Last month Steve Moran, senior housing veteran and colleague, kindly invited me to talk with him about senior living in Mexico. (Steve has experience in Mexico leading humanitarian missions).
We spoke about what I’ve learned and experienced researching healthcare, housing, and hospice in 16 Mexican states, mainly places where expats live.
He asked if there are any Belmont Village or Brookdale style developments. (There is a Belmont Village in Mexico City).
Belmont Village, Santa Fe section, Mexico City
When we finished the chat, I sent Steve an article to post on Senior Living Foresight that outlines what we discussed – current models for senior living and/or senior care in Mexico and what is up and coming.
Not surprisingly American, Canadian, Mexican, and Spanish senior care providers have been looking to expand or initiate development in Mexico.
Please note: I do not receive any referral fees or funds from any senior living homes in Mexico.
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.
When recovering from dental surgery and in an altered state, I was interviewed by colleague and dedicated senior care friend Steve Moran. For more than 10 years Steve has published an on-line magazine reaching thousands of U.S. senior housing executives and their teams – Senior Living Foresight.
Below is a link to our overview chat about Senior Living in Mexico which may be located on Steve’s web site, LinkedIn, and You Tube. (Please scroll to bottom of copy to find link if you are interested).
Part of the 36 minute video is out of sync; it also skips and flip-flops in places.
Toward the end Steve talks about a phone number. If you stay through that one minute, there is a brief mention of Medicare. One of the most asked questions by Americans looking to Mexico is: ” will Medicare be accepted”?
The video is not required viewing. 😉 The intention is to offer helpful information.
I am accustomed to researching, interviewing, listening, and participating in private one-on-ones. I am unaccustomed to being the center of attention. I have much to learn about being on camera.
Thank you Steve for including me in the discussion!!!!
Taking care of frail or gently infirm older adults, even in “good” times, is a challenging job. For many of us in senior care it is also a satisfying way to serve, and offers rewarding engagement.
But how does one rally to protect and defend older adults living in senior communities from COVID-19, the newest corona respiratory virus with multiple symptoms and possibly an unmerciful death, perhaps alone?
Precious American senior at a Lake Chapala assisted living home offering love to a little crab
Medical experts and tragic statistics share that older adults are more vulnerable than others to this borderless virus. A recent New York Times article reports an estimated one-fifth of U.S. deaths are linked to nursing facilities often due to inadequate protection and/or compensation for staff who sometimes work in more than one building to financially survive.
COVID-19 is now in Mexico. It flowed from Asia to Europe and the U.S. first. As of April 18, 958 Mexicans over age 60 have been hospitalized and 160 have required intensive care, representing 37% of the population. (No number is known from senior homes if any, but most patients had underlying health conditions).
Inspired by the response of healthcare workers around the world and despite distressing international and local news, all hands are on deck at approximately 25 assisted living/”nursing” homes at Lake Chapala, Mexico, one hour south of Mexico’s second largest city Guadalajara. Residents are ex-pat and Mexican retirees and do not represent typical populations in other parts of the country.
Garden area, assisted living, Riberas del Pilar, Lake Chapala, Mexico
Important note: In Mexico, there are no nursing homes as they are defined north of the border. Acute care is in hospitals only. Assisted living homes offer some nursing care and rehab. There is more or less a one size fits all approach to senior care in Jalisco state and the rest of Mexico, with exceptions.
Shelter-in-place began March 19, the date of the first confirmed case in Guadalajara. Since then I’ve been engaged by phone and e-mail with home owners and staff where I have found appropriate care for “gringos”. I am also in touch with precious residents via phone, e-mail, and sometimes Skype.
The virus has probably been present at Lake Chapala far longer than April 22, the date of the first reported but yet to be confirmed COVID-19 case locally. Why? Because the lake is a major destination for American, Canadian, and European retirees and/or residents who travel extensively.
What protocols have been in place at assisting living/”nursing homes” since mid-March?
First, no visitors allowed, until further notice.
Each lakeside home (4 to 20 residents, owned by Mexicans or ex-pats) is doing what it can to adhere to guidelines from Jalisco Governor Enrique Alfaro and his Ministry of Health, as well as to those of the World Health Organization (WHO). In a land not known for high health standards and cleanliness, and where compliance for the greater good is not the norm, it is impressive what this virus has prompted at assisted living/”nursing homes”.
