Category: Senior Care Mexico

Aging in Place, Tuscany, Italy, Mexico Senior Living, Senior Care Italy, Senior Care Mexico

Aging in Place & Senior Care in Italy – A Snapshot from Tuscany

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In October I spent 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. Her nickname comes from her daughter and friends who have spent a lifetime watching her overcome obstacles. She was a child during WWII living in the countryside, and later, the sole support of her daughter and other relatives. My heartfelt thanks to Silvana and her daughter for permission to share. Here is what I observed:

Aging in Place

Silvana is aging in place with dignity and self-respect, her way, as much as possible.

From my point of view, it is not easy without unlimited resources and optimum health in Italy, nor almost anywhere else in Europe. Nordic countries and The Netherlands may be mini exceptions. (I have seen well-thought-out senior living and support in Stockholm and outside Amsterdam).

Silvana’s circumstances are what Americans would refer to as middle class. She worked her whole life, ran a small business, and owns a condominium in an attractive section of Florence a few hundred yards from the Arno River. She has been a widow for over 35 years.

She is aware of the importance of diet, buys the freshest food, and continues to create meals from scratch. She used to go to open-air markets but recently has found most produce at the Esselunga market behind the back gate of the condominium. Years ago, we drove to the Tuscan towns of Impruneta or Poggibonsi on weekends and returned with the best quality olive oil, chianti, cheeses, and more. Today this is accomplished by or with her super capable and loving daughter, her only child, who lives next door, and works full-time.

Here below is a photo taken by her daughter outside the Esselunga market under the hot (over 100 degrees) October sun.

Silvana’s home is immaculate – open any armoire and you will find the best quality linen, beautifully laundered and ironed. Ditto for her clothing. In the entrance hall she keeps a marble bowl of necklaces – pearls, Murano glass, and others on a sideboard. When she goes to the supermarket or for a café, she will (unless it is too hot) be wearing a necklace, earrings, and fine watch. Next to the sideboard is her walker for the street.

Guess who cleans the condo, prepares meals, does the laundry, and makes certain all is in order. Silvana!

When you meet her, she exudes kindness, and love. She is an appreciator of life, always smiling and seeing the best in you and those whom she meets. She is a woman of immense energy, generosity, and intelligence. She worries about others and knows her neighbors and their stories. Every day she walks one flight up to check on another aging in place lady who is the caregiver for a severely disabled daughter. The lovely lady upstairs receives no respite or support from social services, neither does Silvana.

The precious little dog in the photo by her daughter below is Nina, Silvana’s companion during the day while her daughter works.

On Thursdays a hairdresser comes to coif Silvana’s hair. The hairdresser also attends to the ladies upstairs. This is Silvana’s investment in feeling better and “a posto” or okay.

Silvana’s attractive appearance defies what she is feeling almost 24/7 – unrelenting pain from rheumatoid arthritis, scoliosis, osteoarthritis, and other co-morbidities.

Nighttime Challenge

Nighttime is more difficult than daytime. Sleep is interrupted with shooting pain despite evening medication. When she gets up to use the bathroom, it is not easy. It takes a while to lift her body comfortably from the bed. (The bed she carefully chose gives best possible comfort and support for her condition). She is wise and focuses on remaining stable as she rises; it is a chore to walk the short distance. She does not use a walker in the house or to navigate at night. The lighting is good. But what if she falls?

Socialization

Silvana loves her independence, walking the local streets and around the condo compound every day. Unlike many disabled and ailing who are retired, she is supremely socialized, though it would be helpful to have visitors or a regular companion during the day other than neighbors who stop by outside her window. Game shows on TV are not of interest, the news is. She enjoys reading and crossword puzzles. Her mind is sharp.

Almost every day I was there we walked to the city center looking to replace my favorite Igi & Co. wedge walking shoes. Each time we went it was a charming adventure watching how she would dart ahead of me with her walker, so excited. She attracts folks like magnets on the street, in stores. It is fun to watch. As you may have surmised, she is super friendly and has a gift for storytelling.

We were late returning from the center one evening and decided to hop on a tram instead of walking back. As she enters the tram with her walker she is smiling and announcing how much she appreciates everyone’s help and she is sorry if she is disturbing anyone. Passengers smile broadly, transfixed by her charisma and warmth. I wish I had thought to make a video of the experience. It was such a pleasure to watch.

Assisted Living in Italy

Silvana has absolutely no interest in a senior living home even if she could afford the prices. There are a handful of “luxury” residences, homes run by nuns, and homes partially supported by the government in Tuscany known as RSA (Residenza Sanitaria Assistenziale – sanitary residence care).

The photo below is of a typical modern assisted living in Florence. The photo is only to show an example, not to recommend or endorse.

In Italy, there is private pay assisted living, and as in the U.S., you will be moved if you require nursing care. Prices range between 2500 and 4500 euros per month, depending on the city and the region. I visited four residences in Florence and two in Pistoia on this trip. My priority was to be with Silvana as much as possible, observe her health, and see if we could discover some surprise solution to ease her aging in place. My last trip was to see Silvana’s loving oldest sister before she passed away – fortunately, with good care paid for in part by the Italian government.

Home Health Aides (known as “badanti”)

Receiving help at home is not paid for or assisted by social services unless you are uncommonly poor and gravely disabled – blind, deaf, paralyzed, etc. Silvana might welcome a “badante”, a caregiver, though she might not readily admit this. She tries not to show it, but she is understandably tired. She is not a complainer. Keep in mind it is cultural to not discuss your woes outside your family, and just as important, is the desire to “fare una bella figura” an idiomatic way of saying always put your best foot forward.(Badante is from the Italian verb badare, to take care of). 

There are agencies for a badante, male or female, in larger Italian cities. In Tuscany and other provinces there is also an underground market (or hidden job network) of migrant Peruvian, Moldavian, and Romanian badantes, some apparently without residency. I heard stories (not confirmed) about abuse or theft on occasion by caregivers who are not vetted or bonded. On the other side, there are stories of “modern servitude” by Italian families hiring badanti.

Below is a photo of a large agency on Via del Sansovino in Florence. There are three other agencies in city center.

According to a British study by Giuliana Costa the hiring of migrant badanti to relieve Italian families has been on-going since around 2000. The average price of a badante starts at about 800 euros/month (about $900 USD) and goes to 1500 euro (about $1600 USD) or 2000 euro per month ($2200 USD) not including room and board. The average gross monthly salary of middle-class Italians is currently 3650 euros, the current average middle class pension is 800-1200 euros/month or more). With prices rising around the world since COVID, the cost for a badante continues to increase.

