Aging, Alzheimer's, Assisted Living, Assisted Living Mexico, CCRC's in Mexico, Health & Wellness, Life Planning Communities Mexico, Living Abroad, Mexico, Mexico Senior Living, Senior Care Mexico

Guidelines for Choosing Assisted Living/Nursing Care in Mexico

Gardens at Casa de las Lunas in Puerto Vallarta with independent living, assisted living and respite care, private pay

According to realtors at Lake Chapala, Mexico, and the information desk at the Lake Chapala Society in Ajijic, the popular ex-pat retirement destination has received more than double the no. of potential renters, buyers, and information hungry folks from Canada and the U.S. than in years before. (Other popular retirement destinations are also seeing an increase in activity – see no. 3 below).

Among visitors intent on moving are travel aficionados looking for a unique cultural experience, the prospect of meeting stimulating people from all parts of the world, but more importantly, an opportunity to stretch their dollars.

And then there is senior living and healthcare, a subject of interest for most. For “sandwich-generation” boomers who lost savings and/or homes during the American recession of 2007-8, or spent savings for the education of millennial children or grandchildren, many are finding there may be little left for themselves or parents if assisted living or nursing care are ever required.

An added concern is that funding for Medicare and Medicaid in the U.S. are currently being challenged.

Alma, a non-profit home for 40 residents in San Miguel Allende

If the cost of assisted and continuing care in Canada (Canada takes care of its disabled, ill, and older adults through universal care programs but there is also private pay care) or the U.S. is not an option, there are more affordable options in other countries. The closest place to look is Mexico.

Here are guidelines for looking at assisted living and continuing care in Mexico, costing between $600 USD to $3500 USD/month, depending on the value of the American dollar and the Canadian dollar vs. the peso, the location, and the residence you choose:

  1. Take note – in Mexico the terms assisted living and “nursing home” are often one and the same, with exceptions. Care facilities are not known as they are north of the border – assisted living, rehabilitation, nursing home, and hospice. It is often an all-in-one approach. Also, with some exceptions, homes mix physically disabled residents with memory care residents.
  2. Select cities or areas you wish to be in for climate – coastal, desert, mountains. (Coastal tropical places cost a little more because A/C is expensive).
  3. If the future resident does not speak Spanish, seek places with ex-pat communities and English-speaking locals who are often a source of volunteers – Baja California Norte (Ensenada, Rosarito Beach, Tijuana), Cancun, Lake Chapala, Mazatlan, Mexico City, Puerto Vallarta. Or, choose smaller places such as Merida, and San Miguel Allende. Some care homes have all foreigners as residents, others locals and foreigners together. Usually one person on staff speaks English, sometimes more than one.
  4. Do the due diligence. Research places and determine costs. Most assisted living and “nursing homes” catering to foreigners have web sites in English easily found on Google Search.
  5. Consider private pay homes and non-profits, as well as residences run by nuns whether you are Catholic or not. Nuns often (but not always) provide quality care as most are nurses with a mission to serve, plus costs tend to be what Mexicans would pay if price is a consideration. Another level of care is found in government homes, some pleasant others not; some accept foreigners with residency cards. There are differences in every region of the country, and there are no rules.
  6. Note: no two places will be alike – financially, environmentally, socially, and in terms of care. Homes are not regulated with the strict standards one is accustomed to in Canada and the U.S.  However, there are places with quality care and high standards.
  7. Conduct site visits. Assess for yourself what might be an acceptable match in terms of environment and people. Would you or your loved one feel comfortable and safe? Do you like the space, the staff?  How are you welcomed? Do residents seem cared for or are they alone in “God’s waiting room” without attention and activities? Ask residents what they like best and what they don’t like. How clean is the home? Standards differ from place to place. Arrive at meal time… is there enough assistance for each resident? Is food fresh, nutritious, and nicely presented? Is it food you would or could eat? Does the home prepare meals compatible with health challenges? What about care plans and medication management? What about emergencies? How are these matters handled?
Patio at a private pay “nursing” home, Casa Nostra, at Lake Chapala

 

Casa de los Abuelos DIF (government) home for seniors, Morelia – these homes are intended for Mexican nationals but on occasion persons with residency visas who pay are accepted, depends on the place and availability

There are no simple answers for selection.

Ideally, we would all have perfect health to our last days and an abundance of funds which would allow us to receive the best possible care wherever we choose to live.

Note: CCRC’s (Continuing Care Retirement Communities, from independent living to demise), now referred to as Life Plan Communities, have not arrived in Mexico, with one exception. There are plans in the works for Life Plan Communities in Baja California, Cancun, and at Lake Chapala from American, Canadian, Mexican, and Spanish developers.

