# Long term home care or nursing home



## MickinUS (Jun 26, 2013)

I've been researching several destinations to spend the "tertiary" part of our lives and when looking at Spain (among others) I don't see inexpensive or adequate nursing home/long term care facilities. I know the Spanish system is very family-centric and many Spanish elderly depend on their immediate family members to care for them in their final years BUT what about the expats with no immediate family around? Am I missing something? My ideal Spanish destination would be south of Malaga at this point.


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## Lynn R (Feb 21, 2014)

MickinUS said:


> I've been researching several destinations to spend the "tertiary" part of our lives and when looking at Spain (among others) I don't see inexpensive or adequate nursing home/long term care facilities. I know the Spanish system is very family-centric and many Spanish elderly depend on their immediate family members to care for them in their final years BUT what about the expats with no immediate family around? Am I missing something? My ideal Spanish destination would be south of Malaga at this point.


You might find this website giving details of the residencias de ancianos in Malaga province helpful (although south of Malaga would put you in the Mediterranean). There doesn't seem to be any shortage of them. 


Residencias de ancianos en Málaga


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## MickinUS (Jun 26, 2013)

Thx Lynn, 
It actually looks like most have no vacancies and are quite expensive.is this the only option?


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## xabiaxica (Jun 23, 2009)

MickinUS said:


> Thx Lynn,
> It actually looks like most have no vacancies and are quite expensive.is this the only option?


there are state run residencias, but generally speaking you have to have been resident for 10 years before you can use them, if indeed there is room


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## MickinUS (Jun 26, 2013)

Thx. So how do most elderly expats mange who need care in their final years, away from family? Any experiences that we know of!


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## Isobella (Oct 16, 2014)

I suppose most return to the UK. An American couple who ran a successful bar/night club in Puerto Banus returned to USA last year after more than 30 years in Spain. They cited old age and health problems.

I shall do this

Florida widow has been living on Crystal Serenity cruise ship for nearly seven years | Daily Mail Online


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## MickinUS (Jun 26, 2013)

That seems like a flaw in the expat plan, doesn't it? Unless you have the $$$ to go private. Is it expensive to hire in-home care?


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## MickinUS (Jun 26, 2013)

BTW, we both are in excellent health TG but I've just read a bit about destitute Brits stranded in Spain unable to go home and living off the charity of other expats and it just sounds depressing.
Anybody here in their late 70s and 80s who have a local home-care setup going? I'd rather not have to go back to the States(or Ireland) and be a burden on family.


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## Pesky Wesky (May 10, 2009)

MickinUS said:


> That seems like a flaw in the expat plan, doesn't it? Unless you have the $$$ to go private. Is it expensive to hire in-home care?


Yes, it is and you're very wise to be thinking about it before you need it.
I have heard that Age Concern is up and running in many expat areas, and is probably very much needed.
Might be an idea to get in touch with them
Age Concern España | Promoting the well-being of older people in Spain


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## GallineraGirl (Aug 13, 2011)

The locals here seem to employ very caring South American ladies to care for their old folk in their own homes. The advantage, obviously is that they speak Spanish and don't charge much.


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## GallineraGirl (Aug 13, 2011)

Three years ago the cost for the highest level of care in a small privately run home near here (inland) was 1400€ a month. I don't think it is much dearer now. This was for a wheel chair bound lady who had a degree of dementia. The fees for the more able were less. It may be the nearer you get the coast, where there are more expats, the higher the fees are?


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## Taurian (Dec 12, 2009)

I must confess that the care in old age question is the one thing that is stopping me considering moving to Spain permanently as opposed to spending a few months a year there - sadly


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## Lynn R (Feb 21, 2014)

GallineraGirl said:


> Three years ago the cost for the highest level of care in a small privately run home near here (inland) was 1400€ a month. I don't think it is much dearer now. This was for a wheel chair bound lady who had a degree of dementia. The fees for the more able were less. It may be the nearer you get the coast, where there are more expats, the higher the fees are?


I was wondering whether the figures quoted in the link I posted earlier (and of course those prices are "from xxx") were per week or per month, but couldn't see any way to check. If they are per month (for the private ones most seemed to be between €1300-1800, then to be honest compared to the figures I am used to hearing about in the UK that does not seem expensive at all to me. If they were per week, that's another matter altogether, but if those are weekly amounts I can't see more than tiny percentage of Spanish families being able to afford them.

