not enter to hold their loved ones as they make their transitions.
Note: This post is being written from Jalisco, Mexico where I have been attending to older adults.
The state of Jalisco (second largest state with Guadalajara as its capital), lead by Governor Alfaro and public health officials, is doing its best to tame the rise of Corona virus. There are several cases throughout the state, reportedly brought in by a group of wealthy Mexicans who traveled to Colorado to ski in mid-March or by travelers (foreign and Mexican) returning from Germany, Italy, and Spain. All persons except those in necessary services have been asked to stay inside through March 29 except for buying provisions or medicine. No travel unless necessary is another request. It is likely the date will be extended. Borders are still open but flights to other nations have diminished. So far, not a single assisted living home in Jalisco has reported a case of the Corona virus.
I had plans to see colleagues in the Mexican highlands and then return home to California. Plans have changed.
I wish to thank several colleagues whom I was going to meet with or revisit in March and early April – folks dedicated to the well-being of older adults. May we meet again soon.
1001 thanks to Lydia Jane Failing, Francoise Yohalem, and Rev. Tom Roseillo of the Unitarian Universalist Fellowship outreach in San Miguel de Allende, Mexico. Warmest greetings and blessings to each of you, your fellowship, and your community-at-large.
I so appreciated your kind invitation to participate in the seminar “Thoughtful Dying in Mexico” with other colleagues March 20, even though it was necessary to postpone as a form of protection for all. My topic was to have been spiritual aspects of dying in Mexico based on psycho-social-spiritual support of older adults at Lake Chapala, plus my involvement with a palliative care mission in Guadalajara.
My thanks also to the owners of assisted living homes in San Miguel de Allende and Cuernavaca who were waiting for me, as well as to hospice nurse Elena Lopez of Hola Hospice and Luz Serena, an assisted living home in central Morelia with two rooms offering American standard hospice. I look forward to visiting all of you and writing about your dedication to quality of life for older adults on other dates.
Many thanks to Café Mortality colleagues Debi Buckland, Jane Castleman, Loretta Downs, and Darryl Painter for their dedication at Lake Chapala. We cancelled gatherings for March and April for public health reasons.
Discussions of our wishes and mortality, especially at this time of crisis, may have been meaningful for attendees, not to mention this co-host. We will find other ways to reach out through Facebook posts and more.
And, last but not least, a big shout out to my care liaison colleague in San Miguel de Allende, Deborah Bickel of www.BeWellSanMiguel.com who is deluged with requests for assistance at this time. Deborah’s colleague, nurse practitioner Sue Leonard, was to have been on the UU Fellowship morning panel on March 20.
Where ever you are and whomever you are I pray you are safe, comfortable, and remembering to breathe. As we reflect on the health of those around us, our own health, and new ways to reach out, let us remember the greater dangers for those less fortunate – the elderly, the homeless, and immigrants on the road, in camps, or in cages.
Please remember our healthcare workers, first responders, drivers, and food purveyors.
Please consider volunteering by sending money to a cause dear to your heart and/or healing thoughts for everyone on your path and on the planet.
And, remember to keep reading inspiring stories if you choose about nail salons converting to sewing centers to make masks, the Chinese manufacturer who sent medical masks in crates to healthcare workers in Italy with a poem by Seneca, the Italians who sing on their balconies to each other, the Spaniards who stand on their balconies applauding healthcare workers as they go off shift at a nearby hospital, the small businesses and their drivers offering take-out throughout the world, and thousands of other folks who make sacrifices as they continue to show up for others.
Wendy Jane Carrel will address a group of American retirees about senior care and senior living options in Mexico at Focus on Mexico, Thursday, February 27 in Ajijic, Mexico. (Ajijic is a village with a population of around 10,000 at Lake Chapala, one hour south of Guadalajara, the country’s second largest city).
Her talk will cover Mexican senior care models (including those owned by Americans, Canadians, and other foreigners), and senior care options in expat retirement havens around a country often better known for its tequila, tamales, and mariachi.
