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Any who live in Latin America?
My husband and I moved to a community in the mountains of western Panama 10 years ago. Now he is totally disabled and has some cognitive impairment. There are no nursing homes, no assisted living, no adult day care, no agencies that provide hired caregivers, no social services that offer support. Husband speaks no Spanish, most hired caregivers speak no English. Friends drop away, because we're no fun any more. I am lonely and isolated. Is anybody else in a circumstance like this?

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panapal: Fortunately I have found some good people here, but there are some I avoid, like you experienced. But isn't that true everywhere? I won't adopt a street dog (two old cats wouldn't like it), but I have helped find homes for dozens of them through the adoption website I maintain and the people who rescue dogs and cats. Our vet in town knows how to get the exit papers and it is easy through her. I will take my cats with me if I leave, or stay here until they die.

igloo572: I have bank accounts in two U.S. cities and am registered to vote in one of them. I have a Miami mail forwarder. My sister lives in San Antonio, and if we need medical care that we can't get here, we can go there. We have Medicare (though we can't use it here, just have the privilege of paying for it!) in case we need it.
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Judy I broke up my time between Boquete and Bocas del Toro (thus the pana) while I was there but had to come home after Dad passed and I could tell from my phone conversations with Mom that she was not able to stay alone any longer.
Frankly while I was there most people that were english speaking were not worth associating with. Mostly tax evaders, wild Bills, or trust fund brats. I was adopted by two street dogs while I was down there and on our daily walks to the marcata to get the carni butcher to cut us some bones we started have local perros join us. I would have 8- 10 dogs walking with us and come back and lay on the porch till I told them to go home. Panama can be a very lonely place and I understand how you feel. Adopt a dog (street) and bring him home with you when your ready to make the move. Grease the local vets palm ($40.00) and he will fill out the quarantine papers buy a crate and when you cant take it any more do what i did and come home our prodical sister.
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Judy -I'd like to suggest that you think about recreating a US address. You may never need it but could be handy to have existing a few years from now. It will not be too hard but will need you to be somewhat dogged in doing this & have someone in the states as your backup person.

Lots of folks live in Latin America yet maintain an address in the US. If something should go awry and you need to move back for health care, it will just make things easier in a stressful situation.I'd ask about in your expat community what others have done or who they use to facilatate for them. International Living has been touting panama & Ecuador a lot and they have articles on both countries and service providers so perhaps read some old issues for resources.

My mom lives in Texas, and there are huge #'s in both San Antonio & houston, who live in Mexico (SMdA, cuernavaca especially) but have local TX address. Both cities have large health science centers with gerintology programs so if you & hubs needs a higher level of care at least you have an address in the US for appointments. In my city (new Orleans) there are quite a few who live in Belize (we used to have direct flights with TACA) and also nicaragua and they tie into a well establised bilingual health care system @ Ocshner hospital & Brent house. Brent house is apartments used for those living abroad to stay when in NOLA for heath care at Ocshner & been there decades - I swear every major Latin American dictator & his family has stayed there(Trujillo, Arrellano). I would imagine the health science centers in other cities do something like this too.

Whatever the city, what seems to work is to establish an address with a private mail box service, that all US based mail goes to. Then the service, every couple of weeks or once a month ships you an envelope with your mail. I prefer DHL but FedEx does a good international job. You need to establish an account with either one. Also you might want to look into banking with one that is on the swiftbic system but has a branch in the US. It may make your life easier to pay for things if you end up going back & forth.

BTW hubs & I are probably going to retire abroad.But will always maintain a US address.
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Thank you for the info about the online courses. I will check that out. Meanwhile, the Kindle is a blessing. All the books I want are available. It used to be hard to find current books here, now no problem.
You are absolutely right about the Spanish.
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Judy, Of course you're sad. You're losing your husband a little at time and you're already grieving. Thank goodness you have some outlets. This may sound crazy, but it helped me through a bad patch. Do you have broadband? (Unfortunately, you'd need that.) I took "college" courses through www.Coursera.org. These are free courses taught online by professors from many different universities. No cost, no college credit, but a chance to get outside yourself and indulge yourself in learning things you "always intended" to learn about, with no pressure at all. I took two courses in Greek and Latin classic literature and just loved them. The readings and online tutorials gave structure to my days; the interaction on the blogs and message boards was fun; and the satisfaction of sinking into other times and other places was enormous. There are courses on everything from detective fiction to the history of rock and roll to abstruse mathematics to astrophysics. Of course it's a solitary sort of thing, but it's better than aimlessness, you can do it at any hour of the day or night, and it leaves you with something all your own. Another site with the same approach is udacity.

