I am on my way to Mexico City to speak at a Senior Living Summit being held at the Hotel Marquis Reforma September 3-4, 2025 about the growing need to create evolved, affordable, holistic enclaves of well-being for older adults to age in place, age in community, and more, a subject on my mind since 2003.
Quick history:
In 2003, when serving as nighttime administrator and day time admissions and marketing officer at an exemplary (still is) memory care campus in Rancho Mirage, California, (thank you owner and mentor Floyd), the writing was on the wall.
Unless you are blessed with excellent health your entire life and have experienced no accidents, in the U.S. the cost of adequate long-term care at home or in a residence, could easily require up to $1 million per person with 2025 fees and pricing. With long-term care insurance at several hundred dollars a month, only 80% of costs would be covered.
This awakening was the impetus to look internationally for more affordable options with quality care and medical infrastructure. Mexico and Ecuador, by virtue of proximity, were places I conducted due diligence and developed hands-on experience with locals and expats, as well as other nations farther away.
Thankfully, as a trusted older adult advocate and consultant I have met like-minded souls on my path including Mexico’s Javier Govi, the « nearretiring » proselytizer and real estate entrepreneur behind CIAMAR’s 9th edition Wellness and Senior Living Summit for 50+ to 80.
About 100 to 150 persons are expected to attend the gathering gently modelled after NIC (National Investment Center conferences in the U.S. with 1500 to 3,000 participants).
The concept to develop and expand senior living options is growing in Latin America as the silver tsunami is not just an American/Canadian/European phenomenon, it is worldwide.
Attendees will be real estate developers, venture capitalists, architects, brokers, folks from the tourism industry, and senior living operators who will meet, greet, and assess future potential for collaboration.
I will be on the Bucket List panel with two others to talk about expats who migrate to Mexico and other countries in Latin America and what their expectations are.
If you are unable to access it, here is how my bio reads:
Wendy Jane Carrel
Founder, Wellness Shepherd
A trusted older adult advocate and consultant who has hands-on experience with healthcare systems, retirement options, senior living residences, and wellness programs in Mexico, Ecuador, and other countries. She provides informed and thoughtful transition guidance and curated options for families and elders moving to Latin America.
Looking forward to this adventure!
I hope to report about the experience and my findings after the summit.
Nestled in Mexico’s highlands, Aguascalientes charms visitors with colonial architecture, clean streets, wide sidewalks, shade trees, and a warm community spirit. About 1.5 million residents live at 6,194 feet above sea level, an easy drive on the highway from Jalisco (three hours from Guadalajara). Known for its safety and relative tranquility, Aguascalientes surprised this newcomer. During my three-day stay persistent winds became an unexpected part of the city’s personality.
Founded in 1575 by royal decree of King Phillip II of Spain, the city’s original name was Villa de Nuestra Señora de la Asunción de las Aguas Calientes (Village of Our Lady of the Assumption of the Hot Waters). Citizens are amusingly referred to as hidrocalidos or hydrothermal people.
Mini-park in central Aguascalientes:
Immaculate street with residences and shops in central Aguascalientes:
Aguascalientes is an industrial city. Major companies present are GM, Honda, Mazda and Nissan. Other notable companies manufacture medical equipment, electronics, car parts, and textiles. Years ago, Aguascalientes built trains. The original station still stands as a museum and there are restored train cars to see.
Not surprisingly, among the expat population estimated around 1,000, there are several Japanese. Trip Advisor lists 34 Japanese restaurants (not all Japanese owned).
A glimpse of what I experienced related to older adult activities, care, hospitals, and end of life:
Older Adult Socialization in Community
Club de la Tercera Edad is a public center for older adults run by CONACYT, the national counsel studying science and technology. When I arrived, there was a danzon class. Danzon is a Cuban music and slow dance tradition, immensely popular in Mexico and other parts of Latin America.
DIF and INAPAM Older Adult Activity Centers Both DIF (Desarrollo Integral de la Familia) and INAPAM (Instituto Nacional de las Personas Adultas Mayores) are government run centers offering activities. They are separate entities but sometimes collaborate. DIF addresses entire family needs and is more about social protection of vulnerable populations. It offers adult daycare centers, psychosocial support, food programs, medical attention, recreational activities, and more. INAPAM is focused on older adult legal rights, transportation discounts, medical and cultural services.
On another trip I hope to meet Aguascalientes DIF director Aurora Jimenez Esquivel, known for her innovative initiatives including a popular travel program to visit nearby states known as “Gigantes Viajeros”. If you have access to Facebook, there are charming photos with older adults from Aguascalientes enjoying a trip at the FB page of Aurora Jimenez Esquivel. The link would not post when I loaded it here.
Señor Sebastian As I made my way to the Panteón de los Ángeles y La Cruz, thirst led me to a sunlit corner store not far from the cemetery gates. There I met the venerable octogenarian you see in the photo whose warmth seemed to animate the whole neighborhood. With his son by his side, he presides over the store like a sage, sharing stories about local elders and aging in place. He graciously pointed me to the entrance of the cemetery. After wandering the peaceful grounds among small and large gravestones, I returned to thank him —feeling, in that moment, not just like a visitor, but welcomed to Aguascalientes. Memorable encounter.
According to INEGI (the Mexican government statistics bureau) and Google, there are about 14 long-term care residences. (In Mexico long-term care is, with some exceptions, all in one – assisted living/memory care/nursing).
I focused on homes in the city center and visited seven to get a feeling for environment, providers, residents, and care.
Three assisted living/memory care homes had closed, one during COVID. Most places were basic, clean, modest, and dark, yet each with devoted caregivers. Residents in some homes seemed thrilled to have a visitor.
I was warmly welcomed at clean, efficient, light-filled Residencia de la Roble which houses 33 older adults including Mexican-Americans who prefer to age in their native Aguascalientes. Care costs are about $700/month USD (13,000 pesos/month) for shared rooms (there were two single rooms). Included in the fee: nutrition with customized diets, television and activities, laundry, medical care by the owner, a geriatrician, and most of all what appeared to be loving, energetic care by devoted nursing assistants. Note: Many Mexicans are accustomed to sharing space. The concept of privacy and your own room is often found with families who are well-off.