Carrel recently wrote an article about corporate senior living developments in Mexico that was posted on SeniorLiving Foresight, a popular senior housing news site in the U.S. The link to the article is below.
Wendy Jane Carrel, MA, is a Spanish-speaking senior care specialist and consultant from California. She has travelled Mexico for several years researching health systems, senior care, and end-of-life care in order to connect Americans, Canadians, and Europeans with options for loved ones. She has investigated hundreds of senior housing choices in 16 Mexican states. Her web site is http://www.WellnessShepherd.com.
Senior care specialist and palliative care liaison Wendy Jane Carrel will speak at the Lakeside Presbyterian Church in Riberas del Pilar, Lake Chapala, on Wednesday January 29, 2020 from 2-3 p.m. about “Palliative Care and Hospice in Jalisco.”
The free public talk will cover Carrel’s years on a palliative care mission in Guadalajara, and introduce what is currently available in Jalisco for pain management, especially at end-of-life.
On January 22, same time, same place, Dr. Sam Thelin, who has a general medical practice in Chapala serving ex-pats, will review “NewHealthcare Options at Lakeside.” Thelin, an American, studied medicine at the highly-regarded private medical school UAG (Universidad Autonoma de Guadalajara). See http://www.drthelin.com
Wendy Jane Carrel, MA, is a Spanish-speaking senior care consultant from California. She has travelled Mexico for several years researching health systems, senior care, and end-of-life care in order to connect Americans, Canadians, and Europeans with options for loved ones. She has investigated hundreds of senior housing choices in 16 Mexican states. You may read more of her history at https://wellnessshepherd.com/about/ .
The movement to bring the subject of mortality into mainstream conversation has been on-going for at least 10 years in the U.S. As a result, the number of gatherings has increased.
The End Well Symposium, now in its third year and soon to be fourth, is a part of this movement.
The 2019 production in early December featured a star-studded kick-off with ABC-TV‘s The View co-host Meghan McCain sharing candidly and compellingly about the death of her father Senator John McCain. She feels everyone should have a discussion about this subject with loved ones, learn their wishes, and do the best one can to prepare.
Country singer Tim McGraw talked about the experience of attending his dying father. As a result, he joined the Board of Directors of Narus Health, a Nashville-based palliative care provider, “to ensure broad access to high-quality care during times of serious illness and through the end of life.”
There were 26 other speakers including author/facilitator/interviewer and social change maker Courtney Martin whose high energy and thoughtful introductions kept the day-long gathering proceed smoothly.
Shoshana Ungerleider, MD and philanthropist, whose family foundation is behindthe End Well Project, graciously and discreetly hosted as well. She succeeded with her goal of introducing a cross-disciplinary line-up that shared her philosophy – death and dying is not only a medical issue but most importantly, a human issue.
Each speaker was unique and dynamic in his or her own way, contributing to the dialogue about creating quality of life for patients at any phase of illness in a variety of settings.
Public and private sector speakers were physician authors, technologists, caregivers, patients, one attorney/end-of-life doula/ordained minister Alua Arthur, spiritual leaders, artists, innovators.
Among the younger voices sharing stories this year were palliative care physician, author, USC Medical School professor Sunita Puri who gave a heartfelt talk based on her book That Good Night: Life and Medicine in the 11th Hour mentioning influences of family health, Hindu poetry, and the importance of word choice and words as tools . Yoko Sen spoke lovingly and compassionately about the importance of healing sounds at the end-of-life. Sen was a speaker last year as well. She is a musician, sound alchemist, and TEDMED speaker.
It was moving to watch Harvard-educated August de los Reyes, Chief Design Officer for Varo, roll onto the stage in his wheel chair to talk about his mission to improve the financial health of Americans through better services and mobile-centric design that include the disabled. De los Reyes was formerly at Xbox, Microsoft and Pinterest. His paralysis is a result of a hospital mistake. His positive energy despite his health condition is most inspiring.