Here's another thought. I recently discovered "The Village Network." Try googling it. It's an approach to aging in place by forming virtual communities for self-help, mutual support and reduced-cost services through economies of scale. It isn't a charity, villagers usually pay an annual subscription fee to their village, and there are costs for accessing the resources of the national organization. It's spreading really fast in the United States; it has manuals and protocols for getting a "village" started. It would be a great thing to get started in your area, where there are surely many retirees who are facing or will soon face what you're up against. I plan to retire soon to my mother's hometown, where nothing of the kind exists, and am thinking about trying to get something going there for my mother's benefit and later, my own. There are subscription fees and such, but it's apparently totally on the up and up, and is working well in different types of communities. Maybe you could develop a model for expat "villages" in foreign countries! Oh, heavens, what a great thing that would be! If I had had a village in place, maybe I could have stayed in Mexico! (Or maybe not --- I wanted to be closer to my kids and grandkids.)

Here's another thought, and please don't take it as a criticism of your Spanish --- I'm also self-taught in Spanish, but am pretty fully fluent. Real fluency --- to joke, sing along at parties, discuss politics and social issues --- gave me access to a much larger community of people while I lived in Mexico --- in fact, most of my friends were Mexican. I stumbled along with purely utilitarian Spanish for years, and then decided to take another step. I started reading in Spanish and then even writing letters and such in Spanish --- full of mistakes but intelligible --- and one day I realized that my Spanish was good enough that doors had opened without my even noticing. I still refer to myself as "the lady without a past" since I stumble on past tenses and conditionals and subjunctives and stuff like that, but I can talk to anyone. And I freelance as a Spanish-to-English translator for a few Mexican clients. It was hard at first to find things to read that held my interest --- I couldn't get into classical Spanish literature or even the contemporary stuff. I mostly read newspapers and academic things. But it worked. So, perfect your Spanish if you're there for the long haul. Judy, I'm glad you're in contact with us. Please keep posting.
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Been there, done that~~~lived in Mexico for several years~~~I choose not to get involved in the medical community for I am more educated then the physicians I ran into there & they were threatened by me??? I did learn Spanish living there & working in the states with many Spanish speaking patients, as well as ASL~~ My children, now in Spirit, I felt since 2 were disabled, needed to be with a drive of the USA & so it was~~~Now I am back here~~~pamstegman tells it like is.
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Thank you realtime and Babalu. I do volunteer with an animal rescue group, maintaining the adoption website. I also have a friend who will stay with my husband if I need to be gone for several hours. There is a large expat community here, and I know a lot of people, but wouldn't call any of them intimate friends. I think I am more paralyzed by sadness than by circumstances. I need to reach out more, I think. Thank you for your support and encouragement.
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Oh, Judy, I understand. I lived in Mexico for 32 years, and came home to the States when I realized that I didn't want to grow old(er) in a foreign country. But I also learned that there are real advantages in living in a Latin American country. Even if your husband's Spanish is limited, you could hire someone to sit with him once a week so that you can get out. You can find someone who compensates for lack of communication with kindness and attention; the culture there values the elderly and infirm in a way we could only dream of up here. Forget about agencies --- word of mouth is the best way to go. Do you have friendly relationship with any of the local storekeepers? They might be able to recommend an aunt, or sister, or adult child who would be good at elder-sitting.

Have you considered volunteering to get out? Expat communities in Latin America often gather to help others, and each other. English practice for school children? You could ask the head of the local school, or maybe the priest or minister at a local church. At least you wouldn't be as isolated. Is there a local expat community? I gather that you did have friends when your husband was in better health; can you invite them over for brunch, or a drink, or some easy kind of time-limited get together that doesn't put stress on your husband or on them? I'm sorry not to be more helpful or to state the obvious. If you just need to talk --- as Babalou says, we're here.
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If an online option works for you, we're here!
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fregflyer, I learned Spanish here. I'm not fluent, but I get by. We retired here when we were both younger and healthier. The cost of living is considerably lower, and that was one of the main reasons we moved here. If we moved back to the states, the cost of hiring care, a nursing home, or assisted living would drain our resources. There has to be something left for me when I need care. I am younger than he is.
I'm not looking for care options. He doesn't take much care, and I am fine with doing it. It's just that I stay home a lot, and nobody visits. I am looking to talk to people who are in a similar situation so as to lessen the feeling of isolation.
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Judypanama, did you use to live in the States or in a larger metro area in Central America? If you lived in the States, what was the reason to move south? I assume since your speak Spanish that you wanted to move back "home". Or because you did know Spanish to move to a less expensive area to retire.

Any time it comes to retirement, it is so very important to move to an area that has good hospitals and senior care facilities. Plus good transportation, close in shopping, doctor offices within a reason distance, etc. Plus areas that offer a selection of really nice retirement communities where one wouldn't feel alone.

Any possibility of moving to Panama City where there are more options for your husband's care?
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Judy, I'm sorry that you're facing this alone.

Thoughts I have are if you are both American citizens and eligible for Medicare, coming "home" to the U S is probably a good option. I understand that you have no physical home to return to, but would your husband and you both be better off in a senior community where in home care might be doable? I would research cities in terms of cost of living and access to care and choose that way
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I speak Spanish. It's my husband who doesn't. Your flip answer