assisted living Archives

Selecting a Facility

March 15, 2019

by James Sims ExPat Guide

Selecting the right care facility for a loved one is a nuanced process that involves extensive research and a clear understanding of the individual’s needs. The decision criteria will evolve as you gain more insights and encounter new information. Here are some key considerations to guide you through the initial stages of selection:

Facilities: Facility environments vary widely. Some offer a basic, utilitarian setup akin to a hospital, while others provide a more luxurious living space with plush furnishings and warm decor. In Mexico, facilities often embody a homely, expansive aesthetic with Mexican-style decor and more generous outdoor spaces. Additionally, the architectural layout is critical, especially in light of health concerns like virus outbreaks, where the design of U.S. facilities may impede social distancing efforts.
Rooms: Accommodations can range from simple shared rooms, reminiscent of college dormitories, to private suites with comprehensive amenities. Mexican facilities typically offer more spacious and attractively furnished rooms.
Grounds: Outdoor space at assisted living and memory care facilities can vary from non-existent to extensive, landscaped grounds with gardens and walking paths. In Mexico, outdoor living spaces are a significant feature due to the cultural emphasis on outdoor activities.
Staff: Staffing levels and expertise differ, with some facilities only offering part-time access to medical professionals, while others have full-time doctors, psychologists, and therapists on-site. Mexican facilities often boast higher levels of professional staff available on the premises.
Philosophies: The care philosophy is a critical aspect to consider. Some facilities operate minimally, engaging residents with passive activities, while others actively engage each resident with tailored physical and cognitive programs. Facilities in Mexico often lean towards a proactive, preventative care approach.
Costs: The cost of assisted living in the U.S. averages around $5,000 per month, with high-end facilities reaching up to $10,000 per month. More affordable home services could range between $2,500-$3,500 per month. These costs often scale with the level of care required. Conversely, comprehensive assisted living services in Mexico can be secured for under $3,000 per month, often with a flat fee structure that includes the full continuum of care through to hospice.
Care: Understanding the care and treatment available at a facility is vital and should be assessed beyond promotional materials. U.S. facilities tend to be clinical, although some infuse energy and enthusiasm by incorporating interns. Mexican facilities frequently exude a natural warmth and personalized care that may surpass what’s commonly found in the U.S.
Services: Assess whether facilities provide a continuum of care, from independent living through to memory care and hospice. Mexican facilities often offer a comprehensive range of services, allowing for a smoother transition as care needs intensify.

In sum, choosing a care facility for your loved one requires a detailed approach that balances tangible factors such as facilities and costs with intangible elements like care philosophy and staff warmth. The goal is to find a place that not only meets the clinical needs of your loved one but also provides a nurturing and supportive environment for their overall well-being.

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.

Travel as a Caregiver

March 13, 2019

by James Sims ExPat Guide

Traveling with a loved one who requires care presents unique challenges that demand meticulous planning and preparation. Here’s a detailed guide to consider when organizing such a trip, especially if it involves international destinations.

Crafting the Narrative: Explaining an international journey to a loved one in need of assisted living or memory care requires a tailored approach. The narrative should be shaped by the individual’s cognitive condition and emotional stability. If reasoning capabilities are diminished, the explanation for the trip should be as reassuring and straightforward as possible. The story may vary, but it should always prioritize the comfort and understanding of your loved one.

Medical Preparations: Consulting with a physician is paramount. You’ll need to discuss the trip and obtain any necessary prescriptions to manage anxiety or agitation during travel. Ensure you have a sufficient supply of regular medications, and secure permission for early refills to last the trip’s duration. A doctor’s letter prescribing assisted living or memory care can serve as official documentation of your caregiving role.

Packing Essentials: Use a nested rolling suitcase system for efficient packing and return travel. Pack clothing appropriate for the destination’s climate and leave valuable jewelry at home. Include sentimental items like photographs to help maintain a sense of familiarity. Prepare a carry-on with essentials for the journey, including a change of clothes for emergencies.

Safety Measures: Safety is a primary concern. Carry any sedatives or anti-anxiety medications prescribed by your doctor for emergency use if your loved one becomes distressed. Consider a wearable ID for your loved one with contact information and a brief note explaining their condition. Discreet cards explaining your loved one’s condition and your role can facilitate assistance from others without causing a scene.

Documentation for Facility Admission: Organize a folder with all necessary documents for seamless admission into a care facility. This should include medical records, current prescriptions, a doctor’s letter, and passports.

Seeking and Accepting Assistance: Be open to seeking help during your travels. Whether it’s assistance with bathroom visits or navigating the airport, don’t hesitate to ask for support. Use family restrooms where available to provide assistance privately and comfortably.

Travel Itinerary Planning: Segment the journey into manageable parts. Consider traveling overnight or during off-peak hours to avoid busy airports, which can be less stressful for both you and your loved one. If evening hours are challenging due to conditions like sundowning, an early morning departure might be best. Staying at an airport hotel the night before can ease the stress of early travel and often includes long-term parking and shuttle services. In Mexico, arrange for a private shuttle to the care facility and book a nearby hotel to allow for rest and acclimation before admission.

Each step in this guide is designed to ensure the journey is as comfortable and stress-free as possible, safeguarding the well-being of both you and your loved one. With careful planning, the trip can be a transition toward a new chapter of care and support.

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.

Admission

March 6, 2019

by James Sims 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 James Sims 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 James Sims 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 James Sims 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.