My sister is Head Housekeeper in a large residential care complex in North West England (cost 10M to build, apparently) and their fees for residential care (for people needing personal care only, nursing care is extra) are 760 pounds a week. That is in a place run by a not for profit organisation.

What would the typical costs in the USA be?


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## Calas felices (Nov 29, 2007)

I'm afraid the way that Spanish business is set up makes it almost impossible to run a profitable home care business. The Spanish don't seem to understand that not everyone can work for 40 hours a week and the minimum level of autonomo is crippling. There is a scheme for fruit pickers who work casually but it won't translate across. They don't seem to understand that carers have mobile work, many clients and yet only one boss. There are a number of organisations that do it but it seems to be using volunteers rather than paid employees and most are struggling, add to that the petrol needed to be used in Spain (in the UK the carers either pay it themselves or have an allowance) and the costs just become prohibitive.


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## MickinUS (Jun 26, 2013)

Lynn R said:


> I was wondering whether the figures quoted in the link I posted earlier (and of course those prices are "from xxx") were per week or per month, but couldn't see any way to check. If they are per month (for the private ones most seemed to be between €1300-1800, then to be honest compared to the figures I am used to hearing about in the UK that does not seem expensive at all to me. If they were per week, that's another matter altogether, but if those are weekly amounts I can't see more than tiny percentage of Spanish families being able to afford them. My sister is Head Housekeeper in a large residential care complex in North West England (cost 10M to build, apparently) and their fees for residential care (for people needing personal care only, nursing care is extra) are 760 pounds a week. That is in a place run by a not for profit organisation. What would the typical costs in the USA be?


Lynn, maybe you're right 1400 a month probably isn't that expensive for some. Again, it depends on where your fixed income is coming from, the exchange rates at the time, anything you've left in the piggy bank etcetera 
I have no idea what the places here in the US charge - I do know it's an arm and a leg. 
Anyway, I appreciate everyone's input - this is a subject that I don't really like to talk about BUT it has to be a consideration when you are contemplating a big move.


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## MickinUS (Jun 26, 2013)

Pesky Wesky said:


> Yes, it is and you're very wise to be thinking about it before you need it. I have heard that Age Concern is up and running in many expat areas, and is probably very much needed. Might be an idea to get in touch with them Age Concern España | Promoting the well-being of older people in Spain


Pesky, just took a look at their website - they seem to be doing excellent work in the areas they are active.


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## Lynn R (Feb 21, 2014)

MickinUS said:


> Lynn, maybe you're right 1400 a month probably isn't that expensive for some. Again, it depends on where your fixed income is coming from, the exchange rates at the time, anything you've left in the piggy bank etcetera
> I have no idea what the places here in the US charge - I do know it's an arm and a leg.
> Anyway, I appreciate everyone's input - this is a subject that I don't really like to talk about BUT it has to be a consideration when you are contemplating a big move.


I guess you have to think about what is being provided for the money. It does seem a lot, but €1500 a month is just €50 per day. A room in a pretty basic hotel would be probably at least €35 per night, then add on the cost of 3 meals per day, personal laundry, before you even add on the cost of staff to help with things like bathing, dressing, etc. 

It can't be done for nothing, the money has to come from somewhere.

In the UK people get help with care home fees (depending on the level of fees, this doesn't always cover the full cost and sometimes people or their families have to pay a top-up), but if they have assets (including their house) worth over 23K then they don't get any assistance. I believe it's the Government's intention to introduce a cap in the next couple of years which is intended to make sure that no-one has to pay more than a total of 75K for care, but that's still more than a great many people have lying around in the bank.


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## Calas felices (Nov 29, 2007)

They do a great job but unfortunately with volunteers and it's run by expats for expats.


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## Pesky Wesky (May 10, 2009)

Interesting info from Saga
Paying for Care Home Fees - Who Pays for What?


> *If the State is paying do I have a choice of care home?*
> Yes and it can even be in a different county. The home you choose must be suitable for your assessed needs, comply with any terms and conditions set by the authority and, not cost any more than they would usually pay for someone with your needs.


