ExPat Guide Archives

Assisted Living Checklist

March 13, 2019

by Cielito Lindo ExPat Guide

There is so much to cover when selecting care facility that it is best to do so with a checklist. Here is an abbreviated checklist. You can download the full checklist as a PDF form from our website at www.CielitoLindoSeniorLiving.com

General Observations

You are greeted and feel welcome?

Staff members are genuinely kind and caring to residents?

Staff call residents by name?

How many living units are there?

Residents appear engaged and happy?

Staff

What is the ratio of staff to residents?

Staff and residents are well-groomed?

Doctor (GP, Gerontologist) on-site full-time?

Psychologist on-site full-time?

Physical Therapist on-site full-time?

Are there qualified staff to administer medications?

Meals

Meals are nutritious and appealing?

Meals may be tuned to individual residents dietary needs?

Do they have a special memory care dining program?

Rooms/Suites/Facilities

Residence is clean and scent-free?

The facilities are aesthetically appealing, warm and inviting?

The layout and floor plan make rooms and communal spaces easy to find?

Do the rooms provide safety, warmth, comfort, privacy and opportunity for personalization?

Are there outdoor spaces that are accessible, warm, beautiful and inviting where residents can enjoy fresh air, sunshine and be able to socialize?

Is the residence cheerful?

Do you feel good about it?

Are stairs and hallways well lit?

Are exits well marked?

Do rooms and bathrooms have handrails and call buttons?

Are there safety locks on the doors and windows?

Are there security and fire safety systems?

Is there an emergency generator or alternate power source?

Is the floor plan logical and easy to follow?

Are the rooms large enough for the resident’s needs?

Temperature is comfortable?

Lighting is good?

Are different sizes and types of units available?

Are all the rooms private?

Are bathrooms private?

Does the residence offer special care units such as those serving people with Alzheimer’s disease?

Activities/Care

There is a robust set of activities that your loved one will enjoy and benefits from?

Is an individual plan of care maintained for each resident? Does that care properly address the unique, physical, cognitive, behavioral and medical needs of each guest

Are the residents and families included in the process of preparing care plans?

What additional services are available if the needs of a resident change?

Who coordinates and supervises outside care-provider visits?

Is there a physician who visits the facility regularly, or better yet, on-site? What about a physical therapist? Psychologist? Gerontologist? Holistic Medical Practitioner?

What is the policy for handling medical emergencies?

Do they have an assisted-living-to-Alzheimer’s care bridge program for early-stage patients?

Do they have walking paths or circular walking paths for residents?

Snoezelen rooms? Or other light treatment?

Do they group residents by cognitive level?

Do they offer pet therapy?

Music therapy?

Reminiscence therapy?

Safety

What is the policy and practices for handling medical emergencies?

What additional services are available if the needs of a resident change?

Handrails are available throughout hallways?

Who coordinates outside care-provider visits?

Exits are clearly marked?

Total Assistance

What sort of efforts are taken to make this entire process easier for the caregiver, family and friends?

Easilty to schedule and conduct video calls

Facilitating relocation, perhaps into associated CCRC?

Regular reports and photos

Helping by offering the lowest costs possible?

Helping to reduce Rx costs with Pharmacy partnership?

Contract

Is a contract available that details fees, services, and admission and discharge policies?

Is the contract easy to read?

Do you understand everything in it?

Are specific services provided by the residence?

Does the contract include all of the services you are looking for?

How frequently are services provided?

What do additional services cost?

Are health care services included?

When and where are meals served?

Which ones?

Does the contract address levels of care? How many?

Are linens/laundry provided?

Are all meals served 7 days a week?

Who determines level of care? Are there services for each level?

Are transportation services provided?

Does the residence offer worship services?

What are the entrance fees?

What is the security deposit?

What is the monthly rent?

Are security deposits refundable?

Are utilities included?

Is telephone included? Long distance?

How are rate increases handled?

Does the contract cover transfer and discharge policies?

Who makes transfer and discharge decisions?

Is the living area held if the resident is in the hospital?

Can you have a pet?

Can you have personal furniture?

Can you come and go at will?

Can personal visitors come and go at will?

Does the contract deny your right to bring legal action against the residence for injury, negligence, or other cause?

Download Assisted Living Checklist – For your convenience, our comprehensive Assisted Living Checklist is available for download as a PDF. Additionally, give us a call at +1.888.406.7990 or email us at information.cielitolindo@gmail.com. We would love to hear from you.

