# Elder Care in Andalucia



## MickinUS (Jun 26, 2013)

Hi, I've just lost a brother and brother in law in the past month to terminal illnesses ( their passing was a blessing for them and their families) so I've started to think more about illness and elder care more. My better half and I are thankfully in good health and our mid 60s and hoping to move back to Europe in the next few years. Our choice of destination would more than likely be in the general Marbella area because of having friends who have homes there. However, I'm wondering generally about care for elderly beyond your normal heathcare situations. Has anyone had any experience with this?
I don't want to retire somewhere and find that all the expats go back home to their families when they get too old and ill to take care of themselves.


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## Lynn R (Feb 21, 2014)

There was another thread recently on the subject of nursing homes in Spain which you might find helpful if you haven't already seen it.

https://www.expatforum.com/expats/s...1473068-cost-quality-nursing-homes-spain.html


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## baldilocks (Mar 7, 2010)

MickinUS said:


> Hi, I've just lost a brother and brother in law in the past month to terminal illnesses ( their passing was a blessing for them and their families) so I've started to think more about illness and elder care more. My better half and I are thankfully in good health and our mid 60s and hoping to move back to Europe in the next few years. Our choice of destination would more than likely be in the general Marbella area because of having friends who have homes there. However, I'm wondering generally about care for elderly beyond your normal heathcare situations. Has anyone had any experience with this?
> I don't want to retire somewhere and find that all the expats go back home to their families when they get too old and ill to take care of themselves.


Here is a village in Jaén province, we have the Residencia - local authority old people s residential care-home for those who need 24 hour care and monitoring. Most elderly people live at home and family look after their needs. However for those who have no family, neighbours keep an eye open on them and/or private carers go in and deal with their needs and, for some, all they need is escorting when they take a walk, in which case, a carer from the Residencia will visit. For those who need frequent domiciliary medical care (changing dressings, etc.) a nurse from the health centre will visit (she/he will also give flu vaccinations, etc. [gives me mine when she/he comes to do the m-i-l and also does SWMBO because she is the m-i-l's carer])


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## MickinUS (Jun 26, 2013)

Thanks for the link, Lynn. Some 'sobering' comments and info. We've never been ones to look ahead that much until just now - we've been more focused on our 2 sons and their families. Daughters in law aren't quite as invested as daughters so we're looking at our options long term.
Some of what Baldilocks mentioned sounded very much like what my very able and 'active' 95 year old mother has in Ireland. She has someone come first thing in the morning and help her shower and dress and another lady comes in the evening to help her get ready for bed. During the day she has several of my siblings drop in and out and help out. Her support is off the charts. There is a large Irish family and most live close by. We will not have that.


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## MickinUS (Jun 26, 2013)

I had to look up "SWMBO" - I should have known)
Isn't that from Rumpole of the Bailey!! One of my favourites.
Thx Baldilocks for the info.


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## Lynn R (Feb 21, 2014)

MickinUS said:


> Thanks for the link, Lynn. Some 'sobering' comments and info. We've never been ones to look ahead that much until just now - we've been more focused on our 2 sons and their families. Daughters in law aren't quite as invested as daughters so we're looking at our options long term.
> Some of what Baldilocks mentioned sounded very much like what my very able and 'active' 95 year old mother has in Ireland. She has someone come first thing in the morning and help her shower and dress and another lady comes in the evening to help her get ready for bed. During the day she has several of my siblings drop in and out and help out. Her support is off the charts. There is a large Irish family and most live close by. We will not have that.


A great situation to be in. I don't have a large family myself (in any country) and no children, so am conscious of the fact that if I am living alone in older age, it will be a question of either employing paid help in the home, if that will suffice, or a residencia if it will not. Since either of those is substantially cheaper to pay for in Spain rather than my country of birth (UK) I intend to stay in Spain rather than returning there.