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## extranjero (Nov 16, 2012)

Lynn R said:


> I guess you have to think about what is being provided for the money. It does seem a lot, but €1500 a month is just €50 per day. A room in a pretty basic hotel would be probably at least €35 per night, then add on the cost of 3 meals per day, personal laundry, before you even add on the cost of staff to help with things like bathing, dressing, etc.
> 
> It can't be done for nothing, the money has to come from somewhere.
> 
> In the UK people get help with care home fees (depending on the level of fees, this doesn't always cover the full cost and sometimes people or their families have to pay a top-up), but if they have assets (including their house) worth over 23K then they don't get any assistance. I believe it's the Government's intention to introduce a cap in the next couple of years which is intended to make sure that no-one has to pay more than a total of 75K for care, but that's still more than a great many people have lying around in the bank.


It's unfair to include the house , as that swallows up the allowance immediately


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## Lynn R (Feb 21, 2014)

extranjero said:


> It's unfair to include the house , as that swallows up the allowance immediately


Well, there is another way of looking at that situation - should someone who owns a house have their care home costs met by the taxpayer rather than selling it to meet the costs of their care? If they can't live in it because they're in a care home, they don't need the house, after all. What if someone doesn't own a house but rents one, preferring to keep the capital in the bank instead? They'd have to fund their own care although their assets would only be worth the same as the home owner's, which wouldn't be fair either.

The bottom line is that because so many people are living into extreme old age (but not necessarily in good health) there just isn't enough money for everyone's care costs to be met by the taxpayer - not unless income tax were to be a good deal higher, that is. Judging from what you say on the subject in other posts, somehow I don't think that would be a popular solution with you, either.

Can't have it both ways, though.

Oh, and it seems the proposed new cap on care costs won't be quite so helpful as we were first led to believe, as is so often the case once the fine print of these much-trumpeted Government initiatives becomes known.

http://www.bbc.com/news/uk-27363896


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## extranjero (Nov 16, 2012)

Apparently, the savings threshold before having to pay is soon to go up substantially!
If there was only the person needing care involved, it wouldn't matter if the house had to be sold, but where there is a partner, then why should all their hard earned money drain away?


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## Lynn R (Feb 21, 2014)

extranjero said:


> Apparently, the savings threshold before having to pay is soon to go up substantially!
> If there was only the person needing care involved, it wouldn't matter if the house had to be sold, but where there is a partner, then why should all their hard earned money drain away?


The Saga link from Pesky Wesky in post #19 covers that situation:-


"My partner needs care, how does this financially affect me?

Only the partner requiring care should be means tested. Property occupied by a partner is disregarded and only fifty percent of any private pension should be taken into account. The local authority will take into account 50% of any joint savings. Therefore, to accelerate financial help, it is better to have separate single accounts meeting care costs paid from the account of the person needing care."


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## Lynn R (Feb 21, 2014)

I heard on the news this morning that the BBC has developed an online calculator designed to help people see how the new cap on care costs due to be implemented in 2016 will affect them, so I thought I'd try it out as a hypothetical exercise. I put in figures based on the UK postcode I left, same value house and what my savings and pension income would amount to once I reach 66. 


BBC News - Care in the UK: The costs you face

It told me I would have to spend over 148K on care over a period of 6 years and 5 months before reaching the cap, and wouldn't be entitled to any assistance with the costs before that.

So my intention to stay here and be prepared to fund my own residential care if I ever need it, at somewhere around €1500 per month (even if costs increase due to inflation) is confirmed.


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## Isobella (Oct 16, 2014)

A lot of people will not be able to afford to have a choice


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## fergie (Oct 4, 2010)

Since I have lived permanently in Spain, it has really been ' an eye opener' for me, I have seen some very lonely elderly people, who have more than often lost partners, then friends due to the aging process, and the enevitable end of life.
I have met physically and mentally challenged people, (due to Alzheimer's )and they are living day to day with just occasional GP input, and friendliness of the longer term bars, where they might go for a cup of tea/coffee and some company.
We have made a plan for the future years, if we can't manage, we will move out of our large house, into an apartment with a lift, if health etc would deteriorate further, our plan is to live in one of these 'villages' we have seen advertised in local newspapers,with private apartments, and communal areas, for older residents, where there is 24/7 doctor and nurse on site, plus the facilities to care for elderly as they become more frail.
We have also set up our own funeral plans, paid up, so that those left behind do not have any hassle dealing with complicated matters after we have gone.
None of us get younger, so planning for the future is the safest bet.


