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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Aging, Assisted Living, Health & Wellness, Mexico, Mexico Senior Living, Older Adults, Senior Care Mexico

Mexico Honors Older Adults August 28, Dia del Adulto Mayor 2016

sweet resident with sweet volunteer Mari
Sweet Zenaida, daughter of Juan Pablo II resident Jose, with precious volunteer Mari who is not only a warm greeter at the home but is part of the outreach to over 30 seniors in the neighborhood

This week Guadalajara, Mexico has seen senior centers, DIF (government social services), non-profits serving older adults, and private sector senior residences celebrating Mexico’s Day of the Older Adult, also referred to as Dia de los Abuelos (Day of the Grandparents). The occasion has been feted every August 28 since 1982.

Guadalajara’s parish of San Bernardo, a social justice block with a church serving 3,000 parishioners, houses a two floor senior home, Asilo Juan Pablo II,  where festivities have been in full force. (The diocese also provides a school for Downs Syndrome children, a rehabilitation home for over 50 men, and a palliative care and hospice with 8 beds and outreach to 65 patients, Juntos Contra el Dolor). The Sr. Cura of the Church, Father Engelberto Polino Sanchez is the guardian for the community.

On Saturday, August 27, DIF sponsored a breakfast for the 52 male and female residents. On Sunday, August 28, Father Engelberto celebrated mass. Afterward, the older adults enjoyed a meal of pozole (a stew of vegetables, hominy, and pork) served with jamaica (a hibiscus drink), plus live Mexican music provided by an electric piano and a singer. Mexicans love festivities and the seniors at Asilo Juan Pablo II are no different. They were happy campers.

Below are photos commemorating those in support of older adults, as well as the appreciative seniors who live at Asilo Juan Pablo II. It is a Mexican custom for the older generation not to smile too quickly in photos. An exception, the charming church priests below with their energy of light…

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Sr. Cura Engelberto who presided mass for the seniors on Mexican Day of Older Adults pictured with Padre Francisco of Templo de San Bernardo, Guadalajara
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Reverent seniors, about 30 of whom are wheel chair bound at Asilo Juan Pablo II, Guadalajara, attending mass on Mexico’s Day of Older Adults
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senior who is not feeling well with Alicia, an adorable favorite enjoying pozole
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disabled senior with super attentive wife who kindly dances with and cheers up other seniors
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Severely disabled man Eliseo who is not a senior, rescued from the street and given a home at Asilo Juan Pablo II.  He is popular for his enthusiasm
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Dancing at Day of the Older Adults, Asilo Juan Pablo II, Guadalajara, Mexico

Note:  The Juan Pablo II home, a non-profit, is well run. There are challenges with raising funds and providing enough for the residents. The home survives successfully, none the less. Seniors with pensions pay for private or shared rooms. There are indigent seniors who have been rescued. One disabled man around the age of 50, was found in the streets and is living most contentedly at the assisted living, as mentioned in photo above.

The dedicated administrator Bertha C. Gonzalez offers a clean, efficient service with good standards for quality of life in Mexico, up to and including Mexican carino (kindness and care). She hand selects and supervises a team of nursing assistants and nurses, many of whom are sent by various schools to train at the home. Every day there is occupational therapy and some form of physical workout. Every other day there is entertainment, among other activities. Many residents are talented artists, handicrafts experts, and poets. The home is connected to the large church so that those in wheelchairs can attend services easily. Being Catholic is not a requirement for residency. The home is currently full. There is a waiting list.

The senior home has outreach to around 30 elders living in the neighborhood through its volunteer group Asilo en Salida. Mari, featured in the first photo, also goes out with the group.  For more information about the activities write to asiloensalida@gmail.com

Contact info:

Asilo Juan Pablo II  Pro Dignidad Humana, AC   asilojp@prodigy.com.mx

Av. Plan de San Luis #1616  Col. Mezquitan Country  tel. 3824-5368

Sr. Cura Engelberto Polino Sanchez, Director General

Bertha C. Gonzalez, Administrator    Maria Delores Cortes, social worker

Facebook:

https://www.facebook.com/Asilo-Juan-Pablo-II-San-Bernardo-100984640248947/

 

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, Assisted Living, End-of-Life Care, Health & Wellness, Senior Housing Security, Senior Living

International Women’s Day – Honoring An Ethiopian Woman Who Rescues Older Adults

It is March 8, 2016, International Women’s Day.

There are amazing women (and men) on our planet. There are many whom we can honor – some are known, others are silently making contributions to advance humanity.

Last night I read a Help Age International article about Assegedech, referred to as the Mother Teresa of Ethiopia. I felt it would be fitting to pay tribute to her on this special day.

Assegedech’s story is heart-warming and inspiring. It’s a tale of a generous, sensitive woman from humble origins who happened to inherit a large property. She noted in an interview that she was fortunate to have a good father and a compassionate husband, both of whom were open to caring for those with less. She’s been on her own for many years now… in a big way.

With the support of Help Age International Assegedech expanded her home into a compound which houses almost 90 destitute older adults. It is, in addition, a sustainable community. Assegedech empowers the residents  by offering them meaningful work in the gardens, if they are able. She keeps them active to their last days.  She offers them a life of dignity.

Photo and by-line from Help Age InternationalAssegedech smiles in her garden

Despite being in her 70s, Assegedech Asfaw shows no sign of slowing down.