Here are photos showing a shared room with pristine, well-organized clothing and linen storage:
There is no website for Residencia de la Roble but you may find several photos of its high energy, activities, and sweet residents and caregivers on Facebook at Residencia para adulto mayor “El Roble”. https://www.facebook.com/profile.php?id=100064126566555
On my next visit I wish to tour Estancia Geriatrica Villas Juan Pablo as I had originally planned. It is a privileged residence in a park-like setting, also with lots of light, a few miles north of the city center. You will find photos at https://estanciageriatricavjp.com/ The environment reminds me of countryside care homes outside Quito, Ecuador – wood cabinetry, vistas of green meadows, tranquility. Under “instalaciones” there are photos of private rooms. The monthly prices at Villas Juan Pablo would be double, or more than double, the costs at Residencia de la Roble.
Note: prices for long-term care in the state of Aguascalientes are less than in the state of Jalisco (home to Guadalajara, Lake Chapala, and Puerto Vallarta). The Aguascalientes homes cater to local Mexican families.
Hospitalsand Dental Care
Aguascalientes has an impressive medical infrastructure with hospitals both public and private. Hospital MAC (there are two, one in the north the other in city center), Centro Hospitalario de Aguascalientes, Star Medica, Centro Medico la Salud, Hospital Cardiologica de Aguascalientes, Medica San Juan de Aguascalientes, Hospital Fundación Medica México Franco Brasileña plus a plethora of other options for specialized medical care as well as dentistry.
Emergency Care at Hospital MAC
The third night of my visit I awakened around 10-10:30 p.m. feeling tingling down my right side and leg. My first thought, oh no, not a TIA/stroke!! But I was able to speak. The sweet elderly man on night duty at the hotel suggested a taxi to the Red Cross. I wished for a hospital. I was super weak and dizzy yet decided to slowly walk to a nearby hotel. The night duty clerk there suggested Hospital MAC, a few blocks away.
There are about 30 MAC hospitals in the country. I had visited others and felt confident. I was especially encouraged because I could see the hospital tower from the front door of the hotel. I walked slowly but surely about four short blocks and made it to the emergency room. A nurse promptly greeted me, took my name, invited me to a room, took my vitals. I was then escorted to meet Dra Nancy originally from Mexico City and a graduate of UNAM. She was amazing – attentive, kind, professional. A thorough assessment of eyes, strength in arms and legs, heart, walking etc. Thankfully I was going to be okay. I was dehydrated (first time ever and quite a lesson) and had a bit of heat stroke from walking in the sun from early morning to sundown. The hospital experience was a gift, and I remain grateful to all who assisted and cared for me at the hotel as well.
Palliative Care and End-of-Life Care
Pain relief for life-limiting illness is offered by 14 anesthesiologists with palliative care credentials at hospitals and clinics. Two of the physicians drive from Guadalajara. According to a list of medical providers, there are 20 geriatricians. In-home pain relief for end-of-life is offered by at least two geriatricians.
All assisted living/nursing homes attend to end-of-life.
One residence, Hogar del Abuelo Maty, was founded with supportive end-of-life care in mind. It is in the countryside one hour to the northeast of Aguascalientes.
The home, opened in 1981, is named in remembrance of Matilde (Maty) Dubroy de Villanueva who was accompanied at end of life by her daughter Carolina Villanueva de Garcia. The profound experience inspired Señora Carolina to build the hogar where every elder could have a dignified death with compassionate, personalized care.
The current administrator of the non-profit is the founder’s son, Carlos Garcia Villanueva. Care is provided by nurse nuns of St. Vincent de Paul. The nuns have a long and rich history of companioning the infirm and those at end-of-life. The website with photos and videos reveals more: https://www.hogardelabuelomaty.org/
While I did not encounter any modern-day end-of-life doulas in Aguascalientes, Mexico, non-medical, psychosocial spiritual support has been a community tradition for centuries. Local women known as “parteras” assist not only with birth but have a significant role supporting families and individuals during the dying process.
Funeral Home Arriaga
Toward the end of each day, I passed Funeraria Arriaga on the way to my hotel. Families waited inside where there are four viewing rooms and a place to sit and sip coffee or tea. Or, they waited in front of the building. There is a florist across the street.
Most Mexicans choose burial in a coffin. For those who choose cremation, the cost with this funeral home is between 9,000 and 20,000 pesos ($470 to $1000 USD) depending on whether there is a memorial service. According to Funeraria Arriaga there is no refrigeration in Aguascalientes but there is embalming. (Refrigeration is possible in Jalisco to create time for family members arriving from far away to view the deceased). The Boinita Group advertises green spaces for cremains (ashes) in Aguascalientes as well as Cancun, Hermosillo, Merida, and San Luis Potosi. https://boinita.com/en/green-niches-of-funerary-forests-in-mexico/
National Museum of Death
The museum, which opened in 2007, exhibits death-related artifacts from pre-Hispanic times to the present from the personal collection of Octavio Bajonero Gil. The 2,000 or so items include sacred religious paintings, sculptures, objects d’arte, and more. They are displayed in three connected buildings of a restored 17th century convent that once housed Franciscan monks. The property is now owned by the University of Aguascalientes.
My experience was not of the macabre. Some items show the unique Mexican sense of humor.
At the entrance of the museum is a gift shop where you pay an entrance fee of 20 pesos ($1 USD). It takes 45 minutes to an hour for a self-guided tour. If you are lucky you will have university student Antonio accompany you to the basement to see reconstructed gravesite remains. The photo below was taken in the basement:
Later, multi-lingual Jesus from Mexico City who delighted me with his Italian might lead you through the floors and buildings.
The museum produces 200 or so events per year including the October/November Day of the Dead Celebrations. At the writing of this post the calendar of events for the 2025 Annual Festival de Calaveras (skeletons) has yet to be posted.