References:

https://www.youtube.com/watch?time_continue=2&v=6lYA7c1Pnuo   Ajijic, Mexico video 2017

http://www.pbs.org/newshour/bb/foreign-retirees-flocking-mexico/

https://www.seniorhousingforum.net/blog/2016/8/3/will-mexico-solve-senior-living-affordability-problem

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Alzheimer's, Dementia, Emergency Preparedness, Health & Wellness, Senior Services

Emergency Room Environment for Alzheimer’s Patients – Denver Hospital Takes the Lead

I would not call the emergency room featured in the article below “paradise”, but I would say it is a vast improvement over others in terms of amenities and should be considered for all emergency rooms, not only for those receiving persons with Alzheimer’s and dementia.

There are large clocks to read the time, big white boards written with exactly what tests and treatments you are receiving and how long they will last, softer lighting, no disruptive noises from monitors, curtains with soothing scenes to look at such as waterfalls.

The report claims the floors are designed with falls in mind but the bathroom floor looks like tile. No to tile! Use linoleum (rubber) or other material which can cushion falls and is quiet!!

Wondering if I missed seeing guard rails on the bed.

The senior TV correspondent in the video in the link falls short of being articulate, but the TV station footage captured at the hospital is worth viewing.

Congratulations to Denver’s Lutheran Medical Center for taking this first step. May the world follow your lead.

Note: The article in the link below was found on an excellent free weekly newsletter (via a Denver TV station). Alzheimer’s Weekly.

Aging, Alzheimer's, Assisted Living, Expats, Health & Wellness, Mexico, Mexico Senior Living, Retirement, Senior Care Mexico, Senior Living

Senior Care/Senior Living Options at Lake Chapala, Mexico

Not long ago I addressed a group of Canadians and Americans at an Open Circle chat at the Lake Chapala Society in Ajijic, Mexico. Most of the attendees were full-time residents with the lay of the land, but curious newcomers attended as well.

The most meaningful part of the presentation?  Introducing American and Mexican senior living owners to the audience. After the chat they were able to become acquainted with one another.

In the photo below, four Mexican registered nurse owners are represented. I am the person holding the microphone.

FotoSeniorLivingProvidersLakeChapala
Senior Care Specialist Wendy Jane Carrel introduces owners of Senior Homes at Lake Chapala to Americans and Canadians

Senior Housing Forum posted my article based on the talk.. See http://tinyurl.com/zoz9zdf or https://www.seniorhousingforum.net/blog/2016/8/3/will-mexico-solve-senior-living-affordability-problem  to read the entire piece, or,  read below…

Will Mexico Solve the Senior Living Affordability Problem?

Published on Wed, 08/03/2016 – 4:55pm

By Wendy Jane Carrel, wellnessshepherd.com

If you cannot afford healthcare or retirement in Canada or the U.S., what are your options? Where do you look?

For the last five decades, and especially since the U.S. economic challenges that became apparent in 2007-2008, retirees have been choosing destinations in Asia, Europe, and Latin America.

Despite news about crime and drug cartels, Mexico reigns as the number one choice for most American and Canadians, primarily because of its lower costs, warmer weather, health care choices, and location so close to home.

According to U.S. Consulates in Mexico there is a current count of between 1.2 – 1.4 million Americans living in Baja California, Cancun, Lake Chapala, Mazatlan, Puerto Vallarta, San Miguel Allende, and other areas. (The number also includes Americans who are not retired). According to the Canadian Consulate in Guadalajara and the Canadians Abroad Registry, approximately 10,000 Canadians are registered in high season and 1,500 are registered as retired full time in Mexico. Not all Canadians register.

Choices for senior living in Mexico are not all that dissimilar to those in Canada and the U.S.:

  • Aging in Place – independent living in your own home or apartment

  • Aging in Community – co-housing

  • Assisted Living – if you require care and cannot afford full-time care at home

  • Nursing Care and Rehabilitation

Lake Chapala

Currently, at Lake Chapala, Mexico there are in the neighborhood of 20,000 retired Americans and Canadians.

North shore Lake Chapala, which includes the communities of Ajijic, Chapala, Jocotepec, San Antonio, and San Juan Cosala (40 minutes drive time from one end of north shore to the other), has several options for senior living with others being planned.

What is different from Canada and the U.S. is the cost of living, especially for health care, often up to two-thirds less.

What is also different is that there are no Life Planning (continuing care) models at Lake Chapala. A project was planned three years ago and has yet to be built. There is one, however, that will open in Mexico City sometime this fall.

Another difference is that in Canada and the U.S. Alzheimer’s and dementia patients are in separate areas on a campus. In most of Mexico, dementia patients are living and sharing the same space with older adults who have mobility issues, not dementia issues, and the care is rarely specialized.

