Charles R. Says:
I am the primary caretaker for my Alzheimer’s-afflicted wife. Finding reliable round-the-clock or (preferably) live-in caregivers is increasingly difficult and expensive in the U.S.
Is such help more readily available today in places like Costa Rica, Panama, or Ecuador?
IL Senior Editor Suzan Haskins Says:
Hi Charles,
Thanks for the important question that raises an issue many of us are (or will be) dealing with.
Until recently, the culture of places like Latin America has been for in-home care of elderly relatives and others in need of full-time help. But as populations age in these countries, and indeed, as more and more of us are retiring overseas, the concept of caregiving, assisted living, memory-care facilities and the like is catching on.
Thankfully, costs for both live-in and in-facility care are low.
My advice is to narrow down your list a bit. In my mind, choosing a community to live in is as important (or more so) than choosing a country. Do your due diligence and choose a community that best fits your wants and needs. You didn’t mention Mexico, but if being close to family in the States is important, Mexico may very well be your best option. More on that in a bit…
In Ecuador—which is the most affordable overall country on your list—general help can be had for about $5/hour and basic nursing care at around $10/hour with special visits from highly qualified nurses at $25 per visit. You will pay a caretaker about the same… say $300-$350/week if you provide room and board and expect 24-7 care. One provider offering in-home care services by trained personnel in Cuenca, Ecuador, is VIP Home Healthcare.
That said, a friend in a small community in Costa Rica reports a rate there of $20 a day for a caregiver that comes to the house to assist her husband who has ambulatory issues (not Alzheimer’s). You will likely pay about $40/day for someone with basic medical training.
One thing to be aware of is that you, and especially your wife, will likely need to understand and speak a good amount of Spanish to navigate all this. While it’s possible to find a caretaker that speaks English, more than likely they will not. How comfortable will your wife be in this situation?
Your first step should be to ensure that any medications taken are available in your intended destination. You might start by joining some expat Facebook groups. Use the search function or pose your questions to get input from expats who live in specific destinations.
Here are some groups that may be useful:
From there, you can drill down to specific communities, such as Panama City Expats and Locals, Expats in Quito, Ecuador, Cuenca Expats and Friends, Expats in Costa Rica’s Central Valley, and so on. Keep in mind that major metropolitan areas are where you will find the best medical care, with a larger pool of English-speaking providers.
Mexico: Don’t discount it, especially the Lake Chapala area, which is one of Latin America’s most popular and well-developed expat retirement spots. Just 45 minutes from the Guadalajara airport for easy, affordable access to the U.S. and elsewhere, it offers well-developed medical care and English is widely spoken. There are several expat Facebook groups to join. One is Friendly Gringos Ajijic and Chapala.
In this temperate-climate area of Mexico, you can typically find a caregiver to come into your home for about 100 pesos (currently about $6) an hour or about $300 a week for a live-in. You will pay more if you need trained nursing help. You may need three caregivers, each doing an eight-hour shift per day, for instance.
If your wife should need even more care, you might consider one of the many assisted living facilities in the lakeside area that can cost as little as $1,400 to $2,000 a month, all-inclusive.
Check out Casa Nostra (tel. +52 (376) 765-4187), Mi Casita, and Happiness House. There are several others in the area to choose from.
Ecuador: Some assisted living facilities with memory care options in Ecuador near Quito are Cumbaya Village and Bellavita (both these sites are in Spanish) and Rioquinto just outside of Cuenca.
Costa Rica: Verdeza, in the San Jose neighborhood of Escazu, offers assisted living and memory support facilities. And this site offers suggestions for many surprisingly affordable assisted living communities in Costa Rica.
Panama: In Panama City, Dr. Debbie Wong (who speaks at IL conferences in that country) is a partner at Wonder Years.
Whatever you decide, be sure to do an abundance of due diligence, including about your health insurance options in these countries. Before you make a move, plan an extended visit to see how you feel about the community and its healthcare offerings.
Hope this helps…
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