My Eye-Opening Tour of an Assisted Living Facility in Mexico
A residents balcony at The Gardens of Mazatlán
My business associate in Mexico, The Intrepid Elise, has always had a soft spot for the elderly that springs from her close relationship with her grandparents. She enjoys talking about how her grandmother, at 100 years old, had a 90-year old “boyfriend” to watch Netflix with. She was in the midst of planning to move to Guadalajara from Canada when she passed away.
In addition to running her property management company, Elise transferred her fondness to a gaggle of elderly expat women in Mazatlán for whom she serves as a what she calls a translation companion. She takes them shopping and helps them run errands, and perhaps reports back to their family members in the U.S. and Canada on how they are doing.
Some of her clients are getting up there and she had been worried about how much longer a few could live on their own. One day she called me very excited about a new assisted care facility she’d heard about. She had already visited the chief administrator at The Gardens of Mazatlán in hopes of building relationships with them on behalf of her clients.
Life granted me the mercy of never having to make difficult decisions about aging parents. I do know of my ex-husband’s struggle with finding a place for his 80+ year-old mother in Boise. She had few resources, he had a demanding job, and his days were frequently interrupted by emergency trips to her apartment or residence due to her opioid addiction. I learned the costs of home care can be horrendous.
Enter Mexico
If you read up on the subject online, you will see that a number of American developers have built or are planning to build assisted living facilities in Mexico. Developers are shifting their traditional condo and townhouse developments for expats in midstream to include assisted-living wings for Americans who want modern facilities with U.S. quality services.
To help developers with the healthcare side of the process, the Mexican Retirement Assistance Association (AMAR) came about to assist companies focused on developing senior housing and eldercare facilities in Mexico. Mexico’s government has plenty of rules about facilities, but not the level of red tape developers encounter in the U.S. These elements make Mexico an attractive ground on many levels.
This is welcome news that makes perfect sense: In the U.S., the cost for assisted care can range from $3,500 to $5,000 a month in states like California. The average cost is $3,600 a month, with the average for memory care running $4,700 a month. For skilled nursing, $6,700 is the average. The cost of these services in Mexico is half to third of what they cost in the U.S, starting at approximately $1,500 a month for a quality assisted living facility.
In the past, the abuelos in Mexico almost always lived with their children. Only recently has that begun to change as Mexicans have begun to move for better jobs. Mexico has a young, vast labor pool and staffing is easier to find for these facilities than in the U.S. Mexican culture treats the aged gently. If you look carefully and listen to social conversations on the subject, you’ll find service jobs such as home health care work are more respected, adding to its appeal to prospective works.
Assisted living facilities in Mexico in general
Assisted living communities exist in most all areas with large expat communities, including Lake Chapala, Baja California, Nuevo Vallarta, San Miguel de Allende, Mexico City, Mérida, and now Mazatlán. They also exist in border cities such as Tijuana, Rosarito, Chihuahua, Monterrey, and Cuidad Juarez, making it easy for children who live in cities right on the border, like San Diego and El Paso, to pop back and forth.
Even though pharmacies, hospitals, and doctors are not authorized to accept Medicare for expats from the United States, these costs are often so much lower in Mexico that seniors still come out way ahead in Mexico.
Many assisted living facilities in Mexico have an onsite doctor whose visits are included in the monthly fee. This doctor is generally sufficient for simple illnesses and basic prescriptions. If a resident suffers from more complex ailments, it is advised that the resident purchase Mexican health insurance to cover additional medical costs or an emergency.
My Tour of The Gardens of Mazatlán
The Gardens of Mazatlán provides assisted living, skilled nursing, and memory care. It is brand-spanking new, Its smell is of fresh paint and new construction. There are views of the marina inlet and palm trees sway outside the windows.
When looking at any organization, whether a school, a company, a hospital, or an institution, I make it a rule to examine most carefully its leadership. As Ralph Waldo Emerson said, “An institution is the lengthened shadow of one man.” Following the truth of that statement has served me well in choosing jobs and I apply the philosophy whenever I am assessing a potential employer or business.
In the case of The Gardens at Mazatlán, the extended shadow is that of Judy Harvey, who came across as not just as a solid administrator, but as a gifted leader. She keeps the humble title of simply “coordinator” on her business card in spite of the center being a long-held dream of hers and her husband Bob Harvey, CEO.
Ms. Harvey explodes with energy and passion yet still keeps in full command of the details. Together she and her husband have accumulated many years experience in healthcare and construction industries and have many years living in Mexico.
A number of features of The Gardens of Mazatlán impressed me above and beyond what I’d read to expect from such a facility. For example, rather than driving to fill the rooms upon opening, The Gardens of Mazatlán had a “soft” opening in order to give the Harveys more time to develop a corporate culture among nurses and staff. “Before we are at full capacity, we have the role and responsibility to instill pride in employees that they are part of something new, and important.” she said.
Ratio of staff to residents is high. There will be one registered nurse and one RCA (nurse’s assistant) per floor and one bilingual on every shift in addition to aides, she added. Staff is provided free English training, an opportunity snapped up in a culture where English skills ensure the best employment options.
How many times have you seen nurses gathered around a reception desk area in a hospital socializing? In The Gardens, There is no nurses’ desk, and nowhere to congregate (which was a great surprise to staff members who had worked in other facilities). Security is a top priority and staff training sessions include watching security tapes. “It’s important that staff gets comfortable with being monitored,” said Harvey.