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## baldilocks (Mar 7, 2010)

MickinUS said:


> Thanks for the link, Lynn. Some 'sobering' comments and info. We've never been ones to look ahead that much until just now - we've been more focused on our 2 sons and their families. Daughters in law aren't quite as invested as daughters so we're looking at our options long term.
> Some of what Baldilocks mentioned sounded very much like what my very able and 'active' 95 year old mother has in Ireland. She has someone come first thing in the morning and help her shower and dress and another lady comes in the evening to help her get ready for bed. During the day she has several of my siblings drop in and out and help out. Her support is off the charts. There is a large Irish family and most live close by. We will not have that.


What also helps in an Andalucian village (rather than town) is the people are much more connected so neighbours will also get involved, much as it used to be in the UK village where I was born nearly 80 years ago. If somebody in the family is ill or in hospital, neighbours will call by to ask what they can do to help and, if it is the man of the house, they will be by with the likes of a chicken, eggs (freshly-laid), etc. to help get him back on his feet and working!


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## emlyn (Oct 26, 2012)

Something to possibly consider is ability to communicate in the spanish language, end of life care ,whether in an institutional setting or in ones own home could be significantly affected by level of understanding.


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## Isobella (Oct 16, 2014)

baldilocks said:


> What also helps in an Andalucian village (rather than town) is the people are much more connected so neighbours will also get involved, much as it used to be in the UK village where I was born nearly 80 years ago. If somebody in the family is ill or in hospital, neighbours will call by to ask what they can do to help and, if it is the man of the house, they will be by with the likes of a chicken, eggs (freshly-laid), etc. to help get him back on his feet and working!


I think it is probably the same in most countries. When I lived in London I never saw any neighbours. Wouldn't have known if they were ill. I live in a village now and when OH was very ill a couple of years ago I was overwhelmed with people offering help, even some I only knew by sight. Same where my relatives live in USA. I lived in a village on the Hudson river when dad was working in new York. Left when I was 10 but remember when he had a car accident neighbours helping out, lots of wonderful cakes and casseroles given too.


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## xabiaxica (Jun 23, 2009)

baldilocks said:


> What also helps in an Andalucian village (rather than town) is the people are much more connected so neighbours will also get involved, much as it used to be in the UK village where I was born nearly 80 years ago. If somebody in the family is ill or in hospital, neighbours will call by to ask what they can do to help and, if it is the man of the house, they will be by with the likes of a chicken, eggs (freshly-laid), etc. to help get him back on his feet and working!


This happens in my town (30,000 ish) which isn't in Andalucía.


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## MickinUS (Jun 26, 2013)

xabiaxica said:


> This happens in my town (30,000 ish) which isn't in Andalucía.


So it seems the idea should be:

1. Learn the language; and
2. Live in a community-type or smaller town setting (as opposed to a golf/vacation community).

Am I wrong in thinking that "home help" is easy to hire and less expensive than most other countries? Do people hire help that can live-in? I know that I could never afford it in the US.


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## Alcalaina (Aug 6, 2010)

Lynn R said:


> A great situation to be in. I don't have a large family myself (in any country) and no children, so am conscious of the fact that if I am living alone in older age, it will be a question of either employing paid help in the home, if that will suffice, or a residencia if it will not. Since either of those is substantially cheaper to pay for in Spain rather than my country of birth (UK) I intend to stay in Spain rather than returning there.


I'm in the same situation. A third option, which appeals to me a lot, is "co-housing", where you buy into a community and get the care services you need while still retaining your independence. They are growing in popularity in Spain, it seems.

https://www.idealista.com/news/inmo...-una-casa-sin-comprarla-ni-alquilarla-una-vez


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## Lynn R (Feb 21, 2014)

MickinUS said:


> So it seems the idea should be:
> 
> 1. Learn the language; and
> 2. Live in a community-type or smaller town setting (as opposed to a golf/vacation community).
> ...