Museo Posada This museum is dedicated to the collected works of Aguascalientes native Jose Guadalupe Posada (2 February 1852 – 20 January 1913), a political satirist/caricaturist, engraver, and printmaker known throughout Mexico as the father of La Calavera Garbancera/La Catrina, a female skeleton dressed to the nines that is seen each year at Dia de los Muertos/Day of the Dead ceremonies. During the presidencies of Portfirio Diaz (1876-1911) Posada introduced skulls and bones as political and cultural critique. La Catrina indicates death comes to all, including politicians and the super wealthy. Here below is a Catrina from the Museum of Death:
Wendy Jane Carrel, MA, is a trusted older adult advocate and consultant who has many years of hands-on experience with healthcare systems, retirement options, senior living and wellness programs in Mexico, Ecuador, Italy, the U.S., and beyond. She provides culturally sensitive transition guidance and curated options for families and elders domestically and internationally. Wendy’s web site is https://www.WellnessShepherd.com
If you live in Mexico or Latin America, have you created a plan for what to do in case of an accident, natural disaster, or healthcare emergency?
Who is going to show up for you?! What if you are no longer able to speak and make decisions for yourself?
If you wish to save your family and other loved ones considerable grief and time, it is important to understand what is involved when a foreigner becomes ill or dies in Mexico or other Latin American nation.
Last month I had the pleasure of joining patient advocate and educator colleague Deborah Bickel of Be Well San Miguel to share with expats why it is wise to create a Mexican declaracion jurada (living will) and/or voluntad anticipada (advance healthcare directive). The voluntad anticipada is incorporated into the declaracion jurada in many sates. My role in the meeting was to give an overview of palliative care and hospice and how to find end-of-life support in Mexico.
We have each invested 14 years or more sharing with expats (Deborah in Mexico, Guatemala, and Nicaragua – me in Mexico and Ecuador) why planning is important no matter your age but especially if you are 55+.
Short list of reasons:
Mexican law is civil law
British, Canadian, and U.S. law is common law.
There are major differences.
If you arrive with an Advance Healthcare Directive or Five Wishes or other document legal in your native country, it will not be legal in Latin America unless you get lucky. In Mexico, you must create a declaracion jurada and/or voluntad anticipada if you want your wishes to be honored. Some attorneys and notaries will incorporate your home country wishes for you. These documents must be created BEFORE any accident, illness, or demise. As of this date only 14 of Mexico’s 32 states offer a voluntad anticipada. The purpose of the voluntad, sometimes referred to as a directriz, is to avoid legal, medical, and bioethical problems that could complicate the situation for you the patient or your family.
Mexico is a country with predominantly Catholic traditions. These traditions influence choices. If you are Catholic, the system may seem familiar, such as burial over cremation. If you had chosen to live in Buddhist or Hindu Asia, cremation would be a relatively easy matter involving fewer steps as cremation is common practice. Or, you could have opted for a Tibetan sky burial. If you wish to be cremated, you will need a notarized document stating this wish.
Latin Americans have large family systems. If something happens to you as a Latin American, a family member will show up and know what to do. Most expats live in Latin America alone or as a couple, sometimes with children.
The Mexican culture, language, and way of thinking are unique. Most of all, procedures may be unfamiliarand complex. Attitudes and response to accidents, illness, and death are different.
Non-Spanish speaking expats often need bilingual advocates to negotiate the system. At least three people are recommended to advocate for your wishes, and/or serve as your healthcare proxies. If one is not available, perhaps another will be.
April 16 is National Healthcare Decisions Day in the U.S. If you do not yet have a plan, every day is a good day to work on one no matter where you are.
Aileen Gerhardt, a fellow patient advocate and educator in Boston writes “decide, document, designate, and discuss!!” Good advice.
Wendy Jane Carrel, MA, is a Spanish-speaking senior care advocate from California. She has travelled Mexico for several years researching health systems, senior care, and end-of-life care to connect Americans, Canadians, and Europeans with healing options for loved ones. She is a compassionate companion and palliative care liaison, legacy writer, co-founder of Café Mortality Ajijic/now Death Café Ajijic and founding member/speaker of the Beautiful Dying Expo (USA). She is a trauma-informed, gentle End-of-Life Doula (National End-of-Life Doula Alliance proficient), and a speaker and published author on subjects related to senior well-being. Wendy’s web site is https://www.WellnessShepherd.com
We live in an aging universe, a universe where older adults live longer than ever before and the need for care is growing.
For centuries we have protected and provided for loved ones from cradle to grave. These acts of reverence, respect, and love still exist and are seen in traditions around the world.
But modern life has shifted from relative stability to burden for many – out-of-the-blue expensive healthcare conditions, a growing number of older adults with chronic diseases/co-morbidities requiring long-term care, fewer folks to work as caregivers, multiple stressors for families overwhelmed with work and caregiving, financial loss, climate change, pandemics, war, forced migration.
Sadly, the reality of aging in the U.S. if you are not independently wealthy requires extra effort, planning, and sacrifice. No matter how much exercise, living with a positive attitude, and attention to healthful lifestyles, you may find yourself with difficult choices due to an unanticipated surprise – do you adjust where you are or imagine alternatives? Staying home is understandably preferable.
Older adults around the globe prefer to Age in Place and make their end-of-life transitions in a community they know and love. Quality of life that is comfortable and familiar is the main objective. This is generally translated to, NOT in a foreign country or anywhere else.
If you have exhausted all avenues of community support at home or in adjacent counties, states, or provinces, and realize care may not be affordable or you may outlive your funds, what are your choices? What if you are a solo ager with no family, spouse, or fallback? What if you must continue to work to support a family and are uncomfortable with the idea of sending mom or dad away for care?
Choosing to move could be a disheartening task. It is a leap into the unknown, no matter how adventurous one is.
One option is to seek care in another country.
There are seven continents on our planet. All but one (Antarctica) provide a form of care for older adults. From Albania to Samoa, unless loved ones are cared for by family, there are in-home support services or residences offering various forms of independent living, assisted living, memory care, nursing care, and/or end-of-life support.
According to Grand View Research, “the global long-term care market size was valued at USD 1.11 trillion in 2023 and is expected to grow at a compound annual growth rate (CAGR) of 6.68% from 2024 to 2030.”
The area with the largest anticipated growth is memory care. Alzheimer’s Disease International reports there are more than 44 million Alzheimer’s patients globally. The number is expected to triple to 135 million by 2050. “If ‘dementia’ was a country it would be the world’s 17th largest economy.” Costs for memory care are exorbitant, especially if the anticipated lifetime of care is 12 years or more.
How do you choose where to go?
