Rising health care costs in the United States have led seniors affected by Alzheimer’s to travel to other countries for affordable treatment.
In the United States, the financial costs of Alzheimer’s are staggering. According to the Alzheimer’s Association, out-of-pocket costs for Alzheimer’s care total $34 billion. When you add Medicare, Medicaid and other sources, the total cost to the nation comes to around $203 billion.
It’s no surprise that seniors and their families are looking for more affordable options for Alzheimer’s care. Many have found those options in foreign countries.
I received a most interesting and unusual response from caregiver David Duce following the publishing of my previous blog “Long-Distance Caregiving”.
David writes, “After caring for my 94-year-old grandmother with latter stage dementia at home for two years, I relocated her four months ago to a full-care nursing home in Transylvania, Romania.”
Please keep in mind that Dave and his partner are parents of three young children under the age of 10. After his grandfather’s passing Dave became the caregiver of his grandmother. With Dave’s permission I am sharing with you his story.
This article happens to be much more lengthy than others, but I felt the family circumstances deserve notice in order that you may understand what led him to make such a choice for his grandmother’s care.
My granny, we soon discovered, had Alzheimer’s. And within a few months her condition rapidly deteriorated. I brought in a daycare helper for about $800 per week (not nearly enough for the work she did). She cooked, cleaned the house, bathed, and loved Granny like family.
I was 500 miles away with a career, two young children and another on the way. At 92 years of age and still fairly mobile, Granny had a number of small accidents, leaving the sink tap running a couple of times flooding the house, and boiling the kettle dry on more than one occasion.
Then those words I had spoken to her years before came back to haunt me: “No, I won’t put you in a nursing home, Granny.” So I rented her house out for $1150 a month and she was collecting $1500 in Social Security benefits. She had $45,000 from Gramps’ retirement.
We packed her things in a small moving van and we road tripped, singing along the way, “California here we come, right back where we started from..” It’s weird, you know; even in her demented state she would say things that were so true and cutting to the bone. I couldn’t help but question is she there inside trying to get out, or was it me reading into her statements. The connection was subliminal, but it struck a chord deep inside.
We continued with a daycare aid about $1000 per week, and I took over the night care and weekends. I found her naked and confused in the corner of the room a few times in the middle of the night, so I put a safety rail on her bed with bells and a baby monitor next to her so I could hear if she was getting out of bed at night. I could hear when she was restless, and we soon got into a routine midnight bathroom run. She still managed to get up and take off her clothes a few times after that, and I was worried that she was going to take a fall.
At that time I was earning about $60k per year and my partner was helping with Granny and managing the household. Granny still had a good sense of humor. And although I loved the time I spent with her, the stress and sleepless nights began to take their toll. Wiping butts and cleaning up messes was the least of it. Even reassuring her that everything was okay wasn’t a problem. She never really asked about Gramps; I became the man in her life. Whether it was her brother who had passed on many years earlier, or her dad, I played the role.
After nearly a year with Granny, my aunt offered to look after her for a while. She left her job to take care of her mom full time, but there was conflict. My granny was verbally abusing my aunt, who is the kindest person and already had a full house. Things took a turn for the worse. Granny had a couple of falls and visits to the emergency room but fortunately no broken bones. Additionally, Granny was not happy at my aunt’s; and when I would speak with her, she would insist that I come get her because they were trying to kill her – not true, I’m sure. My granny would call out the window for the police and had numerous conflicts with family members, whom she never really liked. She knew she didn’t want to stay there. Then there were some 911 calls, and you know, they send the whole entourage, fire trucks, etc.
My aunt did a fine job, but I could tell it was just a matter of time before something bad happened. I explored the option of a home; and with the condition she was in (skilled nursing) care started at around $5k per month. I would have to sell her house worth about $220k. I had to do something.
We met with an estate planner. His advice was to spend down the assets so we could get my grandmother into a Medicaid-covered home. This didn’t seem like the right plan.
I had been working in Eastern Europe over the years and had fallen in love with the countryside of Romania, Transylvania, to be precise. The food is natural and the exchange rate is very favorable, about 4 to 1. Admission into the European Union has opened the door for funding grants, and the medical profession has benefited tremendously.
So I thought we’d give it a try. After investigating our options, we found a brand new nursing facility owned and operated by The Church. We were fortunate in finding a home that provides exceptional care at an affordable cost.
I stayed there (in the immediate area) for the summer and visited most every day at different times of day. The adjustment for my grandmother wasn’t difficult. For about the first week she asked when we were leaving, then that was about it. I would tell her the new house wasn’t ready yet, or we were still on vacation.
We had one really bad day where she thought a nurse had hidden her rings. They were quick to recognize the problem. The nurse took off her white coat and reassured Granny that she was her friend, and had her calmed down in a matter of minutes.
Granny has been there nearly six months now. She has a healthy appetite and is very strong. I have independent people, who check on her at twice weekly and report directly to me. She developed a rash on her face, which the staff was quick to remedy.
Our situation has turned out better than I anticipated, so well in fact that I am starting a service to help other families who are in a similar situation, Angels Respite Program.
Questions regarding this arrangement along with Dave’s answers:
- Steps you took to get your grandmother accepted: “In all fairness credit is due to family friends. They found a recently completed full-care nursing facility. The application process was very simple; a copy of blood work, medical history, and an interview. I also provided three months worth of medications for the transition.”
- How you made the long trip with her: “As you can imagine I was very nervous before the flight, not knowing what to expect, ruminating about all of the possible scenarious, a freak-out scene at customs or refusal to get on the place. None of that happened. I told her we were going to Europe, and she seemed excited and was the perfect patient/passenger the whole way. At 94 she sleeps a lot. We flew Lufthansa andthey were great to help with wheelchairs and a family waiting room during a layover in Frankfurt. I gave Granny a baby aspirin and dressed her with some compression sleeves and socks per doctor before the flight. She even had a glass of wine.
- Did you go it alone: “I didn’t take her alone; my partner and I were also travelling with our three young kids.
- How do you communicate with your grandmother long distance? The nursing facility arranges for us to talk via Skype. Granny has some hearing problems, but we just speak slowly; she recognizes me most days. The Internet/Skype connection is good, and I have someone there to make the connection for us. She likes to show her pictures she has colored.”
- How are financial arrangements handled? “I have set up an electronic payment through an international bank, where it is converted to Romanian currency Leu (Lay).”
- What about elder care in Romania at this time? “There is much to share here; Romania is at the historical crossroads of Europe. The discovery of insulin, invention of the fountain pen, and jet engine – all Romanian. Since the end of communism there has been a technical and medical revolution, bringing Romania back to the forefront. E.U. funding has allowed the latest medical equipment to flood into this developing economy. But more importantly it’s the people; there is a certain passion about them, a positive energy that is undeniable. I see it in the eyes of the nurses; they get it!”
To learn more by communicating with Dave Duce directly, go to: firstname.lastname@example.org.