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

International Day of the Older Adult is Celebrated in Guadalajara, Mexico

The International Day of Older Adults is celebrated, by proclamation of the United Nations, on October 1 every year.

In Mexico this event dovetails with the country’s Senior Day at the end of September. Festivities are held at senior centers, senior homes, and on DIF (government social service) grounds.

For those of you who haven’t been to Mexico, especially Guadalajara, its “tapatio” residents love to sing and dance no matter their age. Being around these folks will automatically lift your spirits. They love to dress up, eat well, and have fun.  Most of all, they never give up despite mobility issues or aches and pains.

Tapatio singing seniors
Tapatio singing seniors

In Mexico there are 7.5 million persons 70 or older. This number is expected to reach 8.5 million in 2020, and 10.2 million by 2030.  According to the Mexican government, at 60 you are an older adult. It is unclear why the number of boomers and persons ages 60-70 are not included in the Mexican government statistics (INEGI) reports.

In the U.S. there are 70-80 million adults who  will be over 65 by 2020.

This year I attended the Asilo Juan Pablo II senior day festivities (see earlier post September 2016) at http://www.WellnessShepherd.com .

Last year I attended an event at DIF’s Centro de Amistad Internacional (Center of International Friendship) on Calle Eulogio Parra 2539 just off Lopez Mateo in Guadalajara. It was co-hosted by the Office of Older Adults for the State of Jalisco, Mexico and by INAPAM ( the National Institute for Older Adults, est. in 2002). It was held on the first Sunday of October from 10 a.m. to 3 p.m.

Groups of seniors performed dances, ladies were offered free beauty treatments by the Irma de Zuniga make-up academy located on Lopez Cotilla in downtown Guadalajara (www.irmadezuniga.com), there were talks by gerontologists, nutritionists and others experts. Jhre Chacon and his team of healing touch trainees from UNCOA offered massages, Reiki, and other relaxing experiences for the guests. There were also poetry readings and card games.

Tapatio caballeros
Tapatio caballeros

 

older adult folkloric dancers, Guadalajara
older adult folkloric dancers, Guadalajara

 

healing touch holistic care for older adults, Guadalajara
healing touch holistic care for older adults, Guadalajara, offered by UNCOA

 

Queen for a Day make-up gift for older adults, Guadalajara
Queen for a Day make-up gift for older adults, Guadalajara

Ana Maria Luz Garcia, owner of the historic restaurant La Fonda de Arcangel Miguel (www.fondasanmiguelarcangel.com, housed in a colonial convent in the center of Guadalajara), hosted the buffet breakfast/brunch. Garcia is a passionate advocate for healthy living at any age.

Consuelo Manzo Chavez, Director of Older Adults for DIF presided with Alma Solis Montiel, who at the time was the Director of INAPAM but is now the Director General of the Institute for Older Adults for the State of Jalisco.

International Day of Older Adults with DIF and INAPAM Directors & amigita Leila
International Day of Older Adults with Senior Care Advisor Wendy Jane Carrel, DIF Director Consuelo Manzo Chavez, and former INAPAM Director Alma Solis – now Director of the Institute of Older Adults for the state of Jalisco, with unidentified older adult, and human rights attorney Laila Martinez de Santiago
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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…

DSCN0719
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/

 

End-of-Life Care, Health & Wellness, Hospice, Mexico, Palliative Care, Palliative Care Mexico

Palliative Care/Hospice Juntos Contra el Dolor of Mexico Holds Kermes (Fundraiser)

Juntos Contra el Dolor - we are helping diminish pain
Juntos Contra el Dolor – “we are helping diminish pain”

 

Juntos Contra el Dolor, A.C., the only 24-7 palliative care/hospice in Jalisco, Mexico, held a kermes to raise funds for its humanitarian medical effort which aides patients with chronic pain, and, at end of life. The Juntos team also provides psychological and spiritual support to families of patients.

The kermes was held on a Sunday from 8 a.m.to 2 p.m. outside the Templo of San Bernardo on Plan San Luis in northwestern Guadalajara, a church with 3,000 parishioners.

A Mexican kermes is an outdoor party for a special cause. To support the cause, people buy food and drink. The Juntos kermes served tacos with birria, quesadillas, homemade jamaica (a hibiscus drink) and horchata (a rice drink). Juntos brochures were on each table.

The nurses, who are the only paid staff (except for volunteer retired nurse Rocio), were taking care of patients at the hospital around the block..

The Spanish word kermes is derived from the Turkish word kermes which originally meant a handicraft bazaar to raise money for charity. It is also derived from the Dutch word kermesse, (kerk = church, mis = mass), a festival after mass.

setting tables for the kermes
setting tables for the kermes
founder Dra Susana Lua Nava with volunteer nurse Rocio
Founder Dra Susana Lua Nava with volunteer nurse Rocio

 

 

 

 

 

 

 

volunteer nurse Rocio and volunteer coordinator Nena
volunteer nurse Rocio and volunteer coordinator Nena
social workers Silvia and Lupita
volunteer social workers Silvia and Lupita

 

sister volunteers, administrator Sara on the right
sister volunteers – Marta and administrator Sara on the right

 

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

Senior Care/Senior Living Options at Lake Chapala, Mexico

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

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

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

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

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

Will Mexico Solve the Senior Living Affordability Problem?