Mexican senior homes are under the purview of the Ministry of Public Health and local fire departments. They are not tightly regulated and inspected as they are in Canada and the U.S.

What is available at Lake Chapala now?

  • Three co-housing/independent living options – one in Ajijic with three individual apartments and five casitas, a pool, lakeside views, and two meals a day; one in Riberas del Pilar on two levels where residents have their own apartment, are provided with two meals a day, and have access to a library, a gym, and a pool; and one in San Juan Cosala, focusing on health, green living, and sustainability.

    At the first two if you become immobile or develop serious health issues you would need to move. At the property in San Juan Cosala (in development) you can invite caregivers to your living quarters.

  • Three assisted living homes specializing in Alzheimer’s and dementia care – one is run by a geriatrician and a nurse, the other two by nurses with doctors on call. One of these homes plans to add a second home in the near future for a total of four dedicated Alzheimer’s care homes at the lake to meet the growing need.

  • Six homes combine assisted living, nursing and some rehabilitation.

    That number climbs to seven if you include two rooms above the offices of a physician in Ajijic (no rehab), and 9 if you include one owner who has three homes (no rehab).

    It climbs to 10 choices with an American-owned recovery care center for plastic surgery (more like a B & B) where you can also rent suites. The recovery center has been in existence for almost 20 years.

    The total number of choices reaches 11 if you include a low-income senior home in Chapala which also has Mexican residents.

  • Four properties have owners who live on site. These properties are either American- or Canadian-owned, or, owned by English-speaking Mexicans who focus on serving the expat community. There usually is one person who speaks English at the senior living options at Lake Chapala.

The above-mentioned places are private pay. Monthly costs for private pay assisted living at Lake Chapala range between $1,000 and $2,000 U.S. per month except for the home in Chapala. (The average U.S. private pay is $3200-$3500, and up to $12,000/month or more for Alzheimer’s care).

Most care homes at the lake have 12 or fewer residents. Service is considered personalized. In many instances there is the quality of “carino,” caregivers treating you like a lovable member of the family.

There are 125 senior living homes in the state of Jalisco, housing 1,723 elders. These numbers include only Mexican citizens. Not included are Americans and Canadians at Lake Chapala or in Puerto Vallarta. There are approximately 758,000 older adults in Jalisco state.

In Guadalajara, an hour from Lake Chapala, there are three models of senior care – private pay, non-profit care primarily with nuns (usually excellent quality), and government care (usually DIF, a social services entity that exists throughout Mexico). Prices range from gratis for the indigent to around $400-$800 U.S. for those with pensions, and up to $3500 U.S. for private pay.

Note: I have met Americans with incomes of $600 or less/month who are living comfortably and safely in Mexican assisted living homes throughout the country.

Resources:

Canadian retirees make new homes in Mexico

Instituto Nacional de Estadistica y Geografia National Institute of Statistics and Geography

US State Department – Relations with Mexico

* Cover photo of Lake Chapala courtesy of en.wikipedia.org
** Map of Lake Chapala region courtesy of mexico-insights.com

 

Aging, Alzheimer's, Dementia, Health & Wellness, Long-Term Care, Mental Health, Mexico, Senior Care Mexico

International Geriatric/Gerontology Conference Guadalajara 2016 – Focus on Dementia

The Hospital Civil “Fray Antonio Alcalde”, also known as the Old Civil Hospital, produced its 21st International Geriatric and Gerontology Symposium July 7-9, 2016, at the Hilton Hotel auditorium in Guadalajara, Mexico. The theme was “Enfermedades Neurodegenerativas en la Vejez”, or, Neurodegenerative Illness in Older Adults.

There were about 250 attendees as well as one pharmaceutical company (Asofarma de Mexico, S.A.), one hospital supply company from Switzerland, and a private pay day care senior center (www.vidavi.mx) offering business cards, pamphlets, free pens, and carry bags to participants in the registration area.

Four geriatric physicians from the hospital organized the event – Dr.David Leal Mora (the international section), Dr.Hector Ivan Cruz Neri, Dr. Julio Alberto Dias Ramos, and Dra Rocio Garcia Talavera. Guest speakers were from Guadalajara, Leon, Mexico City, and the U.S.

Old Civil Hospital Geriatrics Symposium, Guadalajara, 2016
Old Civil Hospital Geriatrics Symposium, Guadalajara, 2016   Dr. Rocio Garcia is at the podium, Dr. David Leal is the first man on the left with dignitaries from the public hospital system

There were memorable talks about the Use and Abuse of Antipsychotic Drugs, Managing the Symptoms of Parkinson’s, When a Day is 36 Hours, Evidence-Based Geriatrics, Government Assistance Programs for Older Adults, and Can We Prevent Dementia?