Among the older adults were fine and funny writer Sally Tisdale, RN (Advice for Future Corpses and Those Who Love Them plus other noteworthy books and essays) whose talk was educational and supportive – tender care for dementia patients at end-of-life.
Jonathan Bartels, a UVA trauma nurse and palliative care liaison, spoke about how he created The Pause – silence in acute care settings, intensive care units, and emergency rooms to honor any person who has just died. His empathetic vision has been adopted across the globe and is now taught as a part of compassionate care education for healthcare workers. See https://thepause.me/2015/10/01/about-the-medical-pause/
Marvin Mutch, son of a Holocaust survivor and a Baptist minister who spent 41 years in prison, spoke about inter-generational trauma and his work with end-of-life at San Quentin with the Human Prison Project.
Much admired San Francisco palliative care and hospice physician at UCSF, and former Executive Director of Zen Hospice BJ Miller (also with a compelling health history) spoke about his desire for more human-centered care for the ill and the dying. His newly released book, co-written with Shoshana Berger is A Beginner’s Guide to the End: Practical Advice for Living Life and Facing Death. See http://www.centerfordyingandliving.org for his mission statement.
The piece de la resistance was the last part of the program, an interview with revered Buddhist teacher and hospice worker Frank Ostaseski, author of the popular book The Five Invitations: What Death Can Teach Us about Living. After a life-time at the bedside of others, he spoke soulfully about the paradox of vulnerability – how he was being cared for following a stroke a few months ago.
For two years, the End Well Conference in San Francisco, CA required a $600 entrance fee for the day. This year founder Ungerleider and her board kindly expanded the conference to a live on-line all-day event for $25. This was a gift for those who could not attend because of commitments they have, or because leaving one’s city or country to attend requires extra resources and time.
Note: The Ungerleider Foundation financed the production of two fine documentaries about the end-of-life experience, End Game and Extremis, both available on Netflix.
Note no. 2:
There are many other such conferences and symposiums throughout the world, primarily in Australia and the UK, and others as far flung as India and Singapore. I intend to list some of the 2020 gatherings in another blog for those who are interested.
Also notable are small volunteer-driven gatherings of Death Cafes (55 countries), Death over Dinners, Conversation Project get-togethers, faith-based meetings, senior center events, and more on a continuing basis, usually monthly.
Wellness Shepherd blog author Wendy Jane Carrel, with 20 years + of hands-on senior care and palliative care experience, is currently involved with a humanitarian mission in Guadalajara, Mexico, www.JuntosContraelDolor.com, the only 24/4 palliative care hospital with outreach to 100 families at home. She is also collaborating with www.HolaHospice.org , currently creating a senior home and hospice in the state of Michoacan, Mexico.
For those of you working in palliative care and hospice, or those of you interested in the subject of end-of-life, transitions, and grief, there are a vast number of educational and support opportunities sponsored by foundations, medical centers, universities, small groups, and individuals around the globe.
This year, I attended a new event in California…
Beautiful Dying Expo, November 2, 2019 which was founded and produced with love and attention by author (Exit Papers 101: Prepare for the Final) and End-of-Life Doula Michele Little at the San Diego Convention Center.
This first time gathering included palliative care and hospice professionals, educators, and volunteers; authors/philosophers/teachers/guides; green burial enterprises; music thanatologists; scientists, and, the public. A “Successful Aging” Expo, in full swing in an adjacent hall, brought curious older adults to attend as well.
According to Little, “Beautiful Dying Expo’s mission is to expand awareness and encourage meaningful conversation, demystifying the process of dying and death by bringing industry experts together to share current tools, new ideas and resources with the public.”