Restful Assisted Living grounds in San Juan Cosala overlooking Lake Chapala
Hand washing for all, several times. Hand sanitizers at all entry ways.
Hand sanitizer on mini-tables outside every room for doctors, nurses, caregivers, and residents.
Personal Protective Equipment (PPE) such as masks and gloves are provided for staff and residents, including masks for sitting in outside garden areas. These items are in regular supply. This is unusual as hospitals countrywide do not have enough PPE. Outside China, Mexico is the largest manufacturer of PPE. Mexico, ironically, sent a majority of its supplies to help China months ago. There is a cottage industry in every lakeside village making cotton double fabric washable masks at reasonable cost. Not the same as N-95 masks which are intended to be disposed after each use in clinical settings and are a challenge to clean. Home-made masks are, however, a helpful alternative.
Staff has stopped wearing scrubs on their way to work.
Rooms for staff to change from street clothes to scrubs have been created. Some places had these areas before with private lockers included.
Washing machines are going all day with resident clothing and staff clothing.
Staff stopped wearing scrubs to work based on hospital doctors and nurses being assaulted with bleach, hot coffee, eggs, or beatings because scrubs identify them with the virus. From Guadalajara to Merida healthcare worker abuse incidents have been markedly on the rise. Some essential workers have been prevented from entering their apartments or evicted by landlords who fear contagion. In one city, hospital workers now live in a hotel. See The Guardian article at end for more details.
Daily disinfection multiple times of door handles, railings, ground walkways
Double the work keeping dementia care residents safe
Food for kitchens now delivered to entry gates, fewer trips out
Meals served in rooms. Disposable utensils instead of flatware.
So far, no staff shortages and no cases as of this writing. Staff is showing up, fear or not. This could change if the infection takes hold. The majority of healthcare workers are young and have families.
One building picks up all staff for work so they do not travel by bus. The ideal situation, though not possible in most places, is having staff live on campus for the duration of the outbreak. Hogar Miguel Leon, a senior home housing 30 residents in Cuenca, Ecuador, for example, has outside staff living with the nurse nuns who are in charge.
Most homes, despite the added work load for prevention and preparation, are addressing isolation and possible loneliness issues of their residents. Volunteer visitors, outside entertainment, and chair yoga teachers on campus are no longer present. There is instead accelerated collaboration with faith communities, the Lake Chapala Society, other service groups, and individuals providing phone trees and Zoom chats. Adopt-a-Senior is happening. Facebook provides various resource guides for COVID-19 and delivery services on lakeside group pages. Example: one home orders to-go lunches which are delivered by a restaurant every Friday.
Assisted living for abandoned Mexican women near Jocotopec, Lake Chapala. An extraordinary volunteer service is offered by ex-pats.
Technology. There is a sudden rise in Facetime and Skype use. Zoom conferencing has been implemented and used for daily or weekly news and events. For those who are cogent, this technology is happily received. For the most part, there are not so many innovations for dementia residents. No one has mentioned the use of telemedicine which is on the rise in the U.S.
Culture. In Mexico, life works depending on who you know. Owners and staff network for support with family, friends, and colleagues for solutions – Facebook reigns.
As mentioned, the majority of homes at Lake Chapala implemented public health advice promptly and with uncommon vigor.
But will the rest of the community outside these homes rally for COVID-19 and honor quarantine and face mask measures?
Is there a way to prevent unprecedented loss of life in assisted living at Lake Chapala?
Senior living homes may not be able to prevent outbreaks, but they are working on delaying them. They are taking known measures to protect vulnerable populations and staff. But the variables are many and luck is required. As in the U.S., testing is slow to arrive.
And, the virus is invisible, so prevention may be an impossible task. Staff could unwittingly be silent carriers. Local quarantines are suggested and are not enforced. Mexicans enjoy gathering in large groups, no matter what, even when they’ve been asked not to.
The song Ay Yay, Yay Yay… Canta, No Llores comes to mind for Mexico in the time of COVID-19. Sing, Don’t Cry, continue on. The words represent a mindset for suffering and profoundly sad situations which the majority of the population has endured for five centuries. The country is rich in resources. Few are well-to-do. The rest struggle to put food on the table. Singing is a way to continue every day.
