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Seniors Head to Mexico for Cheaper Nursing Care - Arizona RepublicAugust 16, 2007
Richard Slater lives at a nursing home in Mexico, comfortably settled into his own cottage surrounded by purple bougainvillea and pomegranate trees.
Here, he has plenty of room for his two dogs. He shares a little patio 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.
For this, Slater pays just $550 a month, less than one-tenth of the going rate back home in Las Vegas. For an additional $140 a year, he gets complete medical coverage from the Mexican government, including all his medicine and insulin for his diabetes.
"This would all cost me a fortune in the United States," said Slater, a 65-year-old retired headwaiter. "I'm real happy with the place."
As the tidal wave of baby boomers reaches retirement age and U.S. health-care costs soar, some seniors are moving into nursing and retirement homes south of the border, drawn by the low prices, mild climate and often-friendlier care. Others have discovered in-home health-care services, which can provide Mexican nurses at a fraction of U.S. prices. Communicating is rarely a problem in popular retiree enclaves, where there are doctors and nurses who speak English.
Many of the Americans seeking care are expatriates who retired to Mexico years ago and are now becoming more frail. Others were brought down by adult children who live and work in Mexico. And a few, like Slater, are recent transplants who simply decided they could get more value for their buck at a retirement home outside the United States.
"You can barely afford to live in the United States anymore," said Harry Kislevitz, 78, of New York. He moved to a convalescent home on the shore of Mexico's Lake Chapala two years ago after suffering a stroke.
Not all Mexican homes are so good, residents warn. Retirement homes are relatively new in Mexico, and there is little government oversight. Some have gone bankrupt, forcing residents to move.
And 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."
Land of retirees
Experts predict a coming surge for long-term care in Mexico as the first of some 78 million American baby boomers reach retirement age and begin looking for inexpensive places to live. About 40,000 to 80,000 American retirees live in Mexico, along with an equal number of Mexican-Americans who have retired to their home country, said David Warner, a University of Texas public-affairs professor who has studied the phenomenon.
Meanwhile, U.S. health-care prices are soaring. In 2006, the average rate for a private room in a nursing home was $206 a day, according to a study by the MetLife insurance company. At Mexican nursing homes contacted by The Republic, the rate was $18 to $50 a day.
Jean Douglas decided to make the leap to Mexico three years ago.
At 71, she was getting frail and knew she needed a nursing home. Her knees were giving out, and the winters in Bandon, Ore., were getting harder to bear alone.
She looked at nursing homes in Oregon but was shocked by the high cost and impersonal care.
So Douglas moved to Lake Chapala, eventually checking into the Casa Nostra, a nursing home. For $1,300 a month, she gets a studio apartment with kitchenette, three meals a day, laundry and cleaning service, and 24-hour care.
"It is paradise," she said. "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 United States), and certainly not for this amount of money."
Slater, the retired headwaiter, came to Lake Chapala four years ago. He loved the weather and the vibrant retiree community but quickly decided he needed more help. He has difficulty standing up and walking.
So two years ago, Slater moved into a cottage on the grounds of the Casa de Ancianos, a non-profit nursing home in the town of Chapala. The cottage has a living room, bedroom, kitchenette, bathroom and walk-in closet.
On a recent day, the prepared lunch 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 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 $2 to $3.
For medical care, Slater pays $140 a year for membership in the Mexican Social Security Institute, or IMSS, which runs clinics and hospitals nationwide. He recently had gallbladder surgery in an IMSS hospital in Guadalajara, and it didn't cost him anything.
The Casa de Ancianos began taking in foreigners in 2000 to raise extra money, Director Marlene Dunham said. It built the cottages for them and uses the income to subsidize the costs of the home's 20 Mexican residents. The program was so successful that there are plans for 12 more cottages.
The downside
Some U.S. experts are concerned about the increasing popularity of Mexican nursing homes, noting that developing countries are often less diligent about regulation.
"It's the same danger you have of going across the border looking for cheap medications," said Larry Minnix, president of the American Association of Homes and Services for the Aging.
"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."
Two of eight nursing-home managers interviewed by The Republic said they did not have state health department licenses. Others said Mexican officials inspect the homes only once annually, unlike in the United States, where inspectors 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 in the Lake Chapala area reported bad experiences at now-defunct homes.
The first home Douglas lived in was staffed by "gossips and thieves," she said. It went out of business.
Irene Chiara of Los Angeles lived in a home that was shut down by Jalisco state authorities.
"It was filthy, and the food was very bad," she said.
Some Mexican managers underestimate the difficulty of running a retirement home. Two hotels that became assisted-living facilities in the town of San Miguel de Allende and the Pacific Coast city of Mazatln recently abandoned the business because of the costs, their managers said.
Americans also face another dilemma when deciding to live abroad: Medicare, Medicaid, the Department of Veterans Affairs and many U.S. insurance companies will not pay for services outside the United States. Retirees near the border can commute to U.S. hospitals, but others are effectively cut off from their benefits.
Jim May, 74, a resident of the Casa de Ancianos in Chapala, said he recently decided to move to Texas to be closer to the VA hospitals.
"That's not to say these doctors here aren't good, but they don't have the same facilities and the technology," May said.
Living in Mexico isn't always easy, residents said. The language barrier can be daunting and the food very different. Some residents said they miss home and find it hard to make friends.
"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.
Growing business
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 Alzheimer's and senile-dementia patients. The towns around Lake Chapala have at least five small retirement homes, most of them opened in the past five years and house up to 25 foreigners. Villa Hogar in Guadalajara and ALMA in San Miguel de Allende both began taking in foreigners in 2002.
In-home nursing services have also sprung up.
In Rosarito, Incare provides nursing aides to retirees starting at $8.33 an hour, less than half the cost in nearby San Diego. The company started two years ago and has served about 150 clients, owner Marcia Napoli-Tejeda said.
In San Miguel de Allende, At Home Care has placed about 200 nurses in foreigners' homes since opening in 2003, owner Robin Fell said.Developers of "independent living" facilities are also looking to Mexico.
Front Porch, a non-profit corporation that runs 41 retirement homes in the United States, will begin construction in October on Luma, a 400-condo development for seniors in Puerto Vallarta, said Lee Ratta, senior vice president for the group's development arm. The development will offer in-home caregivers as residents get older, she said.
A Spanish-U.S. venture is building Sensara Vallarta, a 250-condo complex in Puerto Vallarta aimed at Americans 50 and older.
Academics and government officials are beginning to take notice. In March, the University of Texas held a forum to discuss health care for retirees in Mexico.
Some Mexican officials think caring for America's aged could be a major new industry. The Tijuana Economic Development Council produced a 120-page study this year on how to attract Americans to nursing homes south of the border.
The council is now seeking federal funds to provide seed money for more retirement homes. At its urging, the local campus of Iberoamerican University launched a gerontology program, and the University of Baja California is expanding its nursing school.
"We think this could be a very good business as these baby boomers reach retirement age," said Flavio Olivieri, a council member. "With the right facilities in place, Mexico could give these people a better quality of life at a better price than they could find in the United States."
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