Personal Effects and Supplies

March 10, 2019

by Cielito Lindo ExPat Guide

Admitting a loved one to a care facility is a significant transition, both for them and for you as the caregiver. To ease this transition, personalizing their new space with familiar items is key to providing comfort and a sense of continuity.

Here is a video about our admission process: click here

Personalizing the New Space:

Familiar Keepsakes: Bring items that hold sentimental value or evoke positive memories, such as family photos, treasured artwork, or a beloved figurine. These items can serve as touchstones to their identity and history, offering reassurance in unfamiliar settings.
Comfort Items: Incorporate favorite pillows, a cherished bedspread, or a cozy throw to create a homely atmosphere. These comforts from home can help alleviate feelings of displacement.
Clothing: A practical selection of clothing should be brought along, considering ease of wear, comfort, and the new environment’s climate. Store additional clothing to rotate as needed for changing seasons or wear.
Room Setup: Many facilities offer flexibility in room decoration. You may be able to bring in furniture, lighting, and rugs to recreate a familiar setting, provided they don’t pose safety risks. Check with the facility about their policies to ensure compliance and discuss any potential concerns about theft or damage.

Ongoing Needs:

Replenishing Supplies: As the initial stock of clothes and supplies diminishes, plan for replenishing these items. This can be done through the facility’s services or personally by you, depending on preference and convenience.
Clothing Management: Label clothing and other personal items to prevent loss. Facilities may have communal laundry services, and labeled items are more likely to be returned to the correct resident. Consider the practicality and ease of laundering when choosing which clothes to bring.
Storage Solutions: Keep additional belongings organized and stored in a way that allows for easy access when it’s time to refresh or replace items in the facility. This could be in a storage unit, a designated space in your home, or an allocated area in the facility if available.

Communication with Facility Staff:

Maintain open communication with the facility staff regarding your loved one’s preferences and needs. Staff can be invaluable in helping you understand the nuances of care in the facility and how to best utilize the space and services available to ensure your loved one feels at home.

By thoughtfully curating the personal effects that accompany your loved one into a care facility, you can significantly reduce the anxiety associated with such a profound change in their living situation. These personal touches not only bring comfort but also reaffirm their individuality and dignity during this next phase of life.

Download the Expatriate Guide for Senior Living in Mexico – For your convenience, the entire 50-page guide is available for download as a PDF. Additionally, give us a call at +1.888.406.7990 or email us at information.cielitolindo@gmail.com. We would love to hear from you.

Making the Transition

March 9, 2019

by Cielito Lindo ExPat Guide

Transitioning a loved one to an assisted living facility is often emotionally charged, encompassing a breadth of feelings from stress to profound grief. Recognizing that grief is not solely tied to death, but also to significant life changes, is essential. The loss of self-reliance, the familiarity of home, and community can lead to deep-seated feelings of vulnerability and a sense of identity loss.

Embracing the Emotional Journey: It’s critical to give your loved one space and time to process these complex emotions. Encouraging open communication, providing a sympathetic ear, or seeking professional counseling can be beneficial. Allow them the time they need to grieve and adjust to this new chapter in their life.

Facilitating a Smoother Transition: To ease the move:

Prepare in Advance: Begin sorting and packing well before the move date to avoid last-minute stress and rushed decisions.
Set Expectations: Familiarize both yourself and your loved one with the facility beforehand. Understanding what to expect can alleviate anxiety and provide clarity.
Encourage Engagement: Prompt your loved one to participate in activities and socialize within the new community. This engagement is crucial for acclimation and can foster a sense of belonging.
Be Patient: Adjusting to change is highly individual. Support your loved one in their process, but if adjustment seems particularly challenging, encourage discussions with family, facility staff, or friends who can offer additional support.

Supporting the Move: When supporting a loved one’s move:

Validate Their Feelings: Acknowledge the upheaval they are experiencing. Avoid downplaying their emotions or pushing an overly positive narrative. Respect and empathy are key.
Maintain Contact: Frequent visits or calls help reassure your loved one of your continued care and involvement in their life. Include them in family gatherings when possible.
Address Concerns Collaboratively: Take any concerns seriously and work together to find solutions. Be prepared to explore alternative options if necessary.
Personalize Their Space: Assist your loved one in making their new space feel like home with cherished items. However, let them guide the process, ensuring it reflects their preferences and comforts.

