First India, now Mexico

Let's face it, the US sucks at this....

Seniors head south to Mexican nursing homes
By Chris Hawley, USA TODAY
AJIJIC, Mexico - After Jean Douglas turned 70, she realized she couldn't
take care of herself anymore. Her knees were giving out, and winters in
Bandon, Ore., were getting harder to bear alone.
Douglas was shocked by the high cost and impersonal care at assisted-living
facilities near her home. After searching the Internet for other options,
she joined a small but steadily growing number of Americans who are moving
across the border to nursing homes in Mexico, where the sun is bright and
the living is cheap.

For $1,300 a month - a quarter of what an average nursing home costs in
Oregon - Douglas gets a studio apartment, three meals a day, laundry and
cleaning service, and 24-hour care from an attentive staff, many of whom
speak English. She wakes up every morning next to a glimmering mountain
lake, and the average annual high temperature is a toasty 79 degrees.

"It is paradise," says Douglas, 74. "If you need help living or coping, this
is the place to be. I don't know that there is such a thing back (in the
USA), and certainly not for this amount of money."

As millions of baby boomers reach retirement age and U.S. health care costs
soar, Mexican nursing home managers expect more American seniors to head
south in coming years. Mexico's proximity to the USA, low labor costs and
warm climate make it attractive, although residents caution that quality of
care varies greatly in an industry that is just getting off the ground here.

FIND MORE STORIES IN: American | Mexico | Mexican | San Miguel de Allende
An estimated 40,000 to 80,000 American retirees already live in Mexico, many
of them in enclaves like San Miguel de Allende or the Chapala area, says
David Warner, a University of Texas public affairs professor who has studied
the phenomenon. There are no reliable data on how many are living in nursing
homes, but at least five such facilities are on Lake Chapala alone.

"You can barely afford to live in the United States anymore," said Harry
Kislevitz, 78, of New York City. A stroke victim, he moved to a convalescent
home on the lake's shore two years ago and credits the staff with helping
him recover his speech and ability to walk.

"Here you see the birds, you smell the air, and it's delicious," Kislevitz
said. "You feel like living."

Many expatriates are Americans or Europeans who retired here years ago and
are now becoming more frail. Others are not quite ready for a nursing home
but are exploring options such as in-home health care services, which can
provide Mexican nurses at a fraction of U.S. prices.

"As long as the economies of the United States and Europe continue to be
strong, we're going to see people coming here to Latin America to pass their
final days," said Oscar Cano, manager of Apoyo a los Miguelenses Ancianos, a
non-profit group that runs a nursing home in San Miguel de Allende.

Cozy cottage, meals, health care

Retirement homes are relatively new in Mexico, where the aging usually live
with family. There is little government regulation. Some places have
suddenly gone bankrupt, forcing American residents to move. Some Mexican
homes have rough edges, such as peeling paint or frayed sofas, that would
turn off many Americans.

"I don't think they're for everyone," said Thomas Kessler, whose mother
suffers from manic depression and lives at a home in Ajijic. "But basically,
they've kept our family finances from falling off a cliff."

Residents such as Richard Slater say they are happy in Mexico. Slater came
to Lake Chapala four years ago and now lives in his own cottage at the Casa
de Ancianos, surrounded by purple bougainvillea and pomegranate trees.

He has plenty of room for his two dogs and has a little patio that he shares
with three other American residents. He gets 24-hour nursing care and three
meals a day, cooked in a homey kitchen and served in a sun-washed dining
room. His cottage has a living room, bedroom, kitchenette, bathroom and a
walk-in closet.

For this Slater pays $550 a month, less than one-tenth of the going rate
back home in Las Vegas. For another $140 a year, he gets full medical
coverage from the Mexican government, including all his medicine and insulin
for diabetes.

"This would all cost me a fortune in the United States," said Slater, a
65-year-old retired headwaiter.

On a recent afternoon, lunch at the Casa de Ancianos consisted of vegetable
soup, beet salad, Spanish rice, baked dogfish stuffed with peppers, garlic
bread and a choice of four cakes and two Jell-O salads. Slater's neighbor
doesn't like Mexican food, so a nursing home employee cooks whatever she
wants on a stove beside her bed.

Like many retirees, Slater has satellite television, so he doesn't miss any
American news or programs. When he wants to see a movie or go shopping
downtown, the taxi ride is only $2-$3. Guadalajara, a culturally rich city
of 4 million people, is just 30 miles away.

For medical care, Slater relies on the Mexican Social Security Institute, or
IMSS, which runs clinics and hospitals nationwide and allows foreigners to
enroll in its program even if they never worked in Mexico or paid taxes to
support the system. He recently had gallbladder surgery in an IMSS hospital
in Guadalajara, and he paid nothing.

Many of the nursing home employees speak English, and so does Slater's
doctor.