Somewhere around 2003 it became evident to me as a person dedicated to older adult healthcare that the future for American boomers, Gen-Xers, Millenials, and their parents would be affected by the rising cost of aging care. With the benefit of a lifetime of travel, foreign study, and work on five continents, it became apparent Americans might begin to seek care in another state or abroad if they could not afford the cost of care at home.
In the last 15 years I have witnessed and assisted more and more Americans, as well as Canadians and some Europeans take a leap of faith and choose south of the U.S. border for retirement and care for reasons of proximity (not for Europeans), weather, cost, and a reputation for thoughtful providers.
According to Lottie, a UK research organization and placement advisor, the best countries for senior care named in order are Norway, Sweden, Switzerland, Germany, Canada, and the U.S. You would need to have residency, be a national, or have funds to pay for care. Factors included in the study were pensions, healthcare systems, care services (assisted living, nursing), social support, and government grants.
The best countries for senior care by continent named by Lottie are:
Africa – South Africa
Asia – Taiwan
Europe – France
Oceania – Australia
North and Central America – Mexico
South America – Ecuador
The Lottie report did not include parameters for the above assessment. France as the best in Europe contradicts the previous Lottie report that Norway leads in senior care.
The below review is based on my research and experience.
What countries do Americans and other nationalities consider for retirement and senior care if looking internationally?
Americans and Canadians favor the Caribbean or Mexico by virtue of proximity, and often for weather. Other places in Latin America are considered, mainly Costa Rica, Ecuador, and Panama. In the last 15 years, the Philippines and Thailand have also been chosen based on cost, weather, and a reputation for attentive care. Malaysia, a new face of senior care in Asia since legislation in 2018, attracts some Americans but mostly Australians, Brits, and folks from other Asian nations. Ireland is sometimes considered when qualifying for Irish citizenship or residency. If you are an EU citizen, you have certain residency rights in Ireland.
Frida mural in expat enclave Ajijic, Jalisco, Mexico
If you have the blessing of universal healthcare (Americans do not) and are a national in Norway or Sweden, you are cared for from birth to burial no matter the level of care you require. Norway, as mentioned above, is considered the best country for older adults by virtue of its healthcare system and life expectancy. I can attest to Sweden based on attending graduate school in Stockholm and experiencing the healthcare system.
If you live in the UK, Portugal or Greece look like warmer options by virtue of proximity and favorable tax breaks, but the situation may be more of a challenge post-Brexit depending on your financial status and language considerations. Many American older adults are finding their way to Portugal, and to Greece if they have Greek heritage. Brits as we know have considered India for retirement and medical care (shades of the film about middle class retirees in The Best Exotic Marigold Hotel), or a British base in the Caribbean.
Since the end of the 19th Century Italians (and some French) looking for affordable options have been traveling to Tunisia, not so far from home. Historically, Tunisia was a Roman imperial colony. Vibrant Italian colonies are found in Tunis, Bizerte, and Sfax. On a recent trip to Italy, I learned some Italians are now traveling to Croatia for lower costs, which is interesting as several “badante” or caregivers in Italy are from Croatia. Here is the post about aging in Italy a favored country for retirement, healthcare, and senior care by Americans of Italian descent and others:
In the Arab world, Kuwait, Oman, and Zanzibar (on the Trucial Coast of Africa but formerly the Sultanate of Oman and an important Arab trading center), countries I know, taking care of your elders is a religious and traditional obligation. Home health caregivers and nurses are de rigueur. There are now palliative care and hospice services.
What countries have dignified elder care at a price point less than that of the U.S.?
As of 2024 more affordable price points may be found in Costa Rica, Cuba (not an option for U.S. citizens), some Caribbean nations, Ecuador, India, Mexico, Panama, the Philippines, and Thailand. Note: prices for care are rising worldwide.
In every country of the world there is quality, supportive elder care and there is sub-standard, disengaged “care”.
Quick overview of points to ponder:
Determine country. Easiest to do when you have travelled to far flung places before. Be advised that dream vacations are not the same as living long periods of time in a new place. A preliminary, exploratory trip is always recommended. In expat destinations there are often introductory seminars for how to navigate the place you have chosen. If your heritage is Irish, Italian, Polish, or other, and you qualify for residency and a second passport, countries of heritage may be in mind.
Healthcare beyond in-home care and assisted living. Access to physicians, hospitals. Learn how the healthcare system works in the country that beckons you. Medical care may cost less and yet be of similar quality or better. Vet your medical team as you would in your own country. What is the role of the assisted living residence if any? Is the residence hands on or does it expect family members to participate in your hospital and rehab care from a distance? If you are a solo ager, consider locating a healthcare coordinator/advocate to keep an eye on your care. Review factors that affect health – weather, elevation, pollution, availability of fresh water and food. Will you be in a flat place safe from falls? What is the standard of care?
Residency requirements. Every country provides information on how to qualify for and achieve residency. Will you be able to live there in the future on your income as prices rise? Embassy and consulate websites plus expat forums on-line provide guidance for navigating residency. Expect a lot of effort on your part. If you do not speak the language, consider hiring a facilitator.
Consider the distance and cost of travel, keeping in mind cost to return home should life change. The longer the distance the harder it is to travel with elder loved ones. Will family be able to visit? On a recent Viva Aerobus flight between Los Angeles and Guadalajara a precious senior in obvious pain was traveling with her mindful son. The flight was three hours. The son held her close. She never complained but you could feel it was not easy.
Corporate or Home-Like Environments. What would be the most compatible environment and style for you or your loved one? What is the owner/administrator’s philosophy of care? Do they have a mission to care for elders? Is income the only objective? Will the residence remain in existence for the life of the resident? Search the Internet and AI. You will read about places, mostly those that are corporate, and not necessarily discover smaller places with no budget for outreach. Consider smaller places, some are gems.
Garden at small assisted living home in Mexico
Consider family moves. I have had the privilege of assisting families who moved with their loved ones. The sons and daughters work digitally and visit mom or dad. For those who are unable to move with loved ones, most homes provide Face Time, Google Meets, or Zoom visits.