Noteworthy were the excellent panels moderated by author, podcast host, hospice physician, and founder of End of Life University on-line Karen Wyatt, MD. To read more about this extraordinarily dedicated educator and spiritual teacher please see www.EOLuniversity.comor
The Comfort Measures and Caring for the Dying panel included Dan Diaz of End-of-Life Options (husband of Brittany Maynard who died of a brain tumor with assisted dying in Oregon), author, hospice nurse and chaplain Gabrielle Elise Jimenez (www.thehospiceheart.net), Sharon Lund (author and NDE near death experience speaker), Roger Moore a medical hypnotherapist, Elizabeth Padilla of the Conscious Dying Institute (www.ConsciousDyingInstitute.com ), Dr. Karl Steinberg palliative care physician, and Dr. Bob Uslander (Medical Director and Founder of Integrated MD Care).
The End-of-Life Choices and Planning panel included Scott T. Barton, PhD of UCSD School of Medicine’s Anatomical Department, estate attorney Adam Englund “the best bequest is to have your affairs in order”, Healthcare Chaplaincy member and speaker Ben Janzen (Dr Theology, PhD, VITAS Healthcare Chaplain and Bereavement Manager), Eric Putt, MBA of Thresholds Home and Family-Directed Funerals, Samantha Trad the California Director of Compassion and Choices, and Shawn LaValleur Adame founder of DIY Dying. Drs. Steinberg and Uslander also participated (see paragraph above for their details).
Also noteworthy were panels about Advance Care Planning, POLSTs (in California), end-of-life planning and options for veterans, end-of-life choices, and more. Among the unique exhibitors, workshop hosts, and musicians were Living Reef Memorials (“giving new life to our oceans”), Joshua Tree Memorial Park natural burials, Liz Fernandez DVM on pet euthanasia, Good Grief mandalas, and healing spiritual music from Gia George of http://www.divinelygia.com.
In honor of Mexico’s Day of the Dead it was an honor for me to share an overview of dying in Mexico – family and religious traditions, rituals, plus their origins and meaning told through stories I’ve been witness to based on two years as an educator and outreach liaison at www.JuntosContraelDolor.com – the only 24/7 palliative care hospital and hospice in the state of Jalisco, another two years dedicated to folks nearing end-of-life in a small village at Lake Chapala, and research volunteer work for www.HolaHospice.org to establish a senior home and hospice in the state of Michoacan.
As a result of my expo presentation three hospice nurses, two bi-lingual, were excited to offer volunteer services in Mexico!! What a happy synchronicity, all due to Michele Little’s invitation for which I am grateful. Thanks also to Michele and team for creating a Day of the Dead altar in the middle of the expo room!!!!
Finishing touches were offered at 8:00 p.m. by idiosyncratic guest speaker Stephen Jenkinson, a Harvard-educated theologian and social worker, founder of Orphan Wisdom, and former director of palliative care at Mount Sinai Hospital in Toronto, Canada.
Jenkinson has spent years of his life dedicated to promoting the acceptance of death and is the author of several books including the Nautilus Award-winning Die Wise: A Manifesto for Sanity and Soul. The National Film Board of Canada produced a documentary about Jenkinson and his philosophy entitled Griefwalker.
The 2020 educational event will take place in San Diego, CA October 31 and November 1.
In early November, New York Times best-selling author (Knocking on Heaven’s Door) Katy Butler gave a talk focused on themes from her new 2019 book The Art of Dying Well at Sutter Health CPMC in San Francisco. Approximately 100 healthcare workers participated.
I was fortunate enough to attend and briefly meet Katy and her husband Brian, also active in humanitarian and senior care issues.
The event gave Butler a chance to share compelling, medically complicated personal stories relating to the passing of her parents and friends. She also spoke about her commitment to compassionate care and the human right to die with dignity and grace when possible.
I found what she had to say authentic, heartfelt, and practical… especially her reminders that a good many of us working in senior care and palliative care find imperative to share with others – make a plan for end-of-life if you haven’t already, find your tribe (who will be there for you, presuming your demise is not sudden), stay in charge (ask for what you want and need), and “bring in the sacred.”
Katy hosts a Facebook group entitled Slow Medicine, based on principles in the book of the same name by her Bay Area colleague and friend Dr. Victoria Sweet, calling for change in medical practices. Quality of life over invasive and perhaps unnecessary procedures, especially at end-of-life.
