Here’s a twist: American elderly are going to Mexican nursing homes and assisted living facilities because the costs are far less than anything in the US…

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.

She’s right. Absolutely right.

What are some of the benefits of moving to Mexico?

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.

Correct.

And:

Retirement homes are relatively new in Mexico, where the aging usually live with family. There is little government regulation….
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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.

More than a fortune.

But there are some problems:

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.

I wonder how many of these people are medically fragile? And how many will become so sooner than later, and what will come of their care needs? A lesson from this newer trend, for American nursing homes AND those who work for them: Keep an eye on costs. Unions which drive up wages and benefits might begin losing residents to Mexico. We’re already losing American aides with Mexican immigrants who take our jobs (at far less pay…) The free markets can fix all of this if we allow it. Too many regulations and third party players are ruining nursing homes.

Some older people are taking matters into their own hands. Setting up small communities that will provide services and care on as needed basis. They call this AGING IN PLACE…and it’s very different from those complexes where Assisted Living and Nursing Homes are on a campus.

WASHINGTON — On a bluff overlooking the Potomac River, George and Anne Allen, both 82, struggle to remain in their beloved three-story house and neighborhood, despite the frailty, danger and isolation of old age.

Mr. Allen has been hobbled since he fractured his spine in a fall down the stairs, and he expects to lose his driver’s license when it comes up for renewal. Mrs. Allen recently broke four ribs getting out of bed. Neither can climb a ladder to change a light bulb or crouch under the kitchen sink to fix a leak. Stores and public transportation are an uncomfortable hike.

So the Allens have banded together with their neighbors, who are equally determined to avoid being forced from their homes by dependence. Along with more than 100 communities nationwide — a dozen of them planned here in Washington and its suburbs — their group is part of a movement to make neighborhoods comfortable places to grow old, both for elderly men and women in need of help and for baby boomers anticipating the future.

“We are totally dependent on ourselves,” Mr. Allen said. “But I want to live in a mixed community, not just with the elderly. And as long as we can do it here, that’s what we want.”

Their group has registered as a nonprofit corporation, is setting membership dues, and is lining up providers of transportation, home repair, companionship, security and other services to meet their needs at home for as long as possible.

This is a good idea for those who don’t have a lot of medical needs. And given the spirit of these people of this generation, I fully expect them to overcome that issue as well.

Urban planners and senior housing experts say this movement, organized by residents rather than government agencies or social service providers, could make “aging in place” safe and affordable for a majority of elderly people. Almost 9 in 10 Americans over the age of 60, according to AARP polls, share the Allens’ wish to live out their lives in familiar surroundings.

Many of these self-help communities are calling themselves villages, playing on the notion that it takes a village to raise a child and also support the aged in their decline. Some are expected to open this fall on Capitol Hill; in Cambridge, Mass.; New Canaan, Conn.; Palo Alto, Calif.; and Bronxville, N.Y.

“Providers don’t always need to do things for the elderly,” said Philip McCallion, director of the Center for Excellence in Aging Services at the State University of New York at Albany. “There are plenty of ideas how to do this within the aging community.”

The rest of this article explains the ways and means of this idea; the costs and problems. While it’s a new idea, I bet it catches on all over the country. This is where Home Health Agencies could do a lot of good work as well.

This is cool, and I wish I could find her essay online.

Remona Pasley, a certified nurse’s assistant, won second place in a Florida Health Care essay contest with her entry “Treasure our Elders.”

“I was shocked,” Pasley said.

She has devoted her entire life to caring for other people.

“I never went to college, I had to help my mom take care of the rest of the family,” she said.

More than 35 years ago, Pasley was drawn to medical work, to caring for those who could not care for themselves. She took some classes to get her certification through the organization she was working for.

“I didn’t realize it was college-level work,” Pasley said.

It was, and through perseverance, Pasley completed the courses and became certified.
[...]
“The prize was $300,” Becker said. “She turned around and donated half of it to the facility.”

Pasley smiled and said she is going to keep her eye on the future, and go for first prize. If she ever wins the grand prize money, she said, she wouldn’t hesitate to donate half again.

Do cameras lie?

(August 13, 2007) — An ex-employee of a Rochester nursing home admitted today that she neglected a patient in a case that included the use of a hidden camera.

Tammy Devos, 43, who worked as a certified nurse’s aide at the former Jennifer Matthew Nursing and Rehabilitation Center on Portland Avenue, pleaded guilty to the misdemeanors of second-degree falsifying business records and willful violation of health laws.

Monroe County Judge Alex R. Renzi sentenced her to spend 16 weekends in county jail, beginning Sept. 1. As a condition of her plea, she agreed to surrender her nurse’s aide license.