The situation is challenging if you are caught in the middle. Italian families, the traditional caregivers, must now work or care for their own children as well as their parents.

Depending on which statistics you study, Italy has the second or third largest population of older adults in the world, following Germany or Japan. In Italy today, there is not enough support for the growing population of older adults.

Average Middle-Class Pension in Italy, Will It Pay for a Badante?

The average middle class pension in Italy is around $16,572.22 USD/year.  Monthly, that comes to 1370 euros, but the pension is more likely 800 to 1000 euros per month. Even if your condo is owned, you are paying condo fees, water, gas, electricity, transportation, food, doctors, clothing, and miscellaneous expenses.  Are you able to pay a badante who will need his or her own room + board?  If you are lucky perhaps you may find someone for a few short hours at 10-12 euros per hour. But over time the expense may become prohibitive.

If you own a home and have a pension above the poverty line, it is a given that government social services will tacitly expect your family to care for you. This makes me wonder what happens if you are a solo ager with no support.

If you are above the poverty line in Tuscany, you must pay a fee to go to a senior center, a day care center, receive social worker support and other services. If the choice is paying utilities and eating, will you pay for day care? As far as I have learned from research, there is no organization such as Meals on Wheels in Florence for example, and even if there was, Silvana prefers choosing what food is most healthful for her. I was hoping to learn about a non-profit organization of volunteer companions that visit older adults. Florence does, however, have a volunteer service that drives extremely disabled older adults to doctor appointments.

The local government social services in Florence are housed in the ASL Ufficio di Assistenza (the Assistance Building) which includes the ISEE, the government entity which assesses your economic condition (Equivalent Economic Situation Indicator).

What happens if Silvana has a fall, a stroke, and needs serious care?

Government healthcare will kick in, but for some services, she may be paying in part. Her daughter sends good thoughts to the universe every day so that her mother will not have an accident, so do I.

The national health system in Italy includes state hospitals which are funded by taxes. If you are Italian, or a resident, you do not pay as a patient for the hospital. For scheduled surgery, a referral from a doctor is required. In acute situations, you can go to an emergency room (Pronto Soccorso) without a referral.

What works…

Italy has provided universal healthcare since 1978 through the Ministry of Health and its SSN Servizio Sanitario Nazionale. This service is available to all Italians and Italian residents. Until the last few years, according to many, it has been a positive experience. Recently, due to staff shortages, COVID, and fewer euros to support the system, it takes longer to receive attention. Fortunately, Silvana has an SSN geriatrician whom she is pleased with. SSN does not include dentistry and psychological support. There is also private pay medicine in Italy and private pay health insurance. Many Italians are now participating in both public and private insurance, the latter if they are able to afford it.

Conclusion

The review above is a snapshot. A proper evaluation would require several months or a year of due diligence and observation to understand the changing system of care for older adults in Italy.

Again, as with the U.S. and most “western” nations, much has changed in the last 10 or 20 years – mostly diminishing social services plus higher cost of living and cost of care prices.

My Italian trip made Mexico, (where I focus my energies coordinating senior care, senior housing, and end-of-life care), seem comparatively less complicated and more affordable for Americans, Canadians, or Europeans seeking to age in place outside their home country.

Through Mexico’s INAPAM and DIF, all nationals and residents may participate in programs and activities designed as poverty reduction strategies. Senior centers act as daycare centers with socialization (there are government centers in rural areas as well as metropolitan areas), seniors receive discounts for travel by bus locally and long distance, Mexican national seniors receive a small monthly amount for expenses, and DIF homes (not that many in the country), provide a roof over one’s head and care.

Wendy Jane Carrel, MA, is a Spanish-speaking (and still Italian-speaking) senior care advocate from California. She has travelled 13 states of Mexico for more than 20 years researching health systems, senior care, and end-of-life care. She provides housing and care solutions and guides transitions in/to Mexico for Americans, Canadians, and Europeans. She is a compassionate companion and palliative care liaison, legacy writer, a trauma-informed 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

References:

https://journals.openedition.org/osb/1536 Private Assistants in the Italian Care System, Facts and Policies by Giuliana Costa

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5868556/  well-presented “badante” case study in the city of Verona from 2017.  

https://cafebabel.com/en/article/badante-the-ghosts-of-italian-society-5ae00a19f723b35a145e5e21/  how migrant caregivers are often exploited in Italy

https://cafcisltoscana.it/isee   Social Services in Tuscany, Italy   Assistance for pregnancy, university tuition, older adults and more, if you qualify.

https://housinganywhere.com/Italy/average-salary-italy

https://en.wikipedia.org/wiki/Healthcare_in_Italy

https://www.yourcare.eu/press/assisted-living-boom-predicted-in-italian-cities/ average 2023 monthly salaries for in-home caregivers

https://www.gruppolameridiana.com/en/residenza-sanitaria-assistenziale-rsa-works/   RSA homes in Italy

© Wendy Jane Carrel, 2023 

Assisted Living Mexico, Costs of Care Mexico, Nursing Homes Mexico, Senior Care Mexico

Assisted Living with Nurse Nuns in Mexico

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If you are a resident of Mexico or an about-to-be resident, is Assisted Living with nurse nuns an option to consider if you might need care?

The short answer, for some folks, may be yes.

How many residences in Mexico are Catholic non-profits and where are they located?

According to a 2018 report, INEGI (the National Institute of Statistics and Geography), there are under 900 assisted living communities in Mexico, 85% of which are in the private sector. The remaining 15% are Catholic non-profit residences, other non-profits, or DIF (Desarrollo Integral de la Familia, loosely translated as Integrated Development of the Family) government homes.

Residences are in every state and most large cities. For example, in Guadalajara, Mexico’s second largest city, there are approximately 35 assisted living homes. Of those 35, six are run by five different orders of nurse nuns, one order has two homes.

What may you expect under the care of nurse nuns?

The answer depends on the order of nuns, their mission, the location in Mexico, the resources of the home, how the home is supported by the Archdiocese, volunteer staff, the community, and more.

Historically nuns (and originally monks) were caregivers, nurses, purveyors of healing remedies as herbalists, and suppliers of prayers and psychological support for the ill. They met folks at homes, hospitals, and on the grounds of their wealthy benefactors first in Europe, then the Middle East (aiding crusaders), and later in Latin America beginning around 1540.

