A handful of Americans have made what at first glance seems a radical decision. They have opted to put themselves or their loved ones into an assisted living or nursing home in Mexico. If that sounds extreme, consider their reasons; costs at a fraction of those in the US, high quality medical and personal care, and the reason many foreigners go to Mexico, the weather.
Before you dismiss this unconventional choice, think about the demographic crisis that is just around the corner. According to the Congressional Budget Office, 70% of Americans have less than $25,000 saved for retirement and 25% don’t contribute anything at all. At fifty, if one doesn’t already have a significant retirement fund, its highly unlikely one can be created that will be adequate when its needed. Coupled with the estimate that 40% of the huge baby boom generation, just beginning to hit retirement age, will need assisted living or nursing home care costing a minimum of $3000 and $7000 per month respectively, and the magnitude of the problem becomes clear. The majority of Americans will not be able to afford long term care when they need it.
Of course we do have a social safety net, but state Medicaid budgets are already at the breaking point and many states have begun to reduce funding. (Even if the Medicaid expansion under the Affordable Care Act gets widely implemented, this is money to cover more people, not more money for any individual.) In any case, if you think that this is an acceptable option for yourself or a loved one, I urge you to visit Medicaid only facilities in your community. Many of these are run and staffed by caring people, but for most residents, these are places of last resort and they feel like it.
By contrast, quality assisted and nursing care can be had in Mexico for $1000-$1700 per month. For many working and middle class Americans, their Social Security income would be sufficient to cover care.
But there is a cultural argument for superior care in Mexico as well as an economic one. Cliché as it sounds, elders are valued and treated with respect in Mexican culture and this attitude carries over to seniors in long term care. Americans who have loved ones in Mexican homes say that the warmth is palpable and that they are often treated like family. (See links below)
In addition, the direct care workers in Mexican facilities are paid an adequate living wage and are considered members of a valued profession. Contrast that to American CNAs (Certified Nursing Assistants) who are paid less than $10/hour, just enough to insure that they and their families will remain in poverty. In fact, over 40% of CNAs in the states are on some type of government assistance. Couple that with the low respect this profession commands and one can understand why turnover rates for these jobs remains at an astounding 70% per year even after the recession.
Are there barriers to this kind of solution to elder care? Of course there are. The main one is distance and the frequency one would be able to visit loved ones. But many Americans already live at great distances from their elderly parents. In any case, ask yourself,” Would I rather visit my parents weekly in a facility that feels depressing, the care is only minimally acceptable, and no one seems to know my parent well, or twice a year for a longer period where my parent is happy and I am confident he or she is receiving excellent treatment from caring people.”
Another current impediment is that fact that the Mexican assisted living and nursing home industries are underdeveloped. Placement of elders in these kinds of facilities is uncommon in Mexican life. As a consequence, most long term care homes that cater to Americans are located in areas where expatriates have congregated for a long time such as Lake Chapala, San Miguel de Allende, or the Baja coast. Even there the number of facilities is low. The industry is gearing up however in anticipation of the expected need. AMAR, the Mexican Association for Retirement Communities, predicts that there will be robust growth from Mexican providers as well as American long term care housing corporations expanding across the border.
Critics often disparage the phenomenon of the aged moving to Mexico for care as “elder outsourcing”. This is a matter of perspective however. Tens of thousands of US citizens already get their medical care abroad (medical tourism) and are very happy about the results. In any case, one could counter that what we often do here is not much more than “elder warehousing”.
Unfortunately, the phenomenon of explosive costs for elder care in the United States will not go away anytime soon. I consider the option of receiving care in Mexico a positive and rational response. Like anywhere, research and visits to the facilities are extremely important when choosing a place to receive long term care. This may be more expensive and time consuming in the short run but future low cost and high quality of care may make it very worthwhile.
Here are links to five assisted living homes in Mexico:
Serena Senior Care
Alicia Convalescent Care
This is a link to AMAR, the Mexican Association for Retirement Communities
Here are some links to stories about Americans in Mexican Assisted Living Homes:
The value of Mexican Assisted Living