Safety and happiness. Is the residence secure? How will the residence assist with the transition? Any move is stressful, especially for older adults. It takes three to six months to adapt to a new environment. Not everyone transitions well, some not at all. In my experience, a well-traveled person who has an affinity for adventure or a certain culture, has as easier time. If the loved one has dementia, places in nature with gardens, room to walk, the energy of light, and a high level of activity and engagement encourage positive outcomes. What will the level of socialization be? Are there other expats who would be compatible company? Some expat havens and faith communities have volunteers, usually retirees, who visit homes and keep track of brethren. Is the food fresh, does the home offer diets suitable for diabetes or other illnesses? What are the standards of care? How is staff trained, how many staff per resident?
Quality of life and engagement lead to comfort, better health, and general contentedness.
Local culture. How are older adults viewed by the society and government? Is English a second language and is there experienced, trained staff who speak some English? Will you or your loved one be comfortable living among locals or being examined by a doctor who may not speak English? What is the country like compared to what is familiar to you? What might be missing? Some countries group residents who only have physical disabilities with those who have dementia.
Palliative care and hospice. Will the residence and local doctors accept and respect your wishes? What are local procedures/traditions for treating pain? How is end of life treated? Is there 24/7 attention and vigiling? If you feel close to death, will you be able to return to your home country to die if that is your wish?
Expat forums. There are innumerable expat forums on the Internet, some offer basic guidance about what to expect in the country of choice. Be advised, however, that even with good intentions, information may contain other cultural biases and not necessarily be in alignment with your personal needs, perceptions, and standards.
Summary:
If aging and healthcare options at home become limited, or you realize you may outlive your funds, one option is to look abroad.
Seeking eldercare beyond your own borders is a daunting task and may feel painful. If you have had the privilege of international travel, languages, and on-the-ground experiences that provide you with a level of psychological as well as financial safety and comfort, you may do well. There are also many who have chosen care abroad, never travelled far before, who end up feeling pampered and content. Choosing care near an expat retirement community may bring peace of mind and could provide back-up support and socialization.
Exploring and planning ahead make a difference in your outcomes.
Mission based care (not meant to be interpreted as religious) in smaller residences is often appealing, especially when administrators and staff demonstrate compassionate care daily. Large corporate facilities often require an extra layer of vigilance on the part of families in all countries, so providing an advocate/weekly visitor is helpful if affordable.
There is no perfect place, but there is excellent care to be found in every country.
Research well, make lists, assess your needs, and locate a place that aligns with your preferences.
Abundant blessings for whatever journey you or your loved ones choose.
Wendy Jane Carrel, MA, is an older adult health care advocate, advisor, and consultant from California. She has conducted due diligence for senior living and retirement on five continents and is passionate about supporting families and their elders with solutions. She provides informed, attentive, compassionate guidance and curated options for Ecuador, Mexico, and other destinations both domestic and abroad. She is a speaker and published author on subjects related to older adult well-being. Wendy’s web site is https://www.WellnessShepherd.com
Just returned from three weeks in Italy celebrating the 90th birthday of “Super Silvana” the last living person of her generation who has witnessed my life since I was a teenager. I hope to share what I learned about aging in place, senior care, and end-of-life from Silvana, her daughter, neighbors, friends, and site visits in Tuscany in another post. As with the U.S., much has changed in the last 10 years – mostly diminishing social services (with some exceptions in both nations) and higher prices. Thankfully in Mexico, prices related to care continue to be more affordable, comparatively.
A few days after my return, I became a member of the Older Adult Advisory Board for the City of West Hollywood, CA. Population 36,000, approximately 6,000 older adults (number to be verified). Excited and honored to serve. There will be much to learn, observe, and address with time. I have permission to mention this event and to post the photo with Francisco, the Strategic Initiatives Program Administrator who swore me in. He is a bright and integral part of all that is evolving. We were delighted to discover mutual Spanish and that I knew the charming town in Jalisco his family is originally from.
Francisco G and Wendy Jane are in the photo below by board member Michael Hollingsworth:
For those of us devoted to palliative and hospice education and community-based services, October 14 was World Hospice and Palliative Care Day. Meaningful. November 2 is World Right to Die Day, a controversial subject, but for some well-being = peace of mind, making a transition legally and quietly. In the U.S. November is known as National Hospice and Palliative Care month.
Dra Susana Lua Nava, the palliative care thought leader in Guadalajara, Mexico who created the only 24/7 palliative care hospital (Juntos Contra el Dolor – United Against Pain) in Jalisco state in 2010, travelled to meet the Pope in Rome in October and has returned to Guadalajara to host the 6th International Palliative Care Congress. The main speaker is her mentor and mentor to Latin American and Spanish palliative care physicians, nurses, social workers, psychologists, and others, Dr. Marcos Gomez Sancho of the Canary Islands, Spain. See https://www.mgomezsancho.com/esp/index.php Other speakers will be from Argentina, Costa Rica, Cuba, and Mexico. The congress will be held November 9-11 at Auditorio Fray Antonio Alcalde, Av. Fray Antonio Alcalde 1220, Miraflores, 44270 Guadalajara, Jal., Mexico in Spanish. The fee for three days is 1200 Mexican pesos. For more information see: https://juntoscontraeldolor.com/
Even though I attended three Juntos Contra el Dolor palliative care conferences in Guadalajara I reported only on one, the 2nd International Congress produced by Dra Susana:
We are now in the sign of Scorpio, the sign of death and transformation, a sign that teaches us much. Colleagues in Mexico have created events around the Day of the Dead and death and dying.
Wilka Roig, who is based in San Miguel de Allende, Mexico, is the founder of Elizabeth Kubler-Ross Foundation Central Mexico, producer/host of Death Cafes, a transpersonal psychologist, creator of the first green burial plot in Guanajuato state, and most of all an educator with a community-based approach. She is bringing the American director of The Last Ecstatic Days to Lake Chapala with a documentary that dares to ask one of life’s biggest questions about death. The screenings will kick-off the 1st Latin America Impact Tour November 7 and 8, 2023, 3:00 p.m. at Cine+Lago, with free complementary workshops facilitated by the Fundación Elisabeth Kübler-Ross (EKR) México Centro team on November 7 and 8, 11:00 a.m. at Lake Chapala Society, Ajijic, Mexico. Writes Wilka: “The Last Ecstatic Days explores the physical, emotional, and psychological journey of one man’s desire to not die alone, and introduces the hospice doctor who gives up everything to honor that dying wish.” https://wilkaroig.com/
Gerontologist and death doula Loretta Downs is teaching at the Lake Chapala Society, Ajijic, what is one of my favorite subjects to teach Advance Care Planning: Living Well and Dying Well. The dates are November 8 and 15. This is an evergreen subject, always valuable. https://endoflifeinspirations.com/
This week I will participate in two all-day meetings of Carefest sponsored by Caring Across Generations on the UCLA campus in Westwood, CA. The national organization, founded in 2011, states “We are families, caregivers, people with disabilities, and aging Americans creating a new way to live well and age with dignity.” Eager to meet, greet, and share what I learn. https://caringacross.org/
And then a trip to Baja for a site visit of a new senior living home, and a trip to Sonora state Mexico to meet up with a soulful American end-of-life doula and her expat community to talk about preparing for emergencies and end-of-life.