Some homes have inviting colonial entrances. Others are newer homes.

Asilo Brunet Celerain, Merida, Mexico

Ancianitas de Santa Clara de Asis, A.C was opened by Franciscan nuns in January of 2018 at San Pedro Tesistan, Jocotopec, Jalisco, Mexico. The order of St. Francis of Assisi first came to Mexico in 1955. They have a hospital in Guadalajara. Several expat volunteers at Lake Chapala invest time and love energy to support the home.

Homes tend to be clean and organized with immaculate kitchens, dining rooms, and laundry rooms. “Cleanliness is close to Godliness” seems to be a motto most nun administrators, usually known as “Madre Superiora”, and the Sisters “Hermanas” live by.

Asilo de los Desamparados, A.C. linen room, Guadalajara, Mexico

Women’s dining room Residencia San Jose, Zoquipan, Guadaljara, Mexico
Men’s dining room Residencia San Jose, Zoquipan, Guadalajara, Mexico
Women’s dining room Asilo Brunet Celerain, Merida, Mexico

Food will invariably be Mexican, unlike continental cuisine found at some private pay homes with foreign residents.

Most homes are for women only, some are for men and women.

Residencia San Jose exercise class for men and women, Guadalajara, Mexico

Environment is important. Properties with trees, gardens, places to stroll or sit in the sun or shade are common. Places for meditation and prayer are common, including of course a campus chapel.

Casa Hogar San Vicente inner garden, Lagos de Moreno, Jalisco, Mexico

Casa Hogar Tepayac inner garden, Leon, Guanajuato, Mexico

Casa Hogar Tepeyac inner garden, Leon, Guanajuato, Mexico

Gardens at Residencia San Jose, Zoquipan, Guadalajara, Mexico

The language will usually be Spanish. Some nuns speak English. Nuns in Mexico are from Mexico but also from Africa, Europe, parts of Asia, and other countries in Latin America.

Quality of care. Mexicans in general are known for compassionate care, nurse nuns as well. Nuns have centuries of lived experience and tradition in the art of care. They are educated to serve vulnerable populations, especially older adults. They make sacrifices and overcome many challenges to help all. They show up daily and with attention. Since they have no children, patients are often offered their mothering ministrations. They pray for your healing even when not in front of you. If you believe in the power of prayer, their prayers may be welcome.

Nurse nuns have often worked in Catholic hospitals before working in assisted living and have backgrounds in acute/critical/emergency care.

Sister Augustina from Venezuela, 80+ years old, now retired, on nursing corridor at Residencia San Jose, Zoquipan, Guadaljara, Mexico

Nuns tend to follow early morning rising rituals and do not stay up all night unless tending to residents. This day schedule, as opposed to the Mexican culture stay-up- all-night way of life, may be compatible with the routines of some foreigners.

Is it possible for an expat to live at a senior home run by nurse nuns?

If the person meets the admission requirements, yes. Americans, Brits, and Canadians have been or continue to be residents in assisted living run by Mexican nuns.

Residents of Asilo Brunet Celerain, Merida, Mexico. The sweet lady in the middle is British.

Precious residents of Asilo para Ancianas at the central plaza of Guadalupe, Zacatecas, Mexico. One of the residents is an American who shared she enjoys being under the care of the nuns.

For those who do not have enough funds for private pay, being cared for by nurse nuns at their “casas de reposos” (rest homes), is an option. Many Catholic orders are ecumenical, and open to non-Catholics and “all God’s children.” Pay is based on what each person can afford. The system tends to be democratic. Those with more funds are essentially supporting life for others. Those with more funds may often have their own private room. Those with fewer funds sleep and store belongings in a dormitory-like environment. In Mexican culture, being close to others and not being alone is preferred. Privacy is a Canadian, Western European, and U.S. concept.

Asilo de Desamparados, A.C., a women only home, sleeping quarters, Guadalajara, Mexico

Casa Hogar Tepeyac bedroom for ladies, Leon, Guanajuato, Mexico

Casa Hogar San Vicente private room, Lagos de Moreno, Jalisco, Mexico. The home is supported by the community and a group of well-to-do volunteers.

The Missionaries of Charity (Mother Teresa) offer a small, immaculate, serene place in Tijuana, Baja Norte, Mexico. Some nuns are from India. On a visit the women residents were sewing. From the outside walls and entrance you would not know the nuns and their residents were there. Photos were not allowed, perhaps for security reasons.

What about the costs for assisted living and nursing? What do Mexicans pay, what do expats pay?

There is a sliding scale with nurse nuns and other non-profits. The prices in private pay are the same for everyone.

Most Mexicans cannot afford private pay. In this case families become caregivers, or their elders live with nuns or in other non-profit care homes.

Foreigners in Mexico (generally retirees) often have enough funds for private pay care which costs between $1500 and $3500 USD/month or more depending on the location and the amount of care needed, not including diapers, meds, or outside physicians. The costs with nuns would be lower depending on needs, around $800-$1000 USD (not always). Again, your payment to the residence is a donation that helps the entire community.

Note: care costs in all homes are currently climbing due to inflation in Mexico. The Canadian and U.S. dollar have decreased in value to the Mexican peso.

Will there continue to be homes administered by nurse nuns (and the Catholic Church) in Mexico in the foreseeable future?

Probably. Even though Catholic hospitals and assisted living homes are slowly being purchased and phased out by healthcare conglomerates in the U.S., it seems unlikely there will be a similar scenario in Mexico any time soon.

A 2015 report via ENPECYT (Survey of Public Perception of Science and Technology), an arm of INEGI, estimates 5% of 350,000 licensed nurses in Mexico are monjas (nuns), that would make the number about 17,500. Licensed nurses receive four years of training or more, including nurse nuns who study at their own schools and major universities. The nursing school curriculum includes practical, on-site education at hospitals, homes for older adults, and places where the population is poor and vulnerable. Many nuns have M.A. degrees in bioethics, nutrition, palliative care, and other disciplines. Even though Mexico is a country where few folks consider themselves practicing Catholics, the country is culturally Catholic, and traditions tend to be observed.

Summary:

Nurse nuns are dedicated and trained for the care of older adults as geriatric nurses. Other than contemplative orders, they also work in hospitals or as teachers.

