# healthcare for my 81 year old wife



## gary1958 (Sep 8, 2017)

Hello All,

My name is Gary and my wife is Sheila.I am currently sorting our register issues with this website.
Sheila & I are considering moving to Javea from Northumberland.
We will be visiting from 24 September to 8th October 2017 to get a flavour for the area. My parents lived in Alfaz del Pi for many years.
My question is concerns regarding healthcare for Sheila.She is 81,had a major heart attack 4 years ago,a minor stroke following hip surgery last year and has a pace maker for the last 4 years.
She is stable,on many medications and doing well.
I have always understood that healthcare in Spain was very good(better than the NHS!) but reading feedback it appears the local hospitals leave something to be desired?. I know people will more readily complain than praise when reviewing so I am trying to confirm whether Sheila can get good quality care, especially cardiac care. She has her full state pension,however,I at 59 do not,but I will purchase healthcare when we arrive for myself.
Hope you can help to allay our concerns.
Thank You.Gary & Sheila.


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## Lynn R (Feb 21, 2014)

I can't comment on the quality of hospitals in the Javea area as I don't live there. However, as your wife is a UK state pensioner you will not need to take out private health insurance for yourself - she can request an S1 form for you as her dependent, at the same time she requests one for herself, which will give you state healthcare cover in Spain as well.


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## gary1958 (Sep 8, 2017)

Thank you Lynn R,that is really useful information and I appreciate your response!.Gary.


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## xabiaxica (Jun 23, 2009)

I live in Jávea. The hospital in Dénia, which is our local one, is fantastic. Both my daughters have had surgery there & they saved my younger daughter's life.

I also have several friends who have had joint replacements, cancer care, care following strokes & heart surgery.

It's clean, the staff are efficient, waiting lists for most departments aren't ridiculously long. 

I'd be very interested to know where you heard otherwise?


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## gary1958 (Sep 8, 2017)

Thank you for your reply xabiachica. The reports have been on facebook and google reviews on the hospitals concerned but especially Hospital Marina Salud,Denia.The reports have been by both Spanish and other EU nationals.The ratings given were 3 out of 5 but some more recent reports gave 1 and some awful reviews as examples which is why I am querying this and all of the do's and don'ts so I am prepared before we come out to look around. Your reply does help in allaying those concerns though which is why I joined. One question-I assume Hospital Marina Salud in Denia is a general hospital,where is the nearest hospital that would deal with more major cardiac issues please. Thank you for your help,it is valuable to say the least


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## Isobella (Oct 16, 2014)

gary1958 said:


> Thank you for your reply xabiachica. The reports have been on facebook and google reviews on the hospitals concerned but especially Hospital Marina Salud,Denia.The reports have been by both Spanish and other EU nationals.The ratings given were 3 out of 5 but some more recent reports gave 1 and some awful reviews as examples which is why I am querying this and all of the do's and don'ts so I am prepared before we come out to look around. Your reply does help in allaying those concerns though which is why I joined. One question-I assume Hospital Marina Salud in Denia is a general hospital,where is the nearest hospital that would deal with more major cardiac issues please. Thank you for your help,it is valuable to say the least


I too have seen comments on Facebook from a friend who lives in Calpe. 
According to this there are waiting lists to get on waiting lists.

http://lamarinaplaza.com/2017/07/30...gresar-en-la-lista-de-espera-de-marina-salud/


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## Alcalaina (Aug 6, 2010)

Isobella said:


> I too have seen comments on Facebook from a friend who lives in Calpe.
> According to this there are waiting lists to get on waiting lists.
> 
> Listas de espera para ingresar en la lista de espera de Marina Salud | Noticias La Marina Plaza


As there are in the UK, and probably every other country where austerity measures have forced spending cuts in public services. 

Not just hearsay either, both my late mother (England) and my 91-year-old FIL (Wales) had to wait several months to be accepted onto NHS waiting lists.


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## xabiaxica (Jun 23, 2009)

Isobella said:


> I too have seen comments on Facebook from a friend who lives in Calpe.
> According to this there are waiting lists to get on waiting lists.
> 
> Listas de espera para ingresar en la lista de espera de Marina Salud | Noticias La Marina Plaza


Well I did say 'most' departments....