Peter V. Rabins, MD, MPH, Professor of Psychiatry, Johns Hopkins
Peter V. Rabins, MD, MPH, Professor of Psychiatry, Johns Hopkins, and author

 

 

 

 

 

 

 

 

What stood out most were the physicians, both American and Mexican, who are exploring and interested in alternative non-drug options for dementia prevention. The common theme – we must all be vigilant in keeping our cognitive skills sharp to the very end, if possible.

Topic-Related Resources:

Israeli physicians have developed a surgery to remove shaking due to Parkinson’s disease http://healthamazing.co/2016/07/13/first-in-israel-surgery-that-removes-shaking-due-to-parkinsons-disease/

http://www.latimes.com/opinion/op-ed/la-oe-stone-solvadi-drug-pricing-20160705-snap-story.html   By Daniel Stone, MD, internal medicine and geriatric specialist, Los Angeles, and, Pres of LA Society of Internists. Another physician calling for a stop to the increasing costs of drugs and “pharma greed”.

http://www.AlzheimersDementiaSummit.com focusing on dementia prevention and alternative remedies that already exist for protecting our brains and our minds. Produced by Jonathan Landsman, a natural health advocate with physicians and others as guest speakers – Dr. Russell Blaylock, Dr. David Jockers, Donna Gates, Dr. Mark Hyman, Josh Axe, Sayer Ji, Michael T. Murray and many others. I missed this July 2016 summit on line but believe it might be available to listen to.

http://goodlifeawareness.com/men-may-be-able-to-avoid-dementia-by-marrying-intelligent-women-researchers-say/  Don’t know if the studies are true, but this article caught my attention. 😉

http://yournewswire.com/harvard-professor-says-prescription-drugs-are-killing-population/utm_content=buffer7c70d&utm_medium=social&utm_source=facebook.com&utm_campaign=buffer   article is not professionally written, has a sensational headline, and, requires quotes and some fact-based evidence.
http://seniorhousingnews.com/2016/08/17/communities-turn-to-marijuana-to-treat-memory-care-residents/?_hsenc=p2ANqtz-9Kxe5ppADrvnIp22h1hj0wP4zRi3r8rV1Y_cRXvTORbY5Zis0oK9cbZtcGubP25n_orIdb35T0M8nX7GJuMFljm_Bygw&_hsmi=33083300    article about successful use of marijuana (with family permission) instead of drugs to calm patients in northern California dementia care residence
Aging, Alzheimer's, Assisted Living, End-of-Life Care, Health & Wellness, Hospice, Long-Term Care, Palliative Care, Senior Services

Institute of Medicine End-of-Life Care Conference March 20

I am super excited to attend this on-line conference (a webinar), open to the public, on Dying in America – what we can do for better communication with patients and their families, what education and development opportunities can be created and implemented, and most of all how we can create a future where palliative and hospice care is serene, comfortable, painless (should the patient wish this), supportive, and honoring free will. See link below for details.

IOM looks deep into end-of-life care.

Aging, Alzheimer's, Dementia

Powerful Radio Documentary about Alzheimer’s/Dementia from Pieter Droppert, UK

Pieter Droppert, a British science writer and blogger, has produced a brilliant radio documentary about the “quiet crisis”, not cancer, but the growing number of seniors with some form of dementia.  Statistics, he reports, say one in three persons over 60 will likely develop some form of dementia.

Here below is a link to the extraordinary 25 minute narrative.  Pieter’s mother Audrey is one of the subjects:

Alzheimer's, Assisted Living, Health & Wellness, Senior Services

Interior Design for Alzheimer’s/Memory Care Communities – A Successful British Experiment

For almost two decades, especially since I served as night time administrator and marketing director at an Alzheimer’s campus in southern California, I’ve been focused on universal design – how to create a safe, practical, healthful, and inviting environment not only for those requiring memory care, but for anyone, even those of us fortunate enough to be well.

What could be better than an immaculate, welcoming, protective atmosphere where ever you live?

Yesterday I viewed a video about interior redesign of a dementia wing at Elmhurst, an assisted living village in England. I like much of what was chosen. I might not have chosen laminate flooring even if it looks great and is easy to clean, I don’t find it eco-friendly.  I may have choosen linoleum, cork, or wood instead as there is no off gassing. These green products might be safer for falls.  But I imagine there may have been budget considerations. Other than that, a fine redesign job. Based on a visual site visit, even from afar, I would consider recommending this community focused on wellness.

Note the energy of light features, especially the use of skylights and large windows, and the secure garden area.  Also note the reason red prompts were chosen for the bathroom, and cerulean blue gray for the dining room plates. There is valuable information in the video at the link below.

http://www.alzheimersweekly.com/2014/09/redesigning-home-for-dementia-care.html

   please don’t be shocked by the red, there is an excellent reason for the choice