Feeling grateful and fortunate. Sending healing thoughts to climate refugees, those suffering from injuries/illness, those enduring abuse and war, and all. 2024 promises to be better, perhaps, as it will be an 8 year. Eight = infinity.
Wendy Jane Carrel, MA, is a Spanish-speaking senior care advocate from California. She has travelled Mexico for several years researching health systems, senior care, and end-of-life care to connect Americans, Canadians, and Europeans with healing options for loved ones. She is a compassionate companion and palliative care liaison, legacy writer, co-founder of Café Mortality Ajijic/now Death Café Ajijic and founding member/speaker of the Beautiful Dying Expo (USA). She is a trauma-informed, gentle End-of-Life Doula (National End-of-Life Doula Alliance proficient), and a speaker and published author on subjects related to senior well-being. Wendy’s web site is https://www.WellnessShepherd.com
If you live in Mexico or Latin America, have you created a plan for what to do in case of an accident, natural disaster, or healthcare emergency?
Who is going to show up for you?! What if you are no longer able to speak and make decisions for yourself?
If you wish to save your family, other loved ones, and neighbors considerable grief and time, it is important to understand what is involved when a foreigner becomes ill or dies in Mexico or other Latin American nation.
Last month I had the pleasure of joining patient advocate and educator colleague Deborah Bickel of Be Well San Miguel to share with expats in San Miguel de Allende why it is wise to create a Mexican documentacion jurada (living will) or voluntad anticipada (advance healthcare directive). My role in the meeting was to give an overview of palliative care and hospice.
Deborah Bickel of Be Well San Miguel, Wendy Jane Carrel of Wellness Shepherd
We have each invested 11 years or more sharing with expats (Deborah in Mexico, Guatemala, and Nicaragua – me in Mexico and Ecuador) why planning is important no matter your age but especially if you are 55+.
Short list of reasons:
Mexican law is civil law. British, Canadian, and U.S. law is common law. There are major differences.
If you arrive with an Advance Health Care Directive or Five Wishes or other document legal in your native country, it will not be legal in Latin America unless you get lucky. In Mexico, you must create a documentacion jurada and/or voluntad anticipada if you want your wishes honored. These documents must be notarized.
Notaries in Mexico are experienced attorneys appointed by the Governor of State. Some will incorporate your home country wishes for you. These documents must be created BEFORE any accident, illness, or demise. In some instances documents are created by an attorney who is not a notary and then signed in front of a notary.
Regarding the voluntad anticipada, as of this date only 14 of Mexico’s 32 states offer a voluntad anticipada. The purpose of the voluntad, sometimes referred to as a directriz, is to avoid legal, medical, and bioethical problems that could complicate the situation for you the patient or your family.
Mexico is a country with predominantly Catholic traditions. These traditions influence choices. If you are Catholic, the system may seem familiar, such as burial over cremation. If you had chosen to live in Buddhist or Hindu Asia, cremation would be a relatively easy matter involving fewer steps as cremation is common practice. Or, you could have opted for a Tibetan sky burial. If you wish to be cremated, you will need a notarized document stating this wish.
Latin Americans have large family systems. If something happens to you as a Latin American, a family member will show up and know what to do. Most expats live in Latin America alone or as a couple, sometimes with children, often without a plan for emergency support.
The Mexican culture, language, and way of thinking are unique. Most of all, procedures may be unfamiliarand complex. Attitudes and response to accidents, illness, and death are different.
Non-Spanish speaking expats often need bilingual advocates to negotiate the system. At least three people are recommended to advocate for your wishes, and/or serve as your healthcare proxies. If one is not available when needed, perhaps another will be.
April 16 is National Healthcare Decisions Day in the U.S. and a reminder that if you do not yet have a plan, every day is a good day to work on one no matter where you live.
Aileen Gerhardt, a fellow patient advocate and educator in Boston writes “decide, document, designate, and discuss!!” Good advice.
Deborah’s extensive medical directive service for Guanajuato state Mexico may be found at:
Wendy Jane Carrel, MA, is a Spanish-speaking senior care advocate from California. She has travelled Mexico for several years researching health systems, senior care, and end-of-life care to connect Americans, Canadians, and Europeans with healing options for loved ones. She is a compassionate companion and palliative care liaison, legacy writer, co-founder of Café Mortality Ajijic/now Death Café Ajijic and founding member/speaker of the Beautiful Dying Expo (USA). She is a trauma-informed, gentle End-of-Life Doula (National End-of-Life Doula Alliance proficient), and a speaker and published author on subjects related to senior well-being. Wendy’s web site is https://www.WellnessShepherd.com
The most popular dental tourism places in Mexico seem to be Cancun, Guadalajara, Lake Chapala, Los Algodones, Mexico City, and Tijuana.
Below are two stories and some guidelines based on 20+ years of witnessing and eventually experiencing dentistry in Mexico that may provide some insight.
As with any country, it is best to conduct due diligence first, preferably on-site instead of from afar. I am not a dentist with in-depth knowledge and not in a position to recommend a dentist. Each of us has unique needs. There is no one size fits all. Do your best to choose who you feel is right for you and do your best to locate who has the years of specialization and training that match your needs. That is, of course, if you are intent on dental care in Mexico. More about vetting under “takeaways” and “resources” below.
Dental Care in Los Algodones, MX
My introduction to dentistry in Mexico was as Senior Center Director for the City of Coachella, at the time the sixth poorest city in the U.S.
My precious charges were Mexican born and spoke little English. They had emigrated to California as farmworkers during the “bracero” program of WW II. Most were low income.