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## bob_bob (Jan 5, 2011)

fergie said:


> Since I have lived permanently in Spain, it has really been ' an eye opener' for me, I have seen some very lonely elderly people, who have more than often lost partners, then friends due to the aging process, and the enevitable end of life.
> I have met physically and mentally challenged people, (due to Alzheimer's )and they are living day to day with just occasional GP input, and friendliness of the longer term bars, where they might go for a cup of tea/coffee and some company.
> We have made a plan for the future years, if we can't manage, we will move out of our large house, into an apartment with a lift, if health etc would deteriorate further, our plan is to live in one of these 'villages' we have seen advertised in local newspapers,with private apartments, and communal areas, for older residents, where there is 24/7 doctor and nurse on site, plus the facilities to care for elderly as they become more frail.
> We have also set up our own funeral plans, paid up, so that those left behind do not have any hassle dealing with complicated matters after we have gone.
> None of us get younger, so planning for the future is the safest bet.


A very good post Fergie.

We all need to plan ahead for the future. An example; my son in laws grand father died not long ago, he was @85 years old. The chap had done his homework and left a Will and his complete financial details neatly put together and informed the family where to find them and this has made life so much simpler for his loved ones...we've done much the same.

We've also told our children that neither of us want to be 'peg fed' and that should we have dementia they are not to visit us when we no longer understand who they are. 

On a lighter note, I'm off to Tenerife next week


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## extranjero (Nov 16, 2012)

fergie said:


> Since I have lived permanently in Spain, it has really been ' an eye opener' for me, I have seen some very lonely elderly people, who have more than often lost partners, then friends due to the aging process, and the enevitable end of life.
> I have met physically and mentally challenged people, (due to Alzheimer's )and they are living day to day with just occasional GP input, and friendliness of the longer term bars, where they might go for a cup of tea/coffee and some company.
> We have made a plan for the future years, if we can't manage, we will move out of our large house, into an apartment with a lift, if health etc would deteriorate further, our plan is to live in one of these 'villages' we have seen advertised in local newspapers,with private apartments, and communal areas, for older residents, where there is 24/7 doctor and nurse on site, plus the facilities to care for elderly as they become more frail.
> We have also set up our own funeral plans, paid up, so that those left behind do not have any hassle dealing with complicated matters after we have gone.
> None of us get younger, so planning for the future is the safest bet.


I agree plans have to be made for a time when we are too frail, but retirement villages are too expensive for anyone on a modest income, so the only real solution will be to go back to the UK, warts and all, where at least there is more support.
It's unfair on relatives to expect them to drop everything and fly out when there are ongoing physical and mental problems,
I bet there will be residential and nursing homes springing up all over Spain in years to come, the fear is is that unless they are well regulated, there will be problems with standards, abuses of the vulnerable etc


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## Pesky Wesky (May 10, 2009)

This is a retirement village that is up and running in the Madrid area. This is the kind of project I'll be heading towards if at all possible when the time comes 
http://ecohousing.es/en/nuevos-mode...arquitectura-del-centro-de-mayores-trabensol/

Meanwhile I'm off to work, not Tenerife, like some lucky poster before me


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## fergie (Oct 4, 2010)

extranjero said:


> I agree plans have to be made for a time when we are too frail, but retirement villages are too expensive for anyone on a modest income, so the only real solution will be to go back to the UK, warts and all, where at least there is more support.
> It's unfair on relatives to expect them to drop everything and fly out when there are ongoing physical and mental problems,
> I bet there will be residential and nursing homes springing up all over Spain in years to come, the fear is is that unless they are well regulated, there will be problems with standards, abuses of the vulnerable etc


I agree with you, that not all can afford retirement villages, but people really have to consider possible care in old age when thinking of coming to Spain, and not just the immediate sunshine, beauty of the country and of course culture, because we are guests in this lovely country.
Even in the UK elderly care is not entirely free, so for some British people living in Spain running back to the UK, when frailty hits, is also not an option.
For instance, people of any age could have a stroke, or another kind of accident, not necessarily a slower ageing process, and may need long term care.
Nursing homes popping up in all parts of Spain, I think, wouldn't be a bad idea, for the Spanish people to use as well, also it would provide lots of jobs for Spanish people, which would be great, so many are bi-lingual.