Nuns have cared for vulnerable folks for centuries – the abandoned, the ill, travelers, wealthy patrons – in short, diverse populations.

If you love Mexican culture, are not particular about food, are comfortable with simplicity, and welcome the support of prayers and a unique kind of care, assisted living and nursing care with nuns may be an option. If you are not Catholic and do not speak a lot of Spanish, you may or may not feel comfortable.

© Wendy Jane Carrel, 2023

Wendy Jane Carrel, MA, is a Spanish-speaking senior care advocate from California. She has travelled 13 states of Mexico for more than 20 years researching health systems, senior care, and end-of-life care. She provides care solutions and guides transitions in/to Mexico for Americans, Canadians, and Europeans, and is a published author on subjects related to senior well-being. Wendy was a palliative care volunteer with a physician nun and nurse nuns of Santissima Trinidad in Jalisco, Mexico for three years and came to know Augustine, Carmelite, Dominican, Franciscan, Josefina, Sacred Heart nurses and the Little Sisters of the Abandoned Elderly, Missionaries of Charity (Mother Teresa), and the Sisters of Mary. See more at https://www.WellnessShepherd.com

Resources:

https://en.wikipedia.org/wiki/History_of_nursing

https://en.wikipedia.org/wiki/Category:Catholic_nursing_orders

https://en.wikipedia.org/wiki/History_of_the_Catholic_Church_in_Mexico

https://en.wikipedia.org/wiki/Catholic_sisters_and_nuns_in_the_United_States

https://www.gob.mx/profeco/documentos/asilos-una-alternativa-para-el-cuidado-y-atencion-de-los-adultos-mayores

U.S. nuns face shrinking numbers and tensions with the Vatican

https://desdelafe.mx/noticias/iglesia-en-el-mundo/conoce-a-las-santas-enfermeras-mexicanas/

https://www.eleconomista.com.mx/capitalhumano/Solo-el-11-por-ciento-del-personal-de-enfermeria-en-Mexico-tiene-una-especialidad-20180827-0102.html

https://en.www.inegi.org.mx/

https://en.www.inegi.org.mx/programas/enpecyt/2017/

https://www.ncregister.com/news/religious-sisters-offer-more-compassionate-care-to-the-elderly

http://residenciadeancianosygeriatricos.com/mexico/casa-hogar-para-ancianos-san-vicente-residencia-de-ancianos-lagos-de-moreno-jalisco-mexico/

http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0121-08072016000400015

https://directorioempresarialmexico.com/empresa/0001642855/INSTITUTO-DE-BIENESTAR-MAURO-LOPEZ/ short list of Catholic assisted living homes in Mexico

Taking Care: The Story of Nursing and Its Power to Change Our World by Sarah de Gregorio (Harper, 2023)

Jewish Senior Care Mexico, Life Plan Communities Mexico, Mexico Senior Living, Nursing Homes Mexico, Senior Care Mexico, Senior Living Mexico

A Mexican Surprise – Cuernavaca Senior Care for the Jewish Community

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Hanukkah 2022

Aside from dedication to senior care in Riverside County, California (Coachella, Palm Springs, Rancho Mirage), I have made a point of visiting small and large older adult residences in places I travel to. During the last 25 years I have gratefully been received at innumerable homes in California, Chile, Ecuador, Italy, and Mexico.

I must say, after spending time in Mexican government (DIF homes – department of social services), non-profits (mostly run by nuns), and for-profit homes in 16 states of Mexico, Eishel Nuestro Hogar (Eishel Our Home) in Cuernavaca, is a standout.

Possible reasons why…

This residence functions well because those in charge are serving older adults as their mission. And with compassion. In this way, residents and personnel feel at home despite any minor shortcomings.

At Eishel the director, the physician in charge, and the Board of Directors are transparent. They welcome all who wish to learn about their residence. You may eat a meal, spend the night, or stay longer if you wish to acquaint yourself with the environment. This is unusual.

Few homes in Mexico choose to be as open. Few homes have web pages with authentic photos. For financial and social reasons, many Mexican homes, if they have an Internet presence, choose Facebook.

Culturally, Jewish people are super organized. They care and support each other well. Yes, this is a biased statement, yet it is based on years of observation. (I was NOT brought up in the Jewish faith).

Let’s do a walk through of Eishel Nuestro Hogar/Eishel Our Home :

First, I was expected. Nice !!

For obvious reasons, there is serious security. The modern compound is walled. Within double-locked doors the guards reviewed my ID, then called the administrator.

I was shown to the courtyard where I waited on a comfortable bench with a view through glass front doors to the synagogue. The air was crisp, dry, and warm. (Cuernavaca is known for its spring climate throughout the year).

Synagogue at Eishel Nuestro Hogar, Cuernavaca, Mexico

Within minutes the administrator (who came on her day off) greeted me with the physician in charge. They generously gave their time for a detailed and meaningful tour of the entire compound.

From an American point of view Eishel is a CCRC – a Continuing Care Retirement Community with independent living, assisted living, rehabilitation, nursing care, and end-of-life accomodation. The difference from most CCRC’s in the U.S. is that you offer a monthly donation, and do not own.

Eishel is an A.C., Asociación Civil, a non-profit that has existed in various forms since 1947, 75 years ago. (The first recognized assisted living with 24/7 care in the U.S. opened in Portland, Oregon in 1981).

The Eishel campus has lovely manicured grounds, two modern two-story residences, an outdoor theater, a sculpture garden, an herb garden, two gazebos, and a wall of plaques recognizing the donors.

A gazebo at Eishel Nuestro Hogar facing the independent living indoor/outdoor dining room

Eishel Nuestro Hogar Donor Garden

The fresh herb garden is maintained by residents, the chef, and kitchen staff. In addition to herbs there are tomatoes, lettuce, peppers, and more. Pineapples, blackberries and strawberries also grow on the grounds.

We visited residents in their comfortable airy rooms, the nursing floor, and stopped by the currently empty end-of-life suite with one large light-filled room for the resident patient and another room for his or her family.

Note : Even though some senior living administrators in Mexico have thought to create hospice within senior living, Eishel is the only residence I have visited that has sustained such a space. HOLA (Hospice of the Angels) tried this concept in their Morelia assisted living residence for two years during the pandemic. Unfortunately HOLA closed for a variety of reasons.