Advice for Friends and Relatives:

Do:

- Assist with sorting and moving if asked.
- Listen to reminisces and feelings about what’s been left behind.
- Be supportive, even if you disagree with the move.
- Recognize the significance of this life change.
- Keep in touch frequently, especially during the initial period.
- Remain positive and patient, offering smiles and understanding.

Don’t:

- Dominate the moving process or decisions.
- Make the move about your own feelings.
- Dismiss the importance of the decision.
- Trivialize the transition.
- Rush to sell the former home.
- Make unfeasible promises.
- Exude negativity.

A loved one’s move to an assisted living facility is a profound transition for everyone involved. Navigating it with care, empathy, and support can significantly impact their experience, helping them to embrace this new phase with dignity and a sense of continuity.

Staying in Touch

March 8, 2019

by Cielito Lindo ExPat Guide

Maintaining contact with a loved one in an assisted living or memory care facility is crucial, and modern technology offers various avenues to ensure consistent and meaningful communication. Facilities that understand the importance of this connectivity often provide resources to help bridge the distance between families and residents.

Some of the more common applications for voice and video calls, beyond the basic telephone, include: Skype, WhatsApp, Google Hangouts, and FaceTime (Apple only).

Communication Pods: The concept of a ‘communication pod’ in a facility is an excellent service, providing residents with access to phones and computers. This dedicated space allows for uninterrupted voice and video calls, which are essential for families who cannot visit in person frequently.

Popular Communication Applications: There are several user-friendly applications that have become staples for virtual communication:

Skype: A widely used platform for video and voice calls, available on multiple devices.
WhatsApp: Offers text, voice, and video calling options, and is particularly popular for international communication due to its encryption and ease of use.
Google Hangouts: A versatile tool for messaging, voice, and video calls, integrated with Google’s suite of services.
FaceTime: An Apple-exclusive application that provides high-quality video calls for users with Apple devices.

Visits and Travel Considerations: While in-person visits are the most intimate form of communication, work, family obligations, and the distance to facilities, especially those abroad, like in Mexico, can make regular visits challenging. In selecting a facility, consider how they might assist with local travel logistics, easing the burden of planning for visits.

Video Calls as a Lifeline: When in-person visits aren’t feasible, video calls become a lifeline, allowing for face-to-face interaction. Ensuring your loved one’s facility supports and facilitates this technology is paramount.

Local Advocacy: Having a local advocate or friend periodically check on your loved one can offer peace of mind. This person can provide updates and perhaps even assist with setting up and facilitating virtual calls.

Relocating to Mexico: For caregivers considering relocation, Mexico presents an attractive option for its beauty and cost-effectiveness. Moving closer to the care facility not only makes visits easier but also allows caregivers to enjoy a favorable climate and lifestyle during their retirement years.

In summary, when geography imposes limitations, technology and a supportive care facility can play significant roles in keeping the channels of communication open. Whether it’s through a dedicated ‘communication pod’, regular video calls, or the support of local friends, it’s essential to remain actively involved in your loved one’s life, ensuring they feel cared for and connected, no matter the distance.

Admission

March 6, 2019

by Cielito Lindo ExPat Guide

The admission process is more than just a paperwork formality. Typically, this is where considerable information is gathered and your loved one is assessed to determine if the assisted living or memory care facility is the right place for this individual that is being presented for admission.

Information from the prospective resident’s doctor is gathered and evaluated. This typically includes:

Comprehensive Medical Evaluation:

Historical and Current Medical Information: A thorough review of past and present medical records, including any psychiatric or therapy notes, is essential. This historical context provides insight into the progression of any medical conditions and the effectiveness of past treatments.
Doctor’s Letter: A letter from the current physician, especially if they are recommending the care facility, is a critical component. It typically outlines the necessity for assisted living or memory care and may suggest specific care requirements based on the doctor’s longstanding knowledge of the patient.
Prescriptions and Supplements: A detailed list of current medications, vitamins, dietary needs, and any holistic or over-the-counter treatments the resident is undergoing is crucial for maintaining continuity of care and ensuring no interruption to their regimen.
Caregiver-Provided Medical Details: The caregiver’s input on allergies, previous surgeries, injuries, and other pertinent medical history helps paint a complete picture of the resident’s health status.

Formulating a Care Plan:

Using the gathered information, the facility’s medical team will conduct physical and psychological assessments to establish a tailored care plan that addresses all aspects of the resident’s health and well-being, including physical care, emotional support, cognitive activities, dietary needs, and medication management.