Many blessings for Assegedech and all others who come to the aid of abandoned, frail, vulnerable elders on a daily basis. Photos of the Ethiopian seniors can be found in the link below. The full story is worth reading.

Aging, Assisted Living, Emergency Preparedness, Health & Wellness, Mental Health, Retirement, Senior Housing Security, Senior Living

Housing Security for Older Adults, Syria and the U.S., Three Stories

Below are two American tales, and one Syrian tale, each bringing up an important global issue for older adults – housing security.

This week the Washington Post published an article by Peter Holley about an elderly woman who has been asked to leave the only home she has known for decades, a rented cottage. Apparently, the owner has chosen not to honor the verbal agreement of the previous owner, whom he was related to. The situation could become a death sentence for the tenant in more ways than one, if indeed, she must leave.

Here’s a link to Story #1:

https://www.washingtonpost.com/news/morning-mix/wp/2016/02/24/its-a-death-sentence-facing-eviction-97-year-old-woman-could-wind-up-on-streets/

Here is a photo of 97-year-old Marie taken by her neighbor Lisa Kriger:

 

If you work your entire life to build what you have, and you cherish and are thankful for it, why should comfort and a sense of security be taken away if you are elderly, vulnerable, and not blessed with infinite financial resources?  What are the possible solutions? Moving and making major changes at an advanced age is not easy.

Furthermore, is it Marie’s fault society is crumbling down and things are drastically changing? Could she have known to prepare? No matter where she moves, if it turns out she has to move, it will be psychologically and physically traumatic. Since she may not be able to afford to move, it means she cannot afford to move to senior living, even though the article mentions she was asked about it. As a former senior living administrator I can comment that some seniors, not all, have a hard time adapting to senior living even if they can afford it, especially if they are mentally competent and independent minded.

I trust someone can help Marie and others in her situation create healthful ways to maintain independence, dignity, and sanity.The only saving grace seems to be that Marie has children. I hope they are in a position to come to the rescue.

Story #2  I recently witnessed a situation with an unhappy outcome, similar to Marie’s

A building on my block in West Hollywood was being torn down to build condos (each condo currently worth between $1-$2 million). Most of the tenants were elders under rent control who could not afford to move. Result? Almost every single elder died within the six months or year they were given to leave. No kidding. Heart-rending.

What are the lessons in this?  Could Marie or the seniors of West Hollywood have known to prepare for such an eventuality? Should we learn to be flexible, start paring down to basic clothing and furniture at age 50, give up all that makes us comfortable and content, and not enjoy what we worked to create?  If Marie were Buddhist, and attached to very little, it would still be a challenge to make a move because of one main factor, age.  Added stress as we age can be a contributing factor to a faster demise.

Story #3 takes the issue a step further.

Imagine being an 80 year old Syrian woman who has watched her loved ones killed, her home bombed, and has somehow managed to get to the Jordanian border for rescue. She is alone, has no clothing except what she is wearing, no funds of any kind, no way to make a living, and her home is a camp until a proper roof can be found, if one can be found. She is totally dependent on people she does not know. Quite frankly, at age 80, how would she have the energy to keep on despite the deep trauma and loss she must be feeling? What if she has a chronic health condition and needs meds?  What would it be like to live in exile? She is one of tens of thousands in this inhumane situation created by external circumstances.

For further reading on elder challenges around the world and in Syria, see the on-going rescue efforts being made by Help Age International, http://www.helpage.org . See also one of many stories posted on Syrian elders in exile at http://www.helpage.org/newsroom/press-room/press-releases/syria-three-years-on-older-refugees-in-exile-the-silent-casualties/.  Another telling story with facts about how disabled and elderly refugees are treated is at this link…  https://medium.com/@DFID_Inclusive/minimum-standards-for-age-and-disability-inclusion-in-humanitarian-action-e1932b32c141#.jd4061wxv .

Addendum:

At a recent conference on The Future of Housing for Grown-Ups: A National and Local Perspective, Dr. Anand Pareka, Senior Advisor at the Bipartisan Policy Center is quoted as saying

“I’m quickly realizing that housing is in many ways health. It’s a very important determinant of health.”

Addendum 2:

Liz Seegert of the Association of Health Journalists wrote an excellent piece about those who live with the stress of homelessness… they age faster than those who have a roof over their heads.

See http://healthjournalism.org/blog/2016/04/homeless-get-older-at-younger-ages-than-their-peers-research-says/#more-27689 

Aging, Assisted Living, Ecuador, Ecuador Senior Living, Senior Living

Cuenca, Ecuador Nun Honored for Work with Indigent Older Adults

I am happy to say that an ode to one of my heroines, Sister Patricia Rodriguez, a nun with the Sisters of Charity, has been published.  (See the highlighted link below) .

The City of Cuenca recently honored her amazing contributions not only to seniors but to the community at large.

I have had the pleasure of following Sor Patricia’s work since 2011.  She is indeed inspirational, and, a lot of fun to be around.

The photo below was taken at an Italian restaurant in Cuenca.

I love Sor Patricia, "coordinadora" at Hogar Miguel Leon
I love Sor Patricia, “coordinadora” at Hogar Miguel Leon

At 86 and still going strong, Sister Patricia Rodriguez is honored for her service to Cuenca’s abandoned seniors and to the community.

 

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.