The nursing floor …

Eishel Nuestro Hogar Infirmary

Dr. Golub attending to patients in nursing floor day room at Eishel

Nursing floor dining room with views to nature and tables to accommodate reclining wheelchairs. Visitors from other countries have come to see the unusual curved tables so they might replicate similar practical tables in their nursing areas.

There are two sparkling, immaculate kitchens honoring kosher tradition.

Eishel’s current population of 72, with room for 140, is mostly Mexican. There are residents from Europe and the U.S. The languages most heard are Spanish, Yiddish, and English, in that order. Entrance is for anyone of Jewish faith either Ashkenazi or Sephardic. One must be 65 years of age, wish to live there, and agree to the rules. Persons with aggressive behavior or on dialysis are not admitted. Please see the web site which outlines requirements. Your monthly payment is a donation to the non-profit.

Photo of rehabilitation patio with Dr. Golub greeting residents, and Director Gonzalez in black and beige blouse dancing in front of a resident

Activities include movies (there is a theater), tai chi, trips, art classes, occupational therapy, and more. There is a library. A 70-year-old retired coffee table book author from Mexico City shared with me that he teaches writing. He lives at Eishel for « the fabulous year-round weather, intellectual conversation, the food, and the sense of community. »

According to the director, there is little staff turnover. Some employees stay 25 years.

Every two months Eishel publishes a full-color mini-magazine, a gazeta. There are articles by board members, residents, and staff on a variety of subjects.

Meaning of the name Eishel :

The Hebrew letters Eishel or Aishel (aleph, shin, lamed) are an acronym for Achila (feeding), Shtiya (drinking), and Linah (lodging). Since ancient times, Eishel denoted an inn.

In case you are wondering about population of Jews in Mexico and the rest of the world :

According to the Pew Research Center there are about 14 million Jews around the world representing 0.2% of the global population:

“While Jews historically have been found all around the globe, Judaism is highly geographically concentrated today. More than four-fifths of all Jews live in just two countries, the United States (41%) and Israel (41%).”

According to American Jewish Aging Services there are over 95 Jewish organizations or homes serving older adults in the U.S.

According to Wikipedia approximately 70,000 Jews (both Ashkenazi and Sephardic) live in Mexico (primarily Cuernavaca, Lake Chapala, Mexico City, Puerto Vallarta, and San Miguel de Allende). Another 230,000 live in Argentina.

The first Jews, known as Crypto or Converso Jews because they converted to Catholicism during the Inquisition in Portugal and Spain, came to the Americas with Christopher Columbus on his first expedition (according to Wikipedia and information from the University of Florida George A. Smathers Libraries). They were called cryptos because they secretly practiced their faith but were publicly Catholics.

Summation

My visit was satisfying. Eishel is an unusual Mexican senior home. Its administrators show they are vested in well-being. At this time the residents are mostly Jewish Mexicans and the help is mostly Mexican. The atmosphere is comfortable and convivial, likely the result of residents having much in common. The true reveal would be living there or visiting Eishel over a period of time.

You may read more about the Eishel home and staff at https://www.eishel.org/ or write to mr.gonzalez@eishel.org

Wendy Jane Carrel, MA, is a Spanish-speaking senior care specialist and consultant from California. She has travelled Mexico for several years researching health systems, senior care, and end-of-life care to connect Americans, Canadians, and Europeans with options for loved ones. She has assessed hundreds of senior housing choices in 16 Mexican states. Her web site is https://www.WellnessShepherd.com

Resources:

https://es.wikipedia.org/wiki/Jud%C3%ADos_en_Am%C3%A9rica_Latina_y_el_Caribe   Most Latin American Jews live in Argentina – 230,000; 70,000 live in MX.   In Argentina there are all-Jewish senior care homes, I easily located three on the Internet.  https://beitsion.org.ar/ , https://hogarledorvador.org/quienes-somos/ (modern), https://auno.org.ar/el-hogar-israelita-refugio-para-los-abuelos 4

https://ajas.org/senior-living-resources/find-a-jewish-senior-community/map-of-all-jewish-senior-communities/ map of Jewish senior living communities in the U.S., about 70 total, most in New York, New Jersey, and Florida.

These Bay Area retirees are finding tranquility, and Judaísmo, in Mexico

https://www.tabletmag.com/sections/community/articles/the-jews-of-san-miguel-de-allende

Unbelievable: A Jewish Senior Living Community in a Methodist Corporation
Jewish Assisted Living and Senior Care
Jews

Tree flowers, Lake Chapala, Mexico
Assisted Living Mexico, CCRC's in Mexico, Ex-pats in Mexico, Life Plan Communities Mexico, Mexico Senior Living, Nursing Homes Mexico, Retirement in Mexico, Senior Care Mexico

Senior Living in Mexico – A Chat with SLF’s Steve Moran and Wendy Jane Carrel, Senior Housing and Care Specialist Mexico

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When recovering from dental surgery and in an altered state, I was interviewed by colleague and dedicated senior care advocate Steve Moran. For more than 10 years Steve has published an on-line magazine reaching thousands of U.S. senior housing executives and their teams – Senior Living Foresight.

Below is a link to our overview chat about Senior Living in Mexico which may be located on Steve’s web site, LinkedIn, and You Tube. (Please scroll to bottom of copy to find link if you are interested).


Part of the 36 minute video is out of sync; it also skips and flip-flops in places.


Toward the end Steve talks about a phone number. If you stay through that one minute, there is a brief mention of Medicare. One of the most asked questions by Americans looking to Mexico is: ” will Medicare be accepted”?


The video is not required viewing. 😉 The intention is to offer helpful information.


I am accustomed to researching, interviewing, listening, and participating in private one-on-ones. I am unaccustomed to being the center of attention. I have much to learn about being on camera.

Thank you Steve for including me in the discussion!!!!

Episode 17 – Senior Living In Mexico – The Opportunity


Health & Wellness Mexico, Hospice Mexico, Mexico Senior Living, Palliative Care Mexico, Senior Care Mexico

Mexican-American Nurse Elena Lopez Opens First Residential Hospice in Morelia, Michoacan, Mexico

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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

Website: www.HospiceoftheAngels.org

Facebook page:  https://www.facebook.com/Fundacion-Hospicio-de-Angeles-450224751784959/ 

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.