She’s one of five former employees of the nursing home to face felony charges.
She was initially charged with first-degree falsifying business records, a felony.

The other four are scheduled to go to trial Sept. 4. They are registered nurse Nada Jadrovska, 53; and certified nurse’s aides Marguerite Carrington, 49; Tamiko Goodlet, 29; and Janell Thompson, 20.

Nine other former employees pleaded guilty to misdemeanors and received probation. The nursing home was sold to a new owner in February.

The employees were charged after an investigation by the state Attorney General’s Office that involving putting a hidden camera in a patient’s room in the spring of 2005.

According to court documents, the 70-year-old patient, who suffered from dementia, was not turned regularly, was allowed to lie in his own waste, and was not given adequate food or hydration. False entries were made in the patient’s records to show that proper care was given, the documents said.

Signing off care as being “given”, when it was not, is falsifying records. Not doing care is bad enough…together CNA’s are looking at a felony, at the least. The punishment here is abit extreme I think…since the aides probably tried. Not knowing all the details we can’t judge. I have heard of a case where cameras caught aides on 3rd shift sleeping on couches in resident living rooms, and not providing care BUT signing it all off as done. I have no sympathy for those cases. Bottom line: Don’t blindly sign off books if the care wasn’t given. It is management’s problem to make sure we have staff to get the job done. If all aides were to be honest, perhaps change would happen. But not all aides are willing to admit they are not perfect…one way to get this across is to keep the records honest. At least this leaves a paper trail, and when the state surveyors come in they will pick up on this and cite the facility.

An interesting read:

Reports that Manor Care’s CEO Paul Ormond would personally realize between $118 and $186 million when his company, the largest nursing home chain in the United States, is acquired later this year by a private equity group got us thinking about staffing in nursing homes. Knowing that the federal government has reported that more than 90% of nursing homes do not have enough staff to take care of their residents, we wondered how many nurses and nurse aides could be hired for a year at Manor Care’s nursing facilities with that same money.

Using federal wage estimates for nursing home workers, we calculated that Manor Care’s 278 nursing homes could hire an additional 5346 certified nurse aides or an additional 2198 registered nurses if $118,000,000 were spent on staff (19.2 aides or 7.9 RNs at each Manor Care nursing home). If Mr. Ormond’s $186,000,000 windfall were spent on staff, Manor Care could hire an additional 8427 certified nurse aides or an additional 3464 RNs (30.3 CNAs or 12.5 RNs at each Manor Care nursing home).

Like all nursing home chains, most of Manor Care’s revenues come from public programs, Medicare and Medicaid. How should our public health care dollars be spent? One man’s windfall or certified nurse assistants and registered nurses in nursing homes?

Wander Guard type devices have been in nursing homes for years now. The tech is just catching on for the other markets- esp. family caregivers. This might be a good thing since wandering is one of the top reasons people with Alzheimer’s are placed into nursing homes.

HAINESPORT, N.J. (AP) - It looks like a toy, but the bracelet locked around Bob Melnick’s wrist gives his wife some peace of mind: If this Alzheimer’s patient wanders off and gets lost, he’s wearing a tracking beacon to help bring him home.

“I’m a marked man,” joked Melnick, of Hainesport, N.J. “The police can pick me up anywhere.”

Wandering is one of the most frightening symptoms of advancing dementia, and the Alzheimer’s Association estimates it will happen to nearly 60 percent of patients.

A mini-industry of technologies promises to find lost Alzheimer’s patients - from simple radio-wave beacons that cost $10 a month for batteries, to more-sophisticated GPS devices that can cost hundreds of dollars.
[...]
Radiofrequency “tags” are a hot topic for assisted-living facilities. Patients wear a sensor read by receivers on doors that sound an alarm when someone strolls too far.

Then there’s the more traditional beacon like Melnick’s, which emits a radiofrequency signal for rescue workers to hunt.

“That kind of technology is the most flexible, because it doesn’t require GPS or infrastructure. But it doesn’t work if you don’t notice the person is gone,” Kautz said.

Whatever the transmitter, there’s the question of how to ensure the patient doesn’t wander off without it. Some systems require carrying cell phones; others come in hard-to-remove jewelry; one company sells sneakers implanted with a GPS chip.

The best technology will alert caregivers as to when they’re loved ones/patients exit, and then send signals as to where they are.
And the devices must be subtle and barely noticeable to the person since they will try to remove them.

A word of caution, from those of us who work or have worked with these devices: Don’t become too reliant upon them. Don’t have too much peace of mind…one breakdown in the system is all it takes for an elopement to occur. And they occur often.

Today we’re going to start sharing links to articles that might be of interest to CNA’s and those who are concerned about the work we do. Instead of an entire post on one article, we’ll just provide a link and little commentary.