My neighbour had a knee replacement there 4 weeks ago. Six months from GP referral to being discharged by physio. She's now walking normally & pain free, from having been in a wheelchair.


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## steveng (Jul 4, 2016)

I can't speak for your area, but where I live, the hospital care is excellent. However, once you are out of hospital you are pretty much left to it. One thing you do need to consider though, is if your wife needs home care, there doesn't seem to be much in the way of this unless you pay for private nursing. This might be something you want to look into, as I think it could be quite expensive. Most Spanish people rely on family to help out, but if your wife needs something similar to what is provided by social services homecare in the UK, you may struggle.


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## Alcalaina (Aug 6, 2010)

steveng said:


> I can't speak for your area, but where I live, the hospital care is excellent. However, once you are out of hospital you are pretty much left to it. One thing you do need to consider though, is if your wife needs home care, there doesn't seem to be much in the way of this unless you pay for private nursing. This might be something you want to look into, as I think it could be quite expensive. Most Spanish people rely on family to help out, but if your wife needs something similar to what is provided by social services homecare in the UK, you may struggle.


There_ is_ an equlvalent to social services home care in Spain. You can apply through the social services department of your Ayuntamiento. However, it is means-tested and you may have to wait a while for the result of your assessment.


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## gary1958 (Sep 8, 2017)

Thank you Steveng,

That is good to know,I'll be the nurse in this case as I have been in the UK apart from the 6 monthly visits to the specialist cardiac nurse.Is there an equivalent system in Spain where you attend bi-annual/annual check ups with a specialist nurse?.
thanks


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## Lynn R (Feb 21, 2014)

Alcalaina said:


> There_ is_ an equlvalent to social services home care in Spain. You can apply through the social services department of your Ayuntamiento. However, it is means-tested and you may have to wait a while for the result of your assessment.


Agreed. I see lots of the uniformed carers provided under the Ley de Dependencia going about their work in the community here. 

Naturally enough, all the information about the service is in Spanish, and I'm sure the application forms and assessment process would be in Spanish too, which is something which could well be problematic for lots of elderly English speaking residents.

Junta de Andalucía - Servicio de ayuda a domicilio

Whether there are sufficient resources to meet the demand I don't know, but then the same could be said for the UK, I believe.


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## gary1958 (Sep 8, 2017)

Thanks Alcalaina.


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## gary1958 (Sep 8, 2017)

Thank you for your response Lynne R. I can manage the nursing side,which I do now for my wife.It was the follow up I was wondering about.
In the UK my wife sees a cardiac specialist nurse every 6 months for blood tests,BP,ECG etc.I suppose this would be done by the local GP clinic in the area we lived?.


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## Lynn R (Feb 21, 2014)

gary1958 said:


> Thank you for your response Lynne R. I can manage the nursing side,which I do now for my wife.It was the follow up I was wondering about.
> In the UK my wife sees a cardiac specialist nurse every 6 months for blood tests,BP,ECG etc.I suppose this would be done by the local GP clinic in the area we lived?.


I can't tell you, I'm afraid, as neither of us has had that kind of treatment in the state health system. I do see a cardiologist every 6 months, or more often if necessary, and have those tests, but that's in the private system.

In your case it might be worth getting a summary of your wife's medical history before you leave the UK and having it translated into Spanish, to give to your new GP (called medico familiar here) once you are allocated to one.


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## Juan C (Sep 4, 2017)

Gary

http://http://healthcareinspain.eu/living-in-spain/

Extract: 
_If any of your family members need to receive healthcare *as your dependent *because they may not be entitled to any healthcare cover in Spain in their own right, then they will also need to apply for a separate S1 form as*your dependent. _

I have not been able to find what 'dependent' is defined as.

My wife is my dependent, as she does not work She is under UK retirement age but I get extra on my OAP and she gets free S1 cover.

You may not be a 'dependant' within the rules. 

I would call DWP Overseas Branch so you know where you stand


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## gary1958 (Sep 8, 2017)

Thank you Lynne R,that is very helpful,I'm slowly getting my head round the many questions I have.It is much appreciated!.Gary.