There are always people advertising their services as live-in carers for the elderly. As has already been pointed out, few of them speak English. It would probably be not much less than the cost of the average residencia (the cost for those varies according to whether you could accept a shared room or would want a single one, and the level of care needed, specialist dementia care being the most expensive). But both home care or residential are certainly much less expensive than the UK, I don't know how US costs compare.

Typical adverts from people offering their services:-

https://www.milanuncios.com/servicio-domestico/cuidadora-de-ancianos-interna.htm


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## MickinUS (Jun 26, 2013)

Alcalaina said:


> I'm in the same situation. A third option, which appeals to me a lot, is "co-housing", where you buy into a community and get the care services you need while still retaining your independence. They are growing in popularity in Spain, it seems.
> 
> https://www.idealista.com/news/inmo...-una-casa-sin-comprarla-ni-alquilarla-una-vez


I was reading about this housing model recently - very interesting


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## Pesky Wesky (May 10, 2009)

MickinUS said:


> I was reading about this housing model recently - very interesting


And which is mentioned in the thread that Lynn guided you to


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## MickinUS (Jun 26, 2013)

True. Was mentioned there also. The article I read a few weeks ago was about the Santa Clara in Malaga, one of these co housing examples.
Seniors in Spain are saying no to nursing homes | Fortune


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## emlyn (Oct 26, 2012)

Another thing to consider is Power of Attorney.


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## nigele2 (Dec 25, 2009)

Just a resume and a few more details some hopefully might find helpful:

As said before my MIL has very limited mobility after a stroke, normal range of other medical issues, and will be 88 in August. Dementia is slowly taking hold – and there are times when we can keep it at bay, and others when it leaps to a new level. 

We hire a Spanish lady (our ball of energy) for 4 hours in the mornings, Monday to Friday. She costs 400 Euros a month. However, beware. As often in Spain she gets 14 payments a year and will have some holidays. She can get up, shower, clean and feed my MIL (although when getting up and showering there have been times when another pair of hands were needed). She also entertains, stimulates, reads, discusses TV and Spanish life, both past and present. She’s great and worth every penique.

We have another lady one-hour evenings (clean and puts to bed) and she does weekend mornings and evenings (one hour). She costs 10 Euros an hour. 

We do 98% of feeding and 100% of food preparation.

So about 900 Euros covers 29 hours a week. That leaves 139 hours a week for us to cover.

We have two reserves who live close by. One is the daughter of the evening/weekend lady. My wife has two sisters, who despite living in Jaen and Madrid can give us some breaks throughout the year.

We use a cleaning lady not because we are the idle rich, my wife has never had a cleaner in her life, but because looking after someone creates a lot of extra house tasks like endless washing, food preparation, equipment maintenance, etc.

There are several extra costs that need budgeting within our project. One is equipment: motorised bed and chair, wheelchairs, crane, night camera, wheelchair ramps. Another pads and prescriptions. Another extra electricity for an oxygen machine (this adds 50% to our average electricity bill). We have a downstairs bedroom but took advise and gave up our lounge. You need space above all else if things are to work safely.

But as can be seen this is just about manageable for the 2 of us.

However, if you imagine an expat living alone, I can’t see how it would work without very high costs. And I’d have no idea how the expat would put this all in place. 

None of the above, the doctor, the delivery men, etc. speak English. (We are a Spanish family accept me in case the reader doesn’t know).

A permanent live-in we looked at but often you are talking about an immigrant who certainly doesn’t speak English, and is unlikely to be well educated in how the Spanish systems work. I also am against slave labour and the examples discussed make me wonder about human rights. But an individual living in would still need backup. And who keeps an eye on, or even controls money matters?

I conclude that if your issues are only mobility helpers might work. If, or when dementia raises its head, I can’t see a way forward without family and/or very trusted friends being involved.

For us the residency didn’t work. A prison where people wait for death which arrives as a mercy. But at least it is inclusive. For 1600 Euros shared, and 2000 Euros individual, plus a few small hidden extras, you get the very basics. And as a system it works. And I guess many could fund it by selling property if pensions are not enough.