Employees check in with their finger prints and learn that being on time is imperative - not a normal characteristic of Mexican culture in general. Assisted living is a new concept in Mexico. She felt staff needed more time to adjust to procedural differences between an American-style facility and what they might know from past experiences in Mexican ones.
The Gardens have a chef on site from 7 am to 7 pm. He meets with residents to determine what their eating habits and preferences are and prepares those kinds of foods. Residents can eat whenever they like in the dining room or have their meal brought to them. “One resident ate at 10:30 at night,” Harvey said. “We worked out what foods could be microwaved, since the kitchen closed at 7:00.” Each resident has a half refrigerator of their own in the common room.
The kitchen will prepare meals for resident’s guests according to preferences as well. One resident’s daughter is a vegan so the chef prepared special meals for her when she was there. Another resident liked catsup, and the chef asked if he could make a healthier substitute “The resident said yes and liked it!” Harvey enthused.
An equally flexible approach is taken to room decór. Residents are allowed their own furnishing as long as it doesn’t interfere with navigability and safety. If a resident desires a color, the facility paints the room accordingly. One room I saw was painted a vibrant peach color. “We don’t nickel and dime on those things,” a phrase I heard from Harvey several times in our conversation. (It helps that labor in Mexico is very cheap). Smart televisions are on the wall in each studio. Laundry services are provided, although residents can do their own and often prefer to do so. Studio rooms are cleaned weekly.
While I don’t know all the rules about American assisted living facilities, I am willing to bet that flexibility is not a defining characteristic in the U.S. At the Gardens I saw strict rules for safety sake (strict sign-in and sign-out rules for residents, cameras monitoring all the elevators) but sensed more flexibility to work with residents as individuals than I suspect would be the case in a U.S. facility.
Each common room at The Gardens has three suites (large bedrooms). Couples are allowed for an extra $500/month. The basic cost is $1,500 a month. Memory care $3,000. The maximum extra services could add up to is no more than $1,100.
When admitted, residents are required to have several doctors assessments by a Mexican doctor. This helps determine the help they’ll need and what extra costs might be incurred that were not before mentioned. The assessment is repeated in 30 and 60 days to make sure nothing has been left out. “Clients sometimes hide things that they aren’t comfortable sharing at first,” explained Harvey. The Gardens provide transportation to doctor's appointments as part of the monthly fee.
My take-away (the information that you will find nowhere else but this blog)
You can find a great deal about the basics of assisted living in Mexico in articles and websites and glean that there are a number of high-quality centers. What you will need to read between the lines carefully to discover is this: The very best way to approach the transition to assisted living in Mexico is for the potential resident to live in Mexico several years before needing to move to such a facility.
While talented, compassionate administrators are key to any good center, no matter what your age, moving to Mexico is an adjustment. The first residents of The Gardens (whom I met and appeared very happy) and future residents such as the clients of The Intrepid Elise are the perfect example of how it should be done.
All already knew Mexico and liked living in the country. They likely spoke at least some courtesy Spanish (“Que tengas un buen día!”) They understood a little about Mexican culture and had acquired the patience that living in Mexico that is demanded at any age.
They were familiar with the cuisine and knew if they liked posole and molé. If they didn’t, they knew what they liked that was available instead in Mexico. Having been long-term Mazatlán residents before they made the move to assisted living, residents at the Garden of Mazatlán already knew people in the outside community and felt at home.
In Mexico, personal service providers, hairdressers and the like, will come to your home. That is the norm. Rather than providing personal services themselves, The Gardens has attractive, brand new beauty stations. The residents’ hairdressers and therapists, whom they’d likely contracted for years just come to The Gardens now instead of their home to serve them (One massage a week is included in the Gardens monthly fee).
The same goes for residents’ doctors. Elise’s clients and these early Garden residents already had their doctors lined up before making the transition to The Gardens of Mazatlán. The Gardens only had to assist with setting appointments and provide transportation, which is included in the monthly price. Prior experience in Mexico makes things a heck of a lot easier for both resident and facility.
Other options in Mexico
Given the labor pool in Mexico, a person has more options for affordable in home care as well as assisted living. Many nuns are registered nurses will provide care whether you are Catholic or not.
Visiting Angels is a national network of home care agencies. They provide non-medical senior home care services for those who want to live independently in their own homes and only need occasional assistance. Unlike the U.S., the drastically lower costs make all these choices more available and affordable. It takes time in Mexico to properly investigate the options. The sooner you move ahead of necessity, the easier any transition becomes.
Related links:
End of life planning in Mexico - an article by Puerto Vallarta Daily News.
An account of a couple who moved to Mexico with an aging parent by Mexico News Daily
Cost of assisted living in the US by state - 60 & Me
How costs compare by the hour for skilled care in Mexico - Ventanas Mexico
Most recent:
One cannot fully love a country until the love (at least a little bit) of its music - Why you should not ignore regional music as an expat.
About the author:
Kerry Baker is the author of various books promoting life in Mexico. If Only I Had a Place is a guide to fruitful renting in Mexico.
The Mexico Solution: Saving your money, sanity, and quality of life through part-time life in Mexico was released in 2020 and will tell you exactly how to set yourself up for expat life in a way sure to both inform and entertain.
Her most recent book is The Lazy Expat: Healthy Recipes That Translate in Mexico” a cookbook for travelers, expats and snowbirds who wish to maintain a healthy diet in Mexico (You must cook.)