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## gary1958 (Sep 8, 2017)

Thank you Juan C,

I have been told by DWP I am a dependant(a person who relies on another as the primary source of income,I gave up work to care for her.) of my wife as a carer for her.We receive attendance & carers allowance in the UK. Also because she receives a UK state pension,as a dependant I can also access free S1 cover. But I will take your advice and check with DWP overseas branch to confirm.
Thank you for your help Juan C!.
Gary.


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## Alcalaina (Aug 6, 2010)

Juan C said:


> Gary
> 
> http://http://healthcareinspain.eu/living-in-spain/
> 
> ...


A dependant in this sense is a husband or wife, child under 18, or elderly relative who lives with you and you are caring for. It doesn't matter whether they are working or not.


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## bob_bob (Jan 5, 2011)

Gary, given that the NHS is still the number one health service in the world 
https://www.theguardian.com/society/2017/jul/14/nhs-holds-on-to-top-spot-in-healthcare-survey

and given your wife's age and medical issues are you really sure you want to move country? No offence meant but as a retired Ward Manager I felt I needed to ask the question. Moving country is a very stressful event in a life and not one I'd take on if I were you.

Good luck with the future whatever you both decide to do.


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## Lynn R (Feb 21, 2014)

One more thing to bear in mind - when the OP reaches UK state pension age himself, he will need to apply for a new S1 form in his own right, as he will no longer be classed as his wife's dependent once he starts to receive his own state pension. That will need to be registered with the INSS (Spanish social security department) and the local health centre all over again, unfortunately.

As the registration process when you arrive can take a few weeks, I would make sure you have at least a month's supply of all the medication your wife needs (and more if possible) before you leave the UK, and then start the process of registering your S1s and registering as residents as soon as you possibly can on arrival.


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## gary1958 (Sep 8, 2017)

Hi bob_bob,

No offence taken.My wife is suffering with osteo arthritis and since her stroke last year she has a very low tolerance to the cold weather.We had a holiday in Italy and Switzerland in May and the pain relief and improvement in mobility was considerable in allowing her to move and walk easier and to use her left hand and mouth much easier since the stroke. Since our return she is suffering much more again. We have been looking at the options of either moving to the south of England where it is a little warmer or to Spain where it is a lot warmer and more of an outdoor lifestyle which is what she wants. I hear what you are saying but it's the quality of life she wants.Our doctors have all given the green light and we are travelling to Spain this month for a look.Then we can make a decision. I have my own concerns,like you, which is why I have joined this forum to gain a better understanding of the area,healthcare,laws etc. We'll see how we feel on our return.
Thanks again.Gary.


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## Pesky Wesky (May 10, 2009)

Many people who have to have help at home pay for it themselves in fact, it may even be the majority. These people are often immigrants themselves. At the moment the largest group come from South American countries at least that's what I see here in the Madrid region and Bilbao area. They don't usually work for high salaries. As Lynn R pointed out a lot of the people working as carers wear a kind of uniform, but that doesn't mean they are working for the state.


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## Lynn R (Feb 21, 2014)

Pesky Wesky said:


> Many people who have to have help at home pay for it themselves in fact, it may even be the majority. These people are often immigrants themselves. At the moment the largest group come from South American countries at least that's what I see here in the Madrid region and Bilbao area. They don't usually work for high salaries. As Lynn R pointed out a lot of the people working as carers wear a kind of uniform, but that doesn't mean they are working for the state.


The ones I see are, their uniforms carry the logo of the company (Emvipsa) who supplies these services to the Ayuntamiento. I can think of at least six of my old neighbours who do this type of work, in this area it is more usually local people employed rather than those from other countries - but I have, on visits to Madrid, often seen elderly people being accompanied by foreign carers.