The Casa de Ancianos began taking in foreigners in 2000 as part of an effort
to raise extra money, director Marlene Dunham said. It built the cottages
especially for the Americans and uses the income received from them to
subsidize the costs of the 20 Mexican residents at the home.

The program was so successful that the nursing home has plans for 12 more
cottages, a swimming pool, a Jacuzzi and a gazebo with picnic area. The
nursing home now advertises on the Internet and through pamphlets
distributed in town. Some U.S. companies have also begun investing in
assisted-living facilities in Mexico, said Larry Minnix, president of the
American Association of Homes and Services for the Aging, which represents
5,800 nursing homes and related services.

However, Minnix cautioned that lax government regulation poses dangers at
smaller homes.

"It's the same danger you have of going across the border looking for cheap
medications," Minnix said. "If you don't know what you're getting, and
you're not getting it from people you trust, then you've got an accident
waiting to happen."

'Nice place, but it's lonesome'

Since many nursing homes are run out of private homes, regulation by state
health departments is often spotty. Managers such as Beverly Ward of Casa
Nostra and Maura Funes of El Paraiso, both in Ajijic, said that Mexican
officials inspect them only once a year, unlike U.S. inspectors, who may
visit a home several times a year.

The U.S. Embassy said it had no record of complaints against Mexican nursing
homes, but some residents in the Lake Chapala area reported bad experiences
at now-defunct homes.

The first home that Jean Douglas lived in after she moved from Oregon was
staffed by "gossips and thieves," she said. It went out of business.

Irene Chiara of Los Angeles also lived in a home that was shut down by
Jalisco state authorities.

"It was filthy, and the food was very bad. It was all made in the
microwave," she said.

Some Mexican managers also underestimate the costs and difficulty of running
a retirement home. Two hotels turned into assisted-living facilities, The
Spa in San Miguel de Allende and The Melville in the Pacific Coast city of
Mazatlán, recently abandoned the business, their managers said.

"It was very expensive to run it," said Luis Terán, manager of The Melville.

Some managers said they were especially selective when admitting foreign
residents, to make sure they'll be able to pay. Medicare, Medicaid, the
Department of Veterans Affairs and most U.S. insurance companies will not
cover care or medicine as long as patients are outside the United States.

Some American residents said they had doubts about the quality of Mexican
medical facilities and would go back to the United States if they became
seriously ill. Jim May, 74, a resident of the Casa de Ancianos, said he
recently decided to move to Texas to be closer to Veterans Affairs
hospitals.

The language barrier can be daunting, and Mexican food can be very
different, some residents said.

Some residents said they miss home and find it hard to make friends with
Mexican residents. "It's a very nice place, but it's lonesome," said Polly
Coull, 99, of Seminole, Fla., a resident at Alicia's Convalescent Nursing
Home in Ajijic.

Mexican entrepreneurs are doing their best to prepare for a tide of
Americans.

In the Baja Peninsula town of Ensenada, the Residencia Lourdes opened in
2003, offering care for patients with Alzheimer's disease and senile
dementia. The towns around Lake Chapala have at least five small retirement
homes. Most of them opened in the last five years and house from one to 25
foreigners.

The largest, Alicia's Convalescent Nursing Home, consists of four renovated
homes, one of them specializing in stroke victims and another for
Alzheimer's patients. Prices range from $1,000 to $1,500 a month and include
everything except medicine and adult diapers. The rooms are outfitted in
Mexican style, with murals, hand-carved beds, arched ceilings lined with
brick and individual patios.

In other American enclaves, in-home nursing services have sprung up to serve
the retirees. In Rosarito, just south of the U.S. border, INCARE provides
nursing aides to retirees starting at $8.33 an hour, less than half the cost
of the same service in nearby San Diego.

Developers look to Mexico

Developers of "independent living" facilities for seniors are also beginning
to look to Mexico. A Spanish-U.S. venture is building Sensara Vallarta, a
250-unit condominium complex aimed at Americans 50 and older in the Pacific
Coast resort of Puerto Vallarta. And in the northern city of Monterrey, El
Legado is marketing itself as a "home resort" for seniors.

Academics and government officials are beginning to take notice. In March,
the University of Texas at Austin held a forum for developers, hospital
officials, insurance companies and policymakers to discuss health care for
retirees in Mexico.

"With the right facilities in place, Mexico could give (American retirees) a
better quality of life at a better price than they could find in the United
States," says Flavio Olivieri, a member of Tijuana's Economic Development
Council, which is seeking funding from Mexico's federal government to build
more retirement homes. "We think this could be a very good business as these
baby boomers reach retirement age," he says.

Hawley is the Latin America correspondent for The Arizona Republic and USA
TODAY.

Posted 5d 7h ago
Updated 4d 20h ago E-mail | Save | Print | Reprints & Permissions |
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