Published on Wed, 08/03/2016 – 4:55pm

By Wendy Jane Carrel, wellnessshepherd.com

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

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

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

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

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

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

  • Aging in Community – co-housing

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

  • Nursing Care and Rehabilitation

Lake Chapala

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

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

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

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

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

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

What is available at Lake Chapala now?

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

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

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

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

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

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

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

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

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

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

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

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

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

Resources:

Canadian retirees make new homes in Mexico

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

US State Department – Relations with Mexico

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

 

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

International Geriatric/Gerontology Conference Guadalajara 2016 – Focus on Dementia

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

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

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

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

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

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

 

 

 

 

 

 

 

 

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

Topic-Related Resources:

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

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

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

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

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

Aging – Mexican Physician Advocates Eating Less, Walking More

Dr. Jose Gustavo Valladores, President of the Gerontological Society of Jalisco, addressed a group of older adults in a meeting room at Juntos Contra el Dolor Hospital in the parish of San Bernardo, Mezquitan Country, Guadalajara, a few days ago.

Valladores, a spry, humorous, and fit 75 year old advocated eating less, walking more, sleeping about seven hours, and learning to breath slowly and deeply for a more healthful life.

Dr. Valladores contends we do not need to eat as much as we continue to age. His comments remind me of a movement afloat in senior living in the U.S. called Grind Dining, serving small, elegant portions that are easy to see, easy to consume, and easy to manage, especially for those with arthritis, dementia, etc.  Studies show health outcomes with such meals are positive.

Harvard-trained physician and gerontologist Bill Thomas of the Green Project and Eden Alternative has a not to dissimilar approach for aging well that he calls MESH. Move, Eat, Sleep, Heal.

The conversation for wellness in aging continues with this notable consensus among two gerontologists from two different cultures. A return to basics. Wise.

Dr. Gustavo y Dra Susana 21 de mayo 2016
Dr. Jose Gustavo Valladores y Dra Susana Lua Nava

Dra Susana Lua Nava, the founder of the 24/7 palliative care hospital and hospice, was Dr. Valladores’ medical school student 20 years ago.

End-of-Life Care, Health & Wellness, Hospice, Mexico, Pain, Palliative Care, Palliative Care Mexico

International Pediatric Palliative Care Congress, Mexico, February 2016

With two days of notice I decided to attend a three-day intensive on pediatric palliative care, February 22-24, 2016 at the University of Guadalajara Medical School (Building Q).  It was part of the XVII CIAM (International Congress on Advances in Medicine Contributing to the Future of Health) and was hosted by the Nuevo Hospital Civil (New Civil Hospital) next door. The hospital is where University of Guadalajara Medical School students intern. I am glad I participated.

Until now I have witnessed palliative care (comfort care and non-invasive pain relief) for older adults with chronic conditions or at end-of-life. I knew I would be acquainted with some material. I also knew there would be quite a bit more for me to learn or hear repeated. Heart-rending stories and photos of children fading away were anticipated. And when I saw them, they surely took my breath away. Envision Marlo Thomas and her St. Jude’s Children’s Hospital efforts plus the images you’ve seen of children suffering from maladies across the globe.

Almost 100 physicians, nurses, psychologists, socials workers, and volunteers attended the 22-hour course hosted and organized by Dr. Yuriko Nakashima, a pioneer in this arena in Jalisco state, and a highly-regarded pediatrician and university professor. Yes, her name is Japanese; she is a Mexican citizen.

All speakers were excellent and exceptionally professional.

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Dr. Yuriko Nakashima, Dr. Lisbeth Quesada Tristan, Dr. Jorge Ramos Guerrero, psychologist Ortencia Guiterrez Alvarez

Presentations by special guest Dr. Lisbeth Quesada Tristan of Costa Rica, referred to as the “abuela” or grandmother of pediatric palliative care, were a stand-out. (She’s actually young). Her work and a collaboration with her non-profit Fundacion Pro Unidad de Cuidado Paliativo (see www.cuidadopaliativo.org) were celebrated at a signing ceremony which included the Director of Guadalajara’s New Civil Hospital Dr. Francisco M. Preciado Figueroa, the Director of the Old Civil Hospital Dr. Benjamin Becerra Rodriguez, and Dr. Yuriko Nakashima representing both the New Civil Hospital Department of Pediatrics and the University of Guadalajara Medical School. Dr. Quesdada is also active with  ICPCN, the International Children’s Palliative Care Network.

Dr. Quesada tackled the following subjects with enthusiasm, humor, intelligence, and wisdom:

She started with a definition of palliative care – comfort care, relief from pain, and non-invasive procedures for irreversible medical conditions, progressive diseases with no cures, premature babies, and end-of-life. She asked, do you believe in aggressive procedures with a child hooked up to machines until life’s end or should the child be held in your arms, hearing a soothing voice, feeling the vibrations of love, and feeling a sense of security?  We are not clinicians of pain only, we are mostly providing quality of life in dire circumstances.