My wife and her 2 sisters have some power of attorney but beware as always in Spain things take forever and banks can be b**********s. Everything needs to be done as much as possible in advance. Our current assessment for financial help for example looks like it will take a year. 

Local services, despite type of location, are vital. We have a taxi service that has wheel chair prepared vehicles, a doctor’s surgery within wheel chair distance, two chemists covering a wide range of opening times, flat routes locally that have ramps so wheelchair trips out are easy, hospital not too far (not for the emergency call but for those who need to be there 24 hours to assist the patient). We also have our local dementia association nearby. Worth getting in touch with before you really need them. 

Sorry that ended up a bit of a brain dump but hopefully it helps someone. 

As always I hope we die still looking forward to tomorrow


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## Alcalaina (Aug 6, 2010)

nigele2 said:


> Our current assessment for financial help for example looks like it will take a year.


Very useful information.

Is this assessment for assistance under the Ley de Dependencia? And is that a year before you can get assessed, or a year before you know the outcome?


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## nigele2 (Dec 25, 2009)

Alcalaina said:


> Very useful information.
> 
> Is this assessment for assistance under the Ley de Dependencia? And is that a year before you can get assessed, or a year before you know the outcome?


There are several options that are possible once MIL is officially assessed. We are told that might happen in July. But that just gives us the assessment of MIL. Then we must apply. Various people involved with her health have suggested not holding our breaths for a quick resolution. 

My wife's elder sister is a PP supporter who feels the system is there to benefit those who are smart. So the other two sisters have left it to her. I'll update when I know more.

The only thing we really need is that my wife can officially retire as she is the prime carer (she's 61 in Sept). Even if she receives the minimum it would balance the books. And in 4 more years she'll get something for her 6 years in the UK.

Of course this highlights an issue. I'm sure my mate Antonio in the Residency wasn't meant to survive 11 years. How long do we need to budget for? Which is why we want my wife's pension as that will stop us leaking capital. After all we have no idea how much we will need for ourselves and we for sure have no rich kids. 

I feel sorry for Antonio when his family only visit once every 2 weeks and limit him to 5 ciggies a day, but the drain on their economy year after year must hurt. Maybe I shouldn't but to see his smile when I smuggle him in 20 **** is worth the walk  

ps I say smuggle but that is our little joke. As far as I know he isn't told not to smoke, and nothing is sadder seeing him sitting on the patio with the smokers when he has no ciggies or money to buy them.


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## Tigerlillie (Apr 7, 2015)

nigele2 said:


> There are several options that are possible once MIL is officially assessed. We are told that might happen in July. But that just gives us the assessment of MIL. Then we must apply. Various people involved with her health have suggested not holding our breaths for a quick resolution.
> 
> My wife's elder sister is a PP supporter who feels the system is there to benefit those who are smart. So the other two sisters have left it to her. I'll update when I know more.
> 
> ...


Sorry to disillusion you but if your wife is 61 this year she may not qualify for a UK state pension (however big or small) for another five years or longer. Official retirement age for women of your wife's age in the UK at the moment is now 66.

https://en.m.wikipedia.org/wiki/Retirement_in_Europe



> United Kingdom	65	65	*2018	Retirement age equalized at 66.* *Increasing to 67 by 2021*, 68 by 2028 and 69 by 2046. See also: Pensions in the United Kingdom.


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## nigele2 (Dec 25, 2009)

Sorry. Make that 6/7 years. But neither here nor there as long as we are not reducing capital year by year.


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## Isobella (Oct 16, 2014)

I saw this on an Alzheimer forum.