Assisted Living Mexico, Ex-pats in Mexico, Mexico Senior Living, Nursing Homes Mexico, Senior Care Mexico

Assisted Living Homes at Lake Chapala, Mexico Brace for COVID-19

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Taking care of frail or gently infirm older adults, even in “good” times, is a challenging job. For many of us in senior care it is also a satisfying way to serve, and offers rewarding engagement.

But how does one rally to protect and defend older adults living in senior communities from COVID-19, the newest corona respiratory virus with multiple symptoms and possibly an unmerciful death, perhaps alone?

Precious American senior at a Lake Chapala assisted living home offering love to a little crab

Medical experts and tragic statistics share that older adults are more vulnerable than others to this borderless virus. A recent New York Times article reports an estimated one-fifth of U.S. deaths are linked to nursing facilities often due to inadequate protection and/or compensation for staff who sometimes work in more than one building to financially survive.

COVID-19 is now in Mexico. It flowed from Asia to Europe and the U.S. first. As of April 18, 958 Mexicans over age 60 have been hospitalized and 160 have required intensive care, representing 37% of the population. (No number is known from senior homes if any, but most patients had underlying health conditions).

Inspired by the response of healthcare workers around the world and despite distressing international and local news, all hands are on deck at approximately 25 assisted living/”nursing” homes at Lake Chapala, Mexico, one hour south of Mexico’s second largest city Guadalajara.  Residents are ex-pat and Mexican retirees and do not represent typical populations in other parts of the country.

Garden area, assisted living, Riberas del Pilar, Lake Chapala, Mexico

Important note: In Mexico, there are no nursing homes as they are defined north of the border. Acute care is in hospitals only. Assisted living homes offer some nursing care and rehab. There is more or less a one size fits all approach to senior care in Jalisco state and the rest of Mexico, with exceptions.

Shelter-in-place began March 19, the date of the first confirmed case in Guadalajara. Since then I’ve been engaged by phone and e-mail with home owners and staff where I have found appropriate care for “gringos”.  I am also in touch with precious residents via phone, e-mail, and sometimes Skype.

The virus has probably been present at Lake Chapala far longer than April 22, the date of the first reported but yet to be confirmed COVID-19 case locally.  Why? Because the lake is a major destination for American, Canadian, and European retirees and/or residents who travel extensively.

What protocols have been in place at assisting living/”nursing homes” since mid-March?

First, no visitors allowed, until further notice.

Each lakeside home (4 to 20 residents, owned by Mexicans or ex-pats) is doing what it can to adhere to guidelines from Jalisco Governor Enrique Alfaro and his Ministry of Health, as well as to those of the World Health Organization (WHO). In a land not known for high health standards and cleanliness, and where compliance for the greater good is not the norm, it is impressive what this virus has prompted at assisted living/”nursing homes”.

Restful Assisted Living grounds in San Juan Cosala overlooking Lake Chapala

Hand washing for all, several times. Hand sanitizers at all entry ways.

Hand sanitizer on mini-tables outside every room for doctors, nurses, caregivers, and residents.

Personal Protective Equipment (PPE) such as masks and gloves are provided for staff and residents, including masks for sitting in outside garden areas. These items are in regular supply. This is unusual as hospitals countrywide do not have enough PPE. Outside China, Mexico is the largest manufacturer of PPE. Mexico, ironically, sent a majority of its supplies to help China months ago. There is a cottage industry in every lakeside village making cotton double fabric washable masks at reasonable cost. Not the same as N-95 masks which are intended to be disposed after each use in clinical settings and are a challenge to clean. Home-made masks are, however, a helpful alternative.

Staff has stopped wearing scrubs on their way to work.

Rooms for staff to change from street clothes to scrubs have been created. Some places had these areas before with private lockers included.

Washing machines are going all day with resident clothing and staff clothing.

Staff stopped wearing scrubs to work based on hospital doctors and nurses being assaulted with bleach, hot coffee, eggs, or beatings because scrubs identify them with the virus. From Guadalajara to Merida healthcare worker abuse incidents have been markedly on the rise. Some essential workers have been prevented from entering their apartments or evicted by landlords who fear contagion. In one city, hospital workers now live in a hotel. See The Guardian article at end for more details.

Daily disinfection multiple times of door handles, railings, ground walkways

Double the work keeping dementia care residents safe

Food for kitchens now delivered to entry gates, fewer trips out

Meals served in rooms. Disposable utensils instead of flatware.

So far, no staff shortages and no cases as of this writing. Staff is showing up, fear or not. This could change if the infection takes hold. The majority of healthcare workers are young and have families.

One building picks up all staff for work so they do not travel by bus. The ideal situation, though not possible in most places, is having staff live on campus for the duration of the outbreak. Hogar Miguel Leon, a senior home housing 30 residents in Cuenca, Ecuador, for example, has outside staff living with the nurse nuns who are in charge.

Most homes, despite the added work load for prevention and preparation, are addressing isolation and possible loneliness issues of their residents. Volunteer visitors, outside entertainment, and chair yoga teachers on campus are no longer present. There is instead accelerated collaboration with faith communities, the Lake Chapala Society, other service groups, and individuals providing phone trees and Zoom chats. Adopt-a-Senior is happening. Facebook provides various resource guides for COVID-19 and delivery services on lakeside group pages. Example: one home orders to-go lunches which are delivered by a restaurant every Friday.

Assisted living for abandoned Mexican women near Jocotopec, Lake Chapala. An extraordinary volunteer service is offered by ex-pats.

Technology. There is a sudden rise in Facetime and Skype use. Zoom conferencing has been implemented and used for daily or weekly news and events. For those who are cogent, this technology is happily received.  For the most part, there are not so many innovations for dementia residents. No one has mentioned the use of telemedicine which is on the rise in the U.S.

Culture.  In Mexico, life works depending on who you know. Owners and staff network for support with family, friends, and colleagues for solutions – Facebook reigns.

As mentioned, the majority of homes at Lake Chapala implemented public health advice promptly and with uncommon vigor.

But will the rest of the community outside these homes rally for COVID-19 and honor quarantine and face mask measures?

Is there a way to prevent unprecedented loss of life in assisted living at Lake Chapala?

Senior living homes may not be able to prevent outbreaks, but they are working on delaying them. They are taking known measures to protect vulnerable populations and staff. But the variables are many and luck is required. As in the U.S., testing is slow to arrive.

And, the virus is invisible, so prevention may be an impossible task. Staff could unwittingly be silent carriers. Local quarantines are suggested and are not enforced. Mexicans enjoy gathering in large groups, no matter what, even when they’ve been asked not to.