In closing, gratitude to all Mexican healthcare and essential workers, unsung heroes and heroines. Thank you for your presence. You demonstrate tremendous strength and courage. May you and those you care for be protected in the days ahead.
Final note: The majority of older adults in Mexico cannot afford healthcare, let alone assisted living or in-home care. The majority of assisted living/”nursing home” residents at Lake Chapala are ex-pats, even though there are a number of Mexican residents. Each home has private rooms and baths, few have shared rooms, What’s available at the lake is not typical of the rest of Mexico where almost 900 senior homes are generally more crowded and contagion more likely.
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.
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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.
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.
November 2, 2019
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.
Miguel Angel Torres, one of his supporters, and Wendy Jane Carrel Assisted Living Consultant for Mexico at Serena Care booth
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
I always look forward to addressing folks from Canada, Europe and the U.S. at Focus on Mexico one-week seminars, currently held every two to three months at the Real de Chapala Hotel, Lake Chapala, Mexico.
Most attendees are considering a move to Mexico for a variety of reasons – adventure, climate, housing costs, more affordable healthcare, retirement, and more!
Placard in front of modest assisted living home, Jocotopec, Lake Chapala
The newbies will see my Power Point presentation Thursday morning, August 8, outlining various models of senior living and senior care in Mexico – government, non-profit, and for profit independent living, assisted living, memory care, and Life Plan Communities/CCRC’s. My photos of senior living options are from various states in Mexico from Baja California to Merida in the Yucatan, all ex-pat havens.
To date, Lake Chapala attracts the fastest growing and largest community of ex-pats in Mexico.
I am grateful to Focus on Mexico, where I address the ever-changing topics in Mexico (and elsewhere) of independent living, assisted living, nursing care, Life Plan Communities (CCRC’s – there is only one so far with others being developed).
The next talk to the Focus on Mexico attendees is March 21 at 11:15 a.m. at a hotel in Ajijic, Mexico. See https://www.focusonmexico.com/focus-6-day-program/ Focus on Mexico offers seminars to folks interested in how to move to and/or live in Mexico. All presenters at Focus on Mexico are volunteers.
On Friday, March 29, I will be speaking at a FREE community event (open to the public) at the Lake Chapala Society Sala in Ajijic at Lake Chapala, Mexico at 2:00 p.m. on Why End-of-Life Planning is a Good Idea for Ex-Pats in Mexico.
Veladoras for Guadalupe and those we’ve lost, Mexico City Cathedral
Here below are links to articles I have written on the above-referenced subjects:
Wendy Jane Carrel, M.A., a Spanish-speaking senior care specialist, has spent over seven years traveling province to province in Chile, Ecuador, and Mexico researching senior living options. She acts as an advisor or liaison for those who wish assistance negotiating health systems, senior care options, end-of-life care, and disposition of remains.
Throughout 2018, I have been invited to address Focus on Mexico participants, a lively and engaged group of mostly retirees from Canada and the U.S. curious about Mexico, curious enough to perhaps make a move.
I talk about senior living options, including possibilities at Lake Chapala.
I share a power point presentation with a few statistics and show photographs based on several years of due diligence and relationship building in 16 states of the country. I review independent living, assisted living, and nursing care – what’s here, what the differences are from home, what’s missing, and what is being created for the next generation that may be in need – boomers.
My VOLUNTEER talk shares an insider’s view for those who wish to consider living south-of-the-border. Other speakers focus on real estate, banking, buying cars, health insurance, medical care, bringing pets, etc.
My next talk is the week of October 29, 2018.
Wendy Jane Carrel with Michael Nuschke, Director of Focus on Mexico, addressing participants
If you are interested to learn about Focus seminars and activities, please see their web site at http://www.FocusonMexico.com. The popular education group is celebrating its 20th year.
Note: My articles are posted on http://www.WellnessShepherd.com. Sometimes they are re-posted on other web sites. If an article does not have my by-line, it is not by me. And, I do not post lists.
Some folks with good intentions, but without senior care experience and/or education, write articles and create lists with recommendations. Unless they are health care professionals, they may not be conversant with possible challenges of moving older adults from one nation to another, where the staff turnover is high, how the staff is trained, how med management is handled, what the activities are, and other subjects related to quality of life.
Wellness Shepherd 