Every few months we reserved a bus at a discounted rate, sometimes donated, to transport 40 seniors for a day trip to Los Algondones, MX, about two hours each direction.
Some “gringos” refer to this dental destination as Algodones without the “los”, or, as Molar City.
Note: Algodon means cotton in Spanish. Approximately 18% of Mexico’s cotton is grown in this region.
Algodones is located northeast of Mexicali, MX in the state of Baja not far from the California/Arizona border. Yuma, AZ is 15 minutes drive to the east. If you are coming from California there is a place to park on the U.S. side along a wire fence. We walked in. Some dental offices will send a shuttle to pick you up.
The sweet seniors were thrilled to travel, even for dentistry. They knew where to go based on previous experience or referrals they felt safe with. They felt better communicating with someone in their native language even though most dentists in Algodones speak good English. Thankfully, we did not have any dental casualties. The seniors were also excited to buy medicines at one of the many pharmacies (some meds that require prescriptions in the U.S. can be purchased OTC in MX for considerably less). They could also consult with a physician and/or enjoy a meal at one of the restaurants before heading home on our bus at the end of the day.
Dentistry has always been expensive so extended family in Coachella often pitched in to pay for procedures. Prices then and now are generally, but not always, 60-70% less than in the U.S.
Note: The Mexican border at Algodones is currently open limited hours due to COVID restrictions. Check with the Internet for details. You are considered an essential traveler if you are visiting Algodones for dental care. Americans and Canadians who have discovered Algodones often drive to Yuma, AZ and stay in a Yuma hotel – enjoying a mini-vacation near the Colorado River at the same time.
My 2021 dental story at Lake Chapala, Mexico (one hour south of Guadalajara, Mexico’s second largest city):
I have been more fortunate than most with dentistry managing 35 or more years without cavities, gum challenges, or dental needs other than prophylaxsis every 3-4 months.
In 2020, that changed. Ten months passed before an office was opened to have my teeth cleaned. I was in the little village of Ajijic when the dental hygienist discovered cavities in molars plus loose teeth, bone loss, and movement from sliding and clenching in my lower front teeth. (Yes, somehow without realizing it, the pandemic had affected me).
I interviewed a dozen dentists and four orthodontists. Some I paid a consult for (between $20 and $50) – a worthwhile investment to get a feeling of offices, the dentists, and more. And yes, I was blessed. I had the advantage of renting a room at the lake and did not have to leave. I also did not wish to travel during uncertain times even though my preference for dental care is in Los Angeles.
Ironically, the person I imagined I would not choose, is the person I chose, an endodontist who was focused more on my health than on earning money performing root canals. Nothing replaces attentive health care. In this instance – intelligence, honesty, and a slow medicine naturopathic approach. A most unexpected and welcome gift during a time of concern.
Other dentists wished to perform two root canals to start. This dentist felt removal of #15 molar might be a more healthful choice based on weak bones and slight cracks from clenching. She felt the tooth could crack and result in a serious infection. She was not certain about the second tooth until she removed the inlay, but we would get to that in due time.
I called the U.S. for an opinion. By a miracle the amazing dentist who did the restorative work years ago is still working. We sent him the x-rays. His conclusion was the same as hers. That fortuitous assurance felt good!!
There was trepidation on my part about removing the molar and the surgery involved. I asked friends to please pray, and they did. The dentist gave me a mild dose of lidocaine, coached me as she was giving it to me, mentioned she may have to take the tooth out in sections. Slowly but surely, the tooth came out in one piece and the experience was nothing short of a big relief. She gave me explicit instructions about food and beverage and a date to return to check the healing, and of course to call on her cell phone in case of an emergency.
The next tooth, #14. She gently removed the inlay, removed the decay, cleaned the space, inserted a white filling. She put a temporary cap over it. We waited a few weeks testing for heat and cold. I got lucky, we were able to save this tooth and cover it with a crown.
Next, three lower front teeth with varying degrees of bone loss. The least expensive and most expedient option was to place a metal splint behind the lower front teeth (splints can last up to 20 years), and create a night guard for the upper teeth with more strength than a standard retainer.
I was concerned about the stainless steel splint/wire step so I reached out to an acquaintance who used to teach at USC School of Dentistry. By great good fortune he turned up on an Internet search in Paris!!! Once again, I was guided by someone not only with outstanding credentials but someone who could assure me that the dentist’s choice was wise. I am forever grateful and this support gave me confidence.
Before the placement of the splint, I had two perio scalings with a periodontist who visits the dentist’s office from Guadalajara once a week.
On my own I did a search for an orthodontist as the orthodontist who works with the dentist managed to get COVID. The Internet led me to a man who studied at a dental school famous for orthodontia in Mexico City. He also had orthodontic training at NYU’s Department of Orthodontics!!! I hired a private driver to take me all the way to Guadalajara and stay with me. Mission accomplished.
Note: In my case my lower teeth were bonded cuspid to cuspid. Over the stainless steel wire there is a white cap to hold each tooth in place. If you are curious to see a photo of what the splint looks like there is a photo in the Resource section below at the specialtyappliances.com link. Fortunately, you are unable to tell from the front that there is a wire behind my lower teeth.
Orthodontic stainless steel splint, lower cuspid to lower cuspid, is not visible
Here included is the orthodontist’s link on Instagram which I found a few days after the work was done. You will get a feeling for the beautiful office space at Puerto Hierro but more importantly the quality of his work. He loves orthodoncia. https://www.instagram.com/ortodonciaraul/
If you are wondering why the dentist and the periodontist did not recommend anyone when asked it is typical in Mexico to not refer to other “colleagues”. That concept is worth an entire blog for another occasion.
I am now in Los Angeles and the orthodontic splint has been reviewed by an orthodontist, a dentist, and a dental hygienist who all remarked on how well placed it is and how well the work was done. Hurrah about that! And hurrah about my good fortune to have met the most compatible dentist and orthodontist who could do what is best for my long-term health.
Dental costs in Mexico, different by location:
Generally one-half to two-thirds less than in the U.S.
Please refer to DuckDuckGo link in resource section which provides average prices.
Some takeaways and suggestions:
Study credentials of several dentists, not just one.
There is no accreditation and review in Mexico with U.S. standards.