The song Ay Yay, Yay Yay… Canta, No Llores comes to mind for Mexico in the time of COVID-19. Sing, Don’t Cry, continue on. The words represent a mindset for suffering and profoundly sad situations which the majority of the population has endured for five centuries. The country is rich in resources. Few are well-to-do. The rest struggle to put food on the table. Singing is a way to continue every day.

In closing, gratitude to all Mexican healthcare and essential workers, unsung heroes and heroines. Thank you for your presence. You demonstrate tremendous strength and courage. May you and those you care for be protected in the days ahead.

Final note: The majority of older adults in Mexico cannot afford healthcare, let alone assisted living or in-home care. The majority of assisted living/”nursing home” residents at Lake Chapala are ex-pats, even though there are a number of Mexican residents. Each home has private rooms and baths, few have shared rooms, What’s available at the lake is not typical of the rest of Mexico where almost 900 senior homes are generally more crowded and contagion more likely.

 

Wendy Jane Carrel, MA, is a Spanish-speaking senior care specialist and consultant from California. She has travelled Mexico for several years researching health systems, senior care, and end-of-life care in order to connect Americans, Canadians, and Europeans with options for loved ones. She has investigated hundreds of senior housing choices in 16 Mexican states. Her web site is http://www.WellnessShepherd.com.

 

You have permission to re-post the article when you include author’s name, biography, and contact information as above.

© Wendy Jane Carrel, 2020

Resources:

https://www.theguardian.com/world/2020/apr/23/mexico-health-workers-attacked-covid-19-fears  Mexican healthcare workers being attacked throughout the country

https://medium.com/@richardensor_50805/a-chat-with-mexicos-coronavirus-czar-e2117a3a4757  Economist reporter interviews Mexican Deputy Minister of Health Hugo López-Gatell April 5, 2020, excellent overview of the public health situation

https://mexiconewsdaily.com/news/coronavirus/40-of-seniors-have-survived-covid-19-without-hospitalization/  Mexican seniors who have survived

https://www.bestoflakechapala.com/lake-chapala-steps-up-a-covid-19-resource-guide/

https://www.seniorlivingforesight.net/life-after-covid-19-technologys-starring-role-in-affordable-senior-housing/   technology is making a positive difference for quality of life and care in places where it is affordable and can be implemented

www.reuters.com/article/us-health-coronavirus-canada-seniors/we-are-failing-our-grandparents-canadas-trudeau-says-as-covid-19-hammers-nursing-homes-idUSKCN2253I6  Canadian nursing home situation

https://www.nytimes.com/2020/04/17/us/coronavirus-nursing-homes.html  about a fifth of U.S. virus deaths are linked to nursing facilities

https://ktla.com/news/california/socal-nursing-homes-among-hardest-hit-in-covid-19-outbreak/  list of CA nursing homes affected by virus…. 70%% of deaths in Long Beach.    April 20, 2020

https://www.helpage.org/guidelines-for-care-homes-for-older-people-in-the-context-of-coronavirus-covid19/  Help Age International guidelines for care homes

Assisted Living, Assisted Living Mexico, Death in Mexico, Dying in Mexico, Mexico Senior Living, Senior Care Mexico

Corona Virus Changes Plans for Jalisco, Mexico Older Adults, Travelers, and the World

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Corona Virus is changing where we might be, what we are choosing to do, or what we are restricted from following through with in order to protect the health of others.

This is not a complaint. But it has come to signify postponing meaningful work or gatherings in person, especially with the vulnerable who depend on the presence of family and others who support them.

Circumstances have already created loss and a sense of abandonment for our elders worldwide. You may recall the sad circumstances of elders alone in ICU’s in Italy, as well as in assisted living homes in Georgia and Washington State in recent days where family members may not enter to hold their loved ones as they make their transitions.

Note: This post is being written from Jalisco, Mexico where I have been attending to older adults.

The state of Jalisco  (second largest state with Guadalajara as its capital), lead by Governor Alfaro and public health officials, is doing its best to tame the rise of Corona virus. There are several cases throughout the state, reportedly brought in by a group of wealthy Mexicans who traveled to Colorado to ski in mid-March or by travelers (foreign and Mexican) returning from Germany, Italy, and Spain. All persons except those in necessary services have been asked to stay inside through March 29 except for buying provisions or medicine. No travel unless necessary is another request. It is likely the date will be extended. Borders are still open but flights to other nations have diminished.  So far, not a single assisted living home in Jalisco has reported a case of the Corona virus.

I had plans to see colleagues in the Mexican highlands and then return home to California.  Plans have changed.

I wish to thank several colleagues whom I was going to meet with or revisit in March and early April – folks dedicated to the well-being of older adults.  May we meet again soon.

1001 thanks to Lydia Jane Failing, Francoise Yohalem, and Rev. Tom Roseillo of the Unitarian Universalist Fellowship outreach in San Miguel de Allende, Mexico. Warmest greetings and blessings to each of you, your fellowship, and your community-at-large.

I so appreciated your kind invitation to participate in the seminar “Thoughtful Dying in Mexico” with other colleagues March 20, even though it was necessary to postpone as a form of protection for all. My topic was to have been spiritual aspects of dying in Mexico based on psycho-social-spiritual support of older adults at Lake Chapala, plus my involvement with a palliative care mission in Guadalajara.

My thanks also to the owners of assisted living homes in San Miguel de Allende and Cuernavaca who were waiting for me, as well as to hospice nurse Elena Lopez of Hola Hospice and Luz Serena, an assisted living home in central Morelia with two rooms offering American standard hospice.  I look forward to visiting all of you and writing about your dedication to quality of life for older adults on other dates.

Many thanks to Café Mortality colleagues Debi Buckland, Jane Castleman, Loretta Downs, and Darryl Painter for their dedication at Lake Chapala. We cancelled gatherings for March and April for public health reasons.

Discussions of our wishes and mortality, especially at this time of crisis, may have been meaningful for attendees, not to mention this co-host. We will find other ways to reach out through Facebook posts and more.

And, last but not least, a big shout out to my care liaison colleague in San Miguel de Allende, Deborah Bickel of www.BeWellSanMiguel.com who is deluged with requests for assistance at this time. Deborah’s colleague, nurse practitioner Sue Leonard, was to have been on the UU Fellowship morning panel on March 20.