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## Pesky Wesky (May 10, 2009)

extranjero said:


> I agree plans have to be made for a time when we are too frail, but retirement villages are too expensive for anyone on a modest income, so the only real solution will be to go back to the UK, warts and all, where at least there is more support.
> It's unfair on relatives to expect them to drop everything and fly out when there are ongoing physical and mental problems,
> I bet there will be residential and nursing homes springing up all over Spain in years to come, the fear is is that unless they are well regulated, there will be problems with standards, abuses of the vulnerable etc


But there are residential nursing homes all over Spain now. There are at least 10 in the town where I live. I used to give class to a student who imported articles from China and also owned some nursing homes in Andalucia! When I was teaching him he had some meetings with some Saudi Arabians (or were they from Dubai?) who were interested in buying them.. It would probably be a good investment.
Perhaps you mean ones that will serve an immigrant population?
And here's an article about a different kind of home that's being built
Spain's first gay retirement home passes its first hurdle | World news | The Guardian


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## Isobella (Oct 16, 2014)

fergie said:


> Nursing homes popping up in all parts of Spain, I think, wouldn't be a bad idea, for the Spanish people to use as well, also it would provide lots of jobs for Spanish people, which would be great, so many are bi-lingual.


Not quite correct, you are probably judging by tourist areas and many of the can only speak certain phrases. Get them from behind a bar etc. and out of their environment and they are not fluent.

S?lo cuatro de cada diez espa?oles hablan y escriben alguna lengua extranjera | Espa?a | EL MUNDO


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## Pesky Wesky (May 10, 2009)

A better article about the retirement village co operative in Madrid in English
Spanish pensioners find Utopia in sharing | Europe | DW.DE | 27.12.2013


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## Isobella (Oct 16, 2014)

Lynn R said:


> Well, there is another way of looking at that situation - should someone who owns a house have their care home costs met by the taxpayer rather than selling it to meet the costs of their care? If they can't live in it because they're in a care home, they don't need the house, after all. What if someone doesn't own a house but rents one, preferring to keep the capital in the bank instead? They'd have to fund their own care although their assets would only be worth the same as the home owner's, which wouldn't be fair either.
> ]


No sure. Many people who bought houses scrimped and saved to buy whilst others rented, some with housing benefit and took nice holidays etc. or spent it down the pub. One size doesn't fit all. I don't know what the ideal solution is. Euthanasia


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## Lynn R (Feb 21, 2014)

Pesky Wesky said:


> This is a retirement village that is up and running in the Madrid area. This is the kind of project I'll be heading towards if at all possible when the time comes
> eCOHOUSING Proyecto de arquitectura del Centro de Mayores Trabensol |
> 
> Meanwhile I'm off to work, not Tenerife, like some lucky poster before me


The idea sounds wonderful, but I wish it didn't have the appearance of an open prison!


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## Lynn R (Feb 21, 2014)

Isobella;6297201 I don't know what the ideal solution is. Euthanasia ;)[/QUOTE said:


> I'd vote for that one - seriously. Even if I could afford to do it I'd sooner not have to spend lots of money being cared for and kept alive in a state where I could do little or nothing for myself, I'd sooner the money go to someone else to enjoy. And that wouldn't be my family making me feel that way, it's the way I feel myself, even before there's any immediate prospect of me being in that situation (I hope).


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## Lynn R (Feb 21, 2014)

extranjero said:


> I bet there will be residential and nursing homes springing up all over Spain in years to come, the fear is is that unless they are well regulated, there will be problems with standards, abuses of the vulnerable etc


I agree with Pesky Wesky, there are already many residencias for the elderly all over Spain, although no doubt there will be a need for more and more in the future as Spain, in common with many other countries, has an ageing population.

I don't know what the regulation system is like in other autonomous regions, but in Andalucia the inspection regime of the Junta's Social Services Department appears to be fairly robust.



La inspección detecta fallos en un 2,3% de residencias y en un...


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