Notable aside: Butler, a Buddhist, was lay-ordained by Thich Nhat Hanh, Vietnamese monk and peace activist. She lived seven months at his Plum Village retreat in France, among other significant life experiences.
On November 2 the newspaper San Diego Union-Tribune hosted a free event that attracted a 50+ crowd interested in subjects related to aging. Main speakers were Patricia Schultz (author of 1000 Places to See Before You Die) and Captain Dale Dye, USMC retired (author, filmmaker) focused on veterans and others.
Most of the activity at the San Diego Convention Center was at booths. Among the participants offering information were AARP, Leading Age, healthcare service providers, a cancer awareness initiative group, estate planners, Medicare Advantage Plan insurers such as Humana and SCAN, retirement counselors, senior movers, senior living placement consultants, a sleep therapy advisor, and others.
The highlight for me, related to some of my work as a senior placement consultant for Mexico, was to meet up with Miguel Angel Torres and Marisa Molina of Serena Senior Care in Baja California. I toured their Rosarito assisted living home last year and am eager to return to see their latest developments. I appreciate their dedication, enthusiasm, and focus on quality care. See www.serenacare.net plus links to videos found on their web site.
As an aside, Serena offers residents and visitors to Baja a Full Assistance Card for $99/year ($198 per couple). The Full Assistance Card offers ambulance services, roadside assistance, a 24-hour bi-lingual call center, discounts, and access to online medical records. Have not seen this service in action so am not in a position to comment on it. Information on this is at the web site listed above.
Corey Avala of www.RetireBaja55.com was also present to encourage folks to retire early and “affordably” to one of three developments he is involved with. Have not seen them.
Jane Garcia, a realtor from Dream Home Mexico was also there to espouse the benefits of retiring to Mexico.
One of the advantages of Baja California for assisted living and retirement, aside from the lower cost of living, is its close proximity to San Diego for health care through the Veteran’s Administration, and U.S. healthcare for American ex-pats who wish to return in case of need.
Many thanks for the warm reception by the San Diego Union-Tribune sponsor team! Many thanks to the San Diego Union-Tribune for producing the San DiegoEldercare Directory 2020 available in print at the expo, and also available on-line at http://www.sandiegoeldercare.com. The directory includes listings of independent living and long-term care throughout San Diego County.
This is an exciting fall month for educational events.
Other than shepherding families to appropriate, compatible Mexican assisted living and ”nursing” care for their loved ones, pastoral care visits to sweet older adults at Lake Chapala (always a pleasure), and coordinating the production of health books (one a translation to Spanish), there are seminars to attend and blog about, plus informational talks I have prepared for ex-pats.
Here’s a partial calendar….
October 3 Future of Medical Cannabis conference on-line. Medical cannabis is not yet legal in Mexico, lots of challenges related to its release, but all is possible. Am keeping informed of movements in the U.S. and Canada. Some U.S. doctors are titrating down opioid prescriptions and other pain meds for their patients- slowly, by introducing medical cannabis at the same time.
Oct 16 Beautiful Dying in Mexico Power Point presentation at Lake Chapala Society. In honor of Mexico’s Day of the Dead, Dia de los Muertos, an overview of dying in Mexico – family and religious traditions, rituals, their origins and meaning, and why many Mexicans seem so comfortable with death. Told through stories I’ve been witness to volunteering at a palliative care hospital/hospice and/or as a friend on a village street in Ajijic, Mexico.
Oct 19 Medical Cannabis in Mexico Conference all day in Guadalajara
Oct 22 Preparing for Medical Emergencies at Lake Chapala Power Point presentation at Presbyterian Church
Oct 24-26 4th International Palliative Care Congress at UTEG in Guadalajara produced by www.JuntosContraelDolor.com, the palliative care hospital and service I volunteer with
Oct 30 Focus on Mexico Power Point presentation about Senior Care in Mexico, members only
One of the biggest pleasures for those of us dedicated to healthcare (for me senior care and palliative care from a social, spiritual, and administrative perspective) is to attend a conference where one can network and learn from thought leaders focused on a similar mission – best practices for quality care.