Other discourses:

Is palliative care a right or a necessity for children?

The main things everyone should know about pediatric palliative care

When “hello” means “good-bye”

Communication and support for children and adolescents with terminal illnesses

From Cocoon to Butterfly, the metamorphosis of the suffering child

How to Deal with Dysfunctional Families

The implications of sedation

Here is a paraphrased summation of Dr. Quesada’s comments:

It is offensive to say terminally ill patients. Please be careful with word choice, think about saying “children with life-limiting diseases.”

We must be part of a new paradigm with extensive outreach, going to children in their homes. (Dr. Quesada’s non-profit also serves isolated villages in the mountains of Costa Rica)

Respect children, their rights (they have rights even though not legally competent), their pain, and their wishes

Everyone is important until the last minute of their life.

To work with children one needs huge passion.

We could not do our work without volunteers!!

“Santa morfina”, blessed is the existence of morphine to help relieve pain

“Amar es saltar.”  Saltar literally translated is jumping but the meaning here is love is a way to overcome.

Pediatrician Dr. Jorge Ramos Guerrero (who holds a Master’s in palliative care from a Spanish university) delivered passionate, thoughtful reviews of…

History of Pediatric Palliative Care

Holistic Attention for Children in Palliative Care

Medicine Based on Positive Principles

Dr. Ramos outlined the history of care from Egyptian times to the present with artistic representations, the meaning of the Latin words Hospitum (providing hospitality) and Pallium (to relieve suffering), and reminded the audience that death is a normal process. He emphasized that the primary aspects of treatment are warm care by an interdisciplinary team, and that the objective is pain relief. He reminded the audience: this is not euthanasia. We are present in all moments to create quality of life until the end.

According to INEGI (government) statistics, there are 5-6,000 Mexican children with cancer each year and 56% of these children outlive their diagnosis. Part of holistic care is asking the patient what is most important for him or her. We must put ourselves in the patient’s shoes. With regard to current medicine, Dr. Ramos advocates a newer paradigm – more patient-centered care that offers the best science, the best communication (especially the ability to listen), and the best inter-personal relations.

Dr. Cesareo Gonzalez Bernal spoke of legal implications in palliative care at end-of-life, a subject that always needs continual review. Focusing on patient rights is key. Assisting a patient to die is against the law.

Dr. Regina Okhuysen-Cawley, a Mexican-born American physician working in Houston who specializes in palliative care and hospice, spoke of palliative care as it is used in intensive pediatric care, and how successful an integrative approach can be at the end of life.

Dr Patricia Ornelas and psychologist Ortencia Guiterrez Alvarez (Dr. Nakashima’s long-time colleague at Nuevo Hospital Civil) talked about how to confront death and offered each participant exercises in imagining his or her end-of-life.

Other themes covered by other pediatric palliative care pioneers were how to give the bad/sad news, ethical dilemmas in palliative care, the importance of the nurse on the palliative care team, and spirituality of children.

Madre Martina Zamaya Tamayo, a nurse nun with a Master’s in Bio-ethics, was in the lobby outside the Guadalajara Congress to represent the only 24-7 palliative care hospital in Jalisco, Juntos Contra el Dolor. See www.juntoscontraeldolor.com. She introduced Dr. Susana Lua Nava’s book El Enfermo: Terreno Sagrado (The Ill: Sacred Terrain) to the attendees. Representatives from a dermatological supply house gave out free samples of medicinal lotions.

It was an honor to be in the company of dedicated, informed, and passionate healthcare professionals focused on comfort care and pain relief for ill children.

Note:

No medical schools in Mexico currently offer specializations in palliative care, although according to a Human Rights Watch report from October 2014, six of the country’s 102 medical schools offer some courses. Palliative care diplomas can be received from a palliative care institute in Guadalajara or Mexico City but this is not the same as 2-3 years of specialty training abroad. Mexican doctors usually go to Argentina, Chile, or Spain for this specialization. Anesthesiologists can order morphine, others cannot, unless certified by the government through special courses. And for whatever reason, according to one of the speakers, pediatricians have not been readily included in the arena of palliative care in Mexico to date.

Another note:  

It seems to be in the hearts and minds of Mexican healthcare providers to develop and implement more palliative care services for children.

Dr. Rut Kiman of Argentina, representing  the  ICPCN (International Children’s Palliative Care Network), and Diedrick Lohman of Human Rights Watch, traveled to five states of Mexico in 2015 to see if a December 2014 initiative to include children in palliative care in Mexico was being implemented. They visited the states of Guanajuato, Hidalgo, Morelos, Queretaro, and Toluca. Although they found pediatric palliative care in its infancy,  Dr. Kiman wrote “it is hoped it will soon be a reality in Mexico thanks to the efforts of professionals, non-governmental organizations, and health policy makers.”