Navigating the Emotional Journey:

Acknowledging Reality: Each step in the admission process can bring the caregiver face-to-face with the stark reality of their loved one’s situation. It can solidify the gravity of the decision to transition to facility care.
Touring Facilities: Visiting potential facilities can elicit a mix of emotions, from hope about the quality of care available to anxiety about the changes it will bring to your loved one’s life.
The Admission: The act of admission is often when the situation becomes tangible. It’s a definitive step in acknowledging that a new chapter in the loved one’s care is beginning.
Returning Home Alone: For many caregivers, leaving their loved one in the care of others and returning to an emptier home is profoundly impactful. It’s a vivid reminder of the change in both the caregiver’s and the resident’s daily lives.

It’s important to recognize these steps as significant emotional markers, not just for the resident, but also for the caregiver. Support, whether through family, friends, counseling, or caregiver support groups, is crucial during this time. It’s vital for caregivers to acknowledge their feelings, seek support, and allow themselves time to adjust to the new dynamics. The admission process, therefore, is a critical convergence of clinical diligence and emotional transition, marking a new phase in the journey of care.

Payments

March 4, 2019

by Cielito Lindo ExPat Guide

Payment for services in another country, such as Mexico is a little more complicated than just dealing with the currency exchange rate, although that is something to consider as well. When the exchange rate is particularly good, some people buy CDs in Mexico with various maturity dates. The idea is to get a good return on the money until you need it, yet have it available when needed. Typically, this money is drawn upon when the exchange rates are not as favorable.

One very simple approach towards payments is to write future dated check in US dollars for each month’s rent until your next visit. The same is done for an estimated additional cost covering supplies, prescriptions and so on.

Another approach that is a little more complicated and usually has a fee associated with it is to pay via wire transfer. Some banks, like Schwab, do not charge for wire transfers.

Some thoughtful Mexican assisted living facilities recognize the challenges presented in paying for services in another country. As such, and as part of their ‘total assistance’ philosophy, they are starting to offer other more flexible payment avenues such as Zelle, Venmo, PayPal and credit card. Perhaps they will even accept Bitcoins and Apple Pay in the future.

Relocation to Mexico for Retirement

March 1, 2019

by Cielito Lindo ExPat Guide

Retiring or relocating to Mexico, whether independently or as a caregiver, opens up a world of opportunities. This country’s rich cultural tapestry, stunning architecture, captivating history, diverse cuisine, and affordable living conditions make it an attractive destination for many.

Depending on your and your spouse’s/partner’s age and health, an ideal location would provide the flexibility and range of options more commonly found through a CCRC (continuous care retirement community). This sort of setup would offer a lot of flexibility in both living arrangements and the spectrum of options for care.

Exploring CCRC Options:

A Continuous Care Retirement Community (CCRC) in Mexico offers a versatile range of options suitable for various stages of retirement. Such a community provides the flexibility to transition smoothly from independent living to more comprehensive care as needs evolve.

Example of Mexican CCRC – Cielito Lindo:

Cielito Lindo, nestled within Rancho los Labradores near San Miguel de Allende, exemplifies a full-spectrum CCRC. It boasts amenities like cobblestone streets, serene water features, cozy cafés, and a hotel for extended stays, all surrounded by affordable and attractive homes. The community provides a blend of independent living spaces and comprehensive care facilities, all within a short shuttle ride to the vibrant heart of San Miguel.

San Miguel de Allende – A Retiree’s Haven:

Relocation to San Miguel de Allende is an extraordinary option. It is truly a beautiful Spanish colonial city. UNESCO has declared San Miguel to be a World Heritage Site in 2008.

Wikipedia has some great information on San Miguel: https://en.wikipedia.org/wiki/San_Miguel_de_Allende

Travel + Leisure has voted San Miguel as the best city in the world: https://www.travelandleisure.com/worlds-best/san-miguel-de-allende-best-city-in-the-world

The city is so unbelievably charming, beautiful, enchanting, and welcoming. There is a lot of art and culture, and yet, a strong US and Canadian expatriate presence. And while the cost of living has gone up over the last 10-20 years due to the popularity of the city, it is still profoundly less expensive than living in the US.

Financial Considerations:

One of the primary motivations for relocation to Mexico may be economic, especially for those who have experienced financial setbacks or are seeking to maximize their retirement savings. The cost of living in Mexico is approximately half that of living in the United States, although this can vary depending on your current and future locations.