_In March my 92-year-old mother was admitted to a care home in Motril after a fall at home. She has lived in Southern Spain for 30 years; for 10 years on her own after my father died. I live in London and have been over twice since she was admitted. Last month the resident psychologist gave an initial diagnosis of dementia; the type has yet to be ascertained. This came as quite a shock as it had never crossed my mind that she was anything other than eccentric, elderly, and a bit cranky. In retrospect, however, a number of things have started to make sense, especially since I have begun to educate myself about this condition.
Since her fall she has lost command of Spanish (semantic amnesia) and struggles to communicate with the staff, being the only Anglophone resident. She is very unhappy in the care home and implores me to take her to Britain. Even if I found a way to transport her to the UK it is not practical to move her into my small rented flat, so I would need to find a suitable residence or care home. She is unable to walk unassisted and has double incontinence.
This is all quite overwhelming for me at the moment and I am unsure how to proceed, although I would like to bring her over to the UK. My own funds are quite meagre, and whilst my mother is in receipt of a British state pension, her only capital is tied up in her house. Does anyone have any suggestions or advice?_


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## nigele2 (Dec 25, 2009)

Isobella said:


> I saw this on an Alzheimer forum.
> 
> _In March my 92-year-old mother was admitted to a care home in Motril after a fall at home. She has lived in Southern Spain for 30 years; for 10 years on her own after my father died. I live in London and have been over twice since she was admitted. Last month the resident psychologist gave an initial diagnosis of dementia; the type has yet to be ascertained. This came as quite a shock as it had never crossed my mind that she was anything other than eccentric, elderly, and a bit cranky. In retrospect, however, a number of things have started to make sense, especially since I have begun to educate myself about this condition.
> Since her fall she has lost command of Spanish (semantic amnesia) and struggles to communicate with the staff, being the only Anglophone resident. She is very unhappy in the care home and implores me to take her to Britain. Even if I found a way to transport her to the UK it is not practical to move her into my small rented flat, so I would need to find a suitable residence or care home. She is unable to walk unassisted and has double incontinence.
> This is all quite overwhelming for me at the moment and I am unsure how to proceed, although I would like to bring her over to the UK. My own funds are quite meagre, and whilst my mother is in receipt of a British state pension, her only capital is tied up in her house. Does anyone have any suggestions or advice?_


That's very interesting. My MIL started being looked at seriously after a fall. It was exactly 3 years ago when wheelchair bound we moved her from her flat to Cadiz. She also had just her pension and her flat. 

Things change in an instance. It is although the fall brings on mental issues, or vice versa. But all confidence seems to evaporate.

The good news is that until a stoke we had great times. Deterioration was gradual. And lack of mobility could be managed. 

But the circumstances I think in the case above should really make expats think. You don't get notice of these things.

Thanks Isobella for that.


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## 95995 (May 16, 2010)

Just wanted to say nigele2, I think you and your wife are absolutely amazing the way you are taking care of your MIL.


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## Isobella (Oct 16, 2014)

This is interesting in El Pais in English. Looking after their elderly with hand rails and other things. All sounds wonderful.

https://elpais.com/elpais/2019/05/24/inenglish/1558691924_831230.html


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## Pesky Wesky (May 10, 2009)

Isobella said:


> This is interesting in El Pais in English. Looking after their elderly with hand rails and other things. All sounds wonderful.
> 
> https://elpais.com/elpais/2019/05/24/inenglish/1558691924_831230.html


Really interesting!


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## Alcalaina (Aug 6, 2010)

Our town has built a residential home for 80 elderly people right in the town centre so they are not cut off from their friends and families. Sadly the company that built it went bankrupt during the recession and La Caixa bank repossessed the building. We are now in the ridiculous sitiation where the bank won't hand it over to the Ayuntamiento until they pay off the debt, and the Ayto can't begin to pay off the debt until it can start leasing out the apartments. Meanwhile it's standing empty and old folk are still living in tiny damp houses with steep stairs, or blocks of flats built in the 1970s with no lifts.

The only way out seems to be private capital, which goes against the grain of our socialist administration, but the mayor doesn't have any other option as the lawsuit against the bank went against him.


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