There seem to be lots of the "official" carer jobs being advertised, and from a quick glance in some cases applications are restricted to those resident in the local community. Services like these are more usually contracted out these days rather than being provided directly by the Ayuntamientos.

https://www.opcionempleo.com/empleo-auxiliar-de-ayuda-a-domicilio/andalucia-34836.html


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## Pesky Wesky (May 10, 2009)

Lynn R said:


> The ones I see are, their uniforms carry the logo of the company (Emvipsa) who supplies these services to the Ayuntamiento. I can think of at least six of my old neighbours who do this type of work, in this area it is more usually local people employed rather than those from other countries - but I have, on visits to Madrid, often seen elderly people being accompanied by foreign carers.
> 
> There seem to be lots of the "official" carer jobs being advertised, and from a quick glance in some cases applications are restricted to those resident in the local community.
> 
> https://www.opcionempleo.com/empleo-auxiliar-de-ayuda-a-domicilio/andalucia-34836.html


And I don't doubt it Lynn. That kind of service is provided here too, but the people I know who need these services are not covered by the Ley or prefer to contract private care (I don't know which of these two options)


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## Lynn R (Feb 21, 2014)

Pesky Wesky said:


> And I don't doubt it Lynn. That kind of service is provided here too, but the people I know who need these services are not covered by the Ley or prefer to contract private care (I don't know which of these two options)


The maximum number of hours of care people can receive under the Ley seems to be 70 per month for those with the greatest needs (Level 3, although I don't know exactly what that entails) so people who want carers for longer (especially to live in) probably do have to contract them privately.

A few British people I know fly back to the UK on a regular basis to carry out live-in carer assignments for private companies. The clients have to fund that themselves, too, although if they receive Attendance Allowance that can be put towards the cost.


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## Roy C (Sep 29, 2012)

Gary, something you may already know but if not it may prove useful to know, with Google Chrome if to right click on most Spanish articles or forms etc you are then given an option to translate into English. If it is a form you can then print off the English version and use that as a guide to fill in the Spanish form, with a little help from some form of translator, Google Translate etc. Although if you can afford a proper translator as in person, that would be better but I have found this option useful, especially for newspaper articles etc.


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## gary1958 (Sep 8, 2017)

Thank you Alcalaina!.


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## gary1958 (Sep 8, 2017)

Thank you Lynn R-again!. We always travel with a stockpile of meds given Sheila has 9 to take daily,and your point on registering asap has been noted-all so useful.
Gary


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## gary1958 (Sep 8, 2017)

Roy C ,that is a peach of a tip!!. I will be using that!.
Thanks.Gary.


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## gary1958 (Sep 8, 2017)

Dear All,

I want to thank all the people who have been so helpful with all their tips and advice regarding my wife's hope of moving to Spain at the tender age of 81.She is suffering from the cold following a stroke last year,amongst other ailments.Unfortunately Sheila had a bigger stroke a few days ago,she still has all her faculties but this means we are unable to move to Spain unfortunately. Thank you to you all for your support,it has been appreciated!. Best wishes.Gary & Sheila.


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## Pesky Wesky (May 10, 2009)

gary1958 said:


> Dear All,
> 
> I want to thank all the people who have been so helpful with all their tips and advice regarding my wife's hope of moving to Spain at the tender age of 81.She is suffering from the cold following a stroke last year,amongst other ailments.Unfortunately Sheila had a bigger stroke a few days ago,she still has all her faculties but this means we are unable to move to Spain unfortunately. Thank you to you all for your support,it has been appreciated!. Best wishes.Gary & Sheila.


Such a shame, but she is probably better off where she is now in a system where you can understand what is happening and what the next steps are. Hope you have friends and support around you. Good luck.


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## Megsmum (Sep 9, 2012)

gary1958 said:


> Dear All,
> 
> I want to thank all the people who have been so helpful with all their tips and advice regarding my wife's hope of moving to Spain at the tender age of 81.She is suffering from the cold following a stroke last year,amongst other ailments.Unfortunately Sheila had a bigger stroke a few days ago,she still has all her faculties but this means we are unable to move to Spain unfortunately. Thank you to you all for your support,it has been appreciated!. Best wishes.Gary & Sheila.



How kind of you to take time to come here and say thank you at what must be a difficult time for you both.

Best wishes to you both


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## bob_bob (Jan 5, 2011)

All the best wishes to you both.


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## gary1958 (Sep 8, 2017)

Thank you to you all.Gary & Sheila


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