Addressing Common Concerns:

Affordability: Despite the lower cost of living, the move involves additional expenses such as travel and health insurance. However, the reduced yearly living costs, including more affordable assisted living options, can offer significant financial relief.
Cultural Differences: While adapting to a new culture can be daunting, the warmth and hospitality of the Mexican people can make the transition a pleasurable experience.
Safety: Safety concerns are often overstated. With sensible precautions, similar to those one would take in any new environment, living in Mexico can be as safe as living in the U.S.
Food Differences: Mexican cuisine is rich and varied, and while it may differ from American dishes, the regional diversity offers something for every palate.
Language Barrier: English-speaking staff in expatriate-focused retirement communities can ease communication challenges, but learning Spanish can enhance daily living and enrich the experience.
Complexities and Logistics: While moving to Mexico does present logistical challenges, they are manageable with proper planning and guidance, which this guide aims to provide.

Determining if It’s Worth It:

Ultimately, the decision to relocate hinges on personal circumstances, preferences, and values. The care quality, setting, and affordability in Mexico, particularly for memory care or hospice needs, are compelling reasons to consider such a move. With cities like Puerto Vallarta, San Miguel, Ajijic, Lake Chapala, and Cabo San Lucas offering distinct lifestyles and senior living options, the potential for an enriched and cost-effective retirement is significant.

Relocating to Mexico can offer a fulfilling and financially viable solution for retirement living, providing care in a setting that nurtures both body and soul. Whether for oneself or a loved one, the benefits of a Mexican CCRC can make it a decision well worth considering.

Estate Planning Abroad

February 27, 2019

by Cielito Lindo ExPat Guide

You have been spending some time living the expat life in Mexico and you have taken the effort to explore your options before settling down. Now that you are sure you want to stay for a while and where you want to live, you have also decided that you want to invest in a home.

There are compelling reasons to consider making real estate a part of your international investment portfolio. But what is often overlooked is a strategy to pass on the property to your loved ones in the easiest way possible after you’re gone.

Legal Assistance is Key:

Hire a Local Lawyer: The inheritance laws in civil law countries can be vastly different from those in common law countries like the U.S. A local lawyer will understand the nuances of property laws and can help prevent your estate from becoming entangled in probate or, worse, reverting to the state.
Probate and Inheritance: Even in countries where joint ownership may bypass probate, taxes and fees can be significant, and processes can drag on. Engage with legal counsel to understand the implications and processes in your chosen country.

Understanding Inheritance Tax:

Tax Implications: Inheritance tax can vary greatly, often depending on the beneficiary’s relation to the deceased. Spouses and direct descendants usually benefit from lower taxation rates.

Corporate Ownership Considerations:

Foreign Corporation or LLC: Holding property through a corporation can avoid probate proceedings and may offer tax benefits. However, this comes with annual costs for maintenance and IRS reporting.
Probate for Corporate Shares: Direct ownership of a foreign corporation or LLC may still lead to probate. In some jurisdictions, shared ownership by spouses can provide interim relief, but eventual probate may be inevitable upon the passing of the surviving spouse.

Trusts and Foundations:

Fideicomiso for Beachfront Properties: In Mexico, foreign citizens often hold beachfront properties through a fideicomiso, which can facilitate inheritance and offer asset protection.
Foundations for Asset Protection: Similar to trusts, foundations in some civil law countries can simplify inheritance procedures and protect assets.

Optimal Ownership Structures:

Domestic LLCs and Living Trusts: Holding foreign real estate directly through a domestic trust or LLC can consolidate your global estate and simplify administration. However, registration requirements in the property’s country can pose challenges.

Registration Challenges:

Foreign Entity Registration: Registering a foreign entity, like an LLC, to hold real estate can be complex and costly, and local authorities may not be familiar with certain types of entities.

Conclusion:

International real estate can be an excellent investment and living choice, but it’s imperative to prepare for the eventual transfer of the property to ensure minimal hurdles for your beneficiaries. This preparation includes understanding local laws, considering the cost of maintaining corporate structures, and possibly using a trust or foundation for ease of transfer.

By navigating these considerations with a skilled attorney and ensuring you have a solid plan in place, your investment in Mexican real estate can be both rewarding in your lifetime and a generous legacy for your beneficiaries.

Disclaimer

Please note that this guide is offered to help you in your planning and decision-making by presenting the author’s personal findings and insights based on firsthand experiences and observations. Before making financial, legal or medical decisions, you should consider counsel from the appropriate professional.