If you do not speak Spanish, note who speaks your language.
Some dentists are artists, some will care about your health and wish to build a following, others not.
How will you determine a dentist’s touch? Their manner? I like to see photographs of the dentist and their team and note energy and hands. These are reasons to meet the dentist ahead of time.
Note if there is transparency when the office speaks to you by phone or writes to you.
Make certain you understand prices in dollars and/or pesos and whether or not there are add-ons. Expect to pay in “efectivo” – cash – few offices provide use of credit cards.
It is best to be careful about recommendations of friends and info you read on expat sites. There are many well-meaning folks eager to share. Choices are relative. What may work for one person may not work for another. The key is what procedure or procedures you need. In Mexico, most dentists are specialists, not generalists.
Dental Tourism web sites don’t necessarily vet whom they list. Dentists generally pay them a fee to list and a percentage when someone comes through the web site. You could get lucky, or not.
In the U.S. it is easy to find relatively reliable referrals by calling a dental school. Dentists tend to be transparent about their education and specialties on their web sites. Yelp! in the U.S. will give you hints of who not to see and why. In Mexico it is more of a challenge to figure out who is who.
Again, narrow your list and try to visit in person before choosing.
Proceed slowly and carefully.
You will have no legal fallback if something goes wrong.
Trust your instincts, if something doesn’t feel right, it may not be. Simply absent yourself, there will be another choice. I would do this in any country.
Ideally, it would be nice to pay less, especially if you are on a budget.
Since you know your oral health affects the health of the rest of your body, and therefore the quality of your life, do your best to choose wisely and then pray. Wishes for best outcomes no matter what.
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, housing, 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
In January 2020 Los Angeles-based nurse and case manager Elena Lopez realized the first part of a 20+ year vision – to return to Mexico to open a hospice, the first in her native state of Michoacan.
HOLA Hospice of the Angels/Hospicio de los Angeles Founder Elena Lopez with Charge Nurse Claudia
There have been previous efforts since the 1970’s to create hospice homes in Mexico following models in Canada, the UK, and the U.S. For financial reasons, as well as the predominant family cultural value of caring for the ill at home through end-of-life, the hospice home model with others doing the caring has yet to be accepted or sustainable. There have been hospice homes but none have survived.
How will Lopez create a sustainable model?
Lopez’ residence Hospice of the Angels has married assisted living care with rooms for hospice. Assisted living is a concept prevalent in every state of Mexico.
Lopez has attracted not only local Michoacanos but Mexican-Americans with life-limiting illnesses who wish to live their last months in their native land. Note: It costs families in the U.S. up to $20,000 or more for remains to be shipped from the U.S. for traditional Catholic burial. Choosing Mexico for end-of-life helps defray these expenses for Mexicans living in Canada or the U.S. and allows local family to be present.
Lopez continues to train staff – nurses, caregivers, and volunteers, despite the pandemic -based on her professional experience in California at VITAS, Kaiser Permanente, and in private service. In 2020 her staff also received End-of-Life doula training (psycho-social practical and ritual support) with psychologist and doula Wilka Roig of the Elisabeth Kubler-Ross Foundation of central Mexico. Roig is headquartered in San Miguel de Allende. (See www.ekrmexico.org ).
Hospice of the Angels currently has 10 assisted living residents. The home hosted five hospice patients this year. There are 15 staffers including Luisa Fernanda Ruiz Montiel psychologist/tanatologist who holds a PhD (former professor), the accountant, and an attorney.
Despite COVID, Lopez and team have managed to keep the virus out of the home, and, host fundraisers. Residents are busy with small therapy dogs, arts and crafts, visits by priests, and music performances. Recently, American hospice nurse Ian McCartor, known for creating inspirational Legacy Songs for his patients in English and Spanish, played and sang at the home.
Priest visits residents and staff at HOLA Hospice of the Angels/Hospicio de los Angeles in Morelia, Michoacan, Mexico
An out-patient hospice service in Morelia and neighboring areas has not been deemed practical. It is considered unsafe to send doctors, nurses, and caregivers out at night due to heavy cartel activity.
At Hola Hospice of the Angels, each room offers a bed for the patient and a bed for a family member, a model first instituted in Mexico by Dra Susana Lua Nava at Juntos Contra el Dolor, the first and only level one 24/7 palliative care hospital in the neighboring state of Jalisco. See www.JuntosContraelDolor.com
Mexican end-of-life care is provided through out-patient or in-home services in most states. Since the Mexican Palliative Care Law of 2009, there is now a broader view for care of the ill that includes those with life-limiting, painful illnesses that may last many years.
How to find Hospice of the Angels:
Fundación Hospicio de los Ángeles
Miguel Silva 149 Morelia, Michoacan de Ocampo, 58260, Mexico
Tel. 52 443 275-0279 office; 52 443 331-6647 cell; and USA cell 213 706-1111
Additional hospice project for Uruapan, Michoacan, Mexico:
Lopez is collaborating simultaneously with a Michoacano whose life dream has been to open a home for older adults. The gentleman donated land in a tranquil forest area. Part of the home will be dedicated to assisted living and nursing care, the other part to hospice which will be headed up by Lopez. Architect Ivan Marin of Morelia will fuse old Michoacano style (lots of wood) with Japanese Zen-style structure – healing light, views to nature from all sides, and tranquility (a hard-to-find concept in Mexico). Two years ago Lopez and Marin travelled to Japan to study hospice and architectural concepts they could incorporate. Lopez says she envisions a quiet, meditative, sacred place. They plan to break ground within two years.
Wendy Jane Carrel, MA, is a Spanish-speaking senior care specialist, consultant, and Mexico senior living writer 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.
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:
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).
PaceForum.org headquarters in San Miguel de Allende at Hotel Posada de las Monjas, a former monastery
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.
PaceForum.org 2019 Hotel de Real Minas lobby mascots
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.
Cruz Roja (Red Cross) paradmedics at PaceForum.org 2019
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.
PaceForum.org breakfast meeting with Ms. Karen, Dr. Angel Brana-Lopez, Elena Lopez of Hola Hospice, Wendy Jane Carrel of Wellness Shepherd and Book Ambassador,, and Dr. Haywood Hall, founder of PACEMD, Pace Forum, and MedSpanish
“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.
Wellness Shepherd 