The 2nd PACE Pan American Forum for Emergency Care and Global Health held at Hotel Real de Minas in San Miguel de Allende, Mexico last month, was a gift for all attendees. (Below is a photo of Hotel Posada de las Monjas in SMA, a former monastery, where the PACEforum.org offices are located).
The three-day conferencefocused on innovative ways to offer medical training to communities in lower-resource, culturally challenging settings through technology (tele-mentoring, digital health monitoring), and one-on-one communication and care skills.
Public health leaders in Emergency Medicine shared years of accumulated knowledge from state, national, and international levels. Tracks included general emergency medicine, disaster management, obstetrics, pediatrics, the ECHO tele-mentoring program, rural and wilderness medicine, palliative care, and many more. Attendees received CME credits.
Each track was of the utmost importance.
The most meaningful tracks forme were physicians teaching palliative care to emergency resident physicians, a demonstration of a clinically proven mental health protocol for first responders and physicians to keep themselves and others calm through Breath-Body-Mind (trade-marked), and the presentation by internationally renowned social entrepreneur, university professor, and conference founder Dr. Haywood Hall who focused on the formidable impact the PACE program has had in Mexico, plus a current international concern, health and mental health issues at the US-Mexico border.
Thanks to the international work of Dr. Angel Braña-Lopez, and New York integrative psychiatrists Drs. Richard Brown and Patricia Gerbarg of www.Breath-Body-Mind.com who teach innovative programs to help people recover from trauma and mass disasters, I was able to travel to San Miguel de Allende. Many thanks also to Dr. Haywood Hall!! It was a privilege to attend.
Other attendees were medical school professors from Latin America (mostly Mexico) and the U.S., specialists, generalists, nurses, mid-wives, paramedics, community health workers and others.
More about PACE Global Health
PACE Global Health (aka Groupo PACE) is an off-shoot of the award-winning social impact program PACE MD, founded over 20 years ago “to improve emergency and general medical care in Latin America through community-based training in skills, knowledge and ability as well as to improve medical care in the US and Latino populations through MedSpanish’s language and cultural literacy training (offering CME and GME credits).”
PACE MD founder Haywood Hall is an Emergency Medicine Specialist, Telemedicine Physician, and Professor at the University of New Mexico and the University of North Carolina. He is an American fluent in Spanish language and culture, and is an Ashoka Change Maker Fellow who works with Duke University’s Innovations in Healthcare. His PACE program has trained and certified over 41,000 healthcare providers and 6,000 lay people in systems-based emergency care.
For his achievements in positively affecting the chain of survival through emergency care skills Dr. Hall has won the International Federation of Emergency Medicine Humanitarian Award as well as the College of Emergency Physician’s Hero of Emergency Medicine Award, LATAM’s Top 10 Social Impact Enterprise in Latin American and the Caribbean Award, the American Heart Association’s Silver Award, as well as 2nd place for Social Innovation from Mohammad Yunus Creative Labs.
“The future of emergency medicine is here and it’s up to us to pave the way,” states Dr. Hall. “As front line healthcare providers we are in a unique position to be agents of change. We know the exact problems that plague our societies.”
If you are interested in learning more about Latin culture and how you can use healthcare technology to reach low resource areas you may wish to attend the next Pan-American Forum for Emergency Care and Global Health (date not yet set), or contact PACE via the information below:
Another take away: What many people may not realize is the enormous effort and energy required to create innovative, sustainable public health programs, especially related to emergency medicine, which is often a 24/7 profession. Most participants, and PACE founder Dr. Hall, usually depend on their teaching income to fund their outreach passions and programs.
Note: PACE International is not to be confused with another PACE, a US federal Program of All Inclusive Care for the Elderly. The objectives are similar, however – to treat all with dignity, compassion, and quality care.