Where ever you are and whomever you are I pray you are safe, comfortable, and remembering to breathe.  As we reflect on the health of those around us, our own health, and new ways to reach out, let us remember the greater dangers for those less fortunate – the elderly, the homeless, and immigrants on the road, in camps, or in cages.

Please remember our healthcare workers, first responders, drivers, and food purveyors.

Please consider volunteering by sending money to a cause dear to your heart and/or healing thoughts for everyone on your path and on the planet.

And, remember to keep reading inspiring stories if you choose about nail salons converting to sewing centers to make masks, the Chinese manufacturer who sent medical masks in crates to healthcare workers in Italy with a poem by Seneca, the Italians who sing on their balconies to each other, the Spaniards who stand on their balconies applauding healthcare workers as they go off shift at a nearby hospital, the small businesses and their drivers offering take-out throughout the world, and thousands of other folks who make sacrifices as they continue to show up for others.

 

 

Aging, Assisted Living Mexico, Ex-pats in Mexico, Mexico Senior Living, Retirement in Mexico, Senior Care Mexico

Successful Aging Expo San Diego, November 2019

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On November 2 the newspaper San Diego Union-Tribune hosted a free event that attracted a 50+ crowd interested in subjects related to aging. Main speakers were Patricia Schultz (author of 1000 Places to See Before You Die) and Captain Dale Dye, USMC retired (author, filmmaker) focused on veterans and others.

November 2, 2019

Most of the activity at the San Diego Convention Center was at booths. Among the participants offering information were AARP, Leading Age, healthcare service providers, a cancer awareness initiative group, estate planners, Medicare Advantage Plan insurers such as Humana and SCAN, retirement counselors, senior movers, senior living placement consultants, a sleep therapy advisor, and others.

The highlight for me, related to some of my work as a senior placement consultant for Mexico, was to meet up with Miguel Angel Torres and Marisa Molina of Serena Senior Care in Baja California. I toured their Rosarito assisted living home last year and am eager to return to see their latest developments.  I appreciate their dedication, enthusiasm, and focus on quality care. See www.serenacare.net plus links to videos found on their web site.

As an aside, Serena offers residents and visitors to Baja a Full Assistance Card for $99/year ($198 per couple).  The Full Assistance Card offers ambulance services, roadside assistance, a 24-hour bi-lingual call center, discounts, and access to online medical records. Have not seen this service in action so am not in a position to comment on it. Information on this is at the web site listed above.

Miguel Angel Torres, one of his supporters, and Wendy Jane Carrel Assisted Living Consultant for Mexico at Serena Care booth

Corey Avala of www.RetireBaja55.com was also present to encourage folks to retire early and “affordably” to one of three developments he is involved with. Have not seen them.

Jane Garcia, a realtor from Dream Home Mexico was also there to espouse the benefits of retiring to Mexico.

One of the advantages of Baja California for assisted living and retirement, aside from the lower cost of living, is its close proximity to San Diego for health care through the Veteran’s Administration, and U.S. healthcare for American ex-pats who wish to return in case of need.

Many thanks for the warm reception by the San Diego Union-Tribune sponsor team!  Many thanks to the San Diego Union-Tribune for producing the San Diego Eldercare Directory 2020 available in print at the expo, and also available on-line at http://www.sandiegoeldercare.com. The directory includes listings of independent living and long-term care throughout San Diego County.

https://www.youtube.com/watch?v=pjO4FIeS-7g

Assisted Living Mexico, Dying in Mexico, Emergency Medicine Mexico, Ex-pats in Mexico, Senior Care Mexico

Wellness Shepherd Wendy Jane Carrel Shares with Ex-pats about Senior Care in Mexico, Preparing for Medical Emergencies, and Beautiful Dying

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This is an exciting fall month for educational events.

Other than shepherding families to appropriate, compatible Mexican assisted living and ”nursing” care for their loved ones, pastoral care visits to sweet older adults at Lake Chapala (always a pleasure), and coordinating the production of health books (one a translation to Spanish), there are seminars to attend and blog about, plus informational talks I have prepared for ex-pats.

Here’s a partial calendar….

October 3   Future of Medical Cannabis conference on-line.  Medical cannabis is not yet legal in Mexico, lots of challenges related to its release, but all is possible. Am keeping informed of movements in the U.S. and Canada. Some U.S. doctors are titrating down opioid prescriptions and other pain meds for their patients- slowly, by introducing medical cannabis at the same time.

Oct 16        Beautiful Dying in Mexico Power Point presentation at Lake Chapala Society.  In honor of Mexico’s Day of the Dead, Dia de los Muertos, an overview of dying in Mexico – family and religious traditions, rituals, their origins and meaning, and why many Mexicans seem so comfortable with death. Told through stories I’ve been witness to volunteering at a palliative care hospital/hospice and/or as a friend on a village street in Ajijic, Mexico.

Oct 19        Medical Cannabis in Mexico Conference all day in Guadalajara

Oct 22       Preparing for Medical Emergencies at Lake Chapala Power Point presentation at Presbyterian Church

Oct 24-26  4th International Palliative Care Congress at UTEG in Guadalajara produced by www.JuntosContraelDolor.com, the palliative care hospital and service I volunteer with

Oct 30       Focus on Mexico Power Point presentation about Senior Care in Mexico, members only

Assisted Living Mexico, CCRC's in Mexico, Ex-pats in Mexico, Life Plan Communities Mexico, Mexico Senior Living, Senior Care Mexico

Wendy Jane Carrel to Talk About Senior Care/Senior Housing at Focus on Mexico, August 2019

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I always look forward to addressing folks from Canada, Europe and the U.S. at Focus on Mexico one-week seminars, currently held every two to three months at the Real de Chapala Hotel, Lake Chapala, Mexico. 

Most attendees are considering a move to Mexico for a variety of reasons – adventure, climate, housing costs, more affordable healthcare, retirement, and more!

Placard in front of modest assisted living home, Jocotopec, Lake Chapala

The newbies will see my Power Point presentation Thursday morning, August 8, outlining various models of senior living and senior care in Mexico – government, non-profit, and for profit independent living, assisted living, memory care, and Life Plan Communities/CCRC’s. My photos of senior living options are from various states in Mexico from Baja California to Merida in the Yucatan, all ex-pat havens. 

To date, Lake Chapala attracts the fastest growing and largest community of ex-pats in Mexico. 

See http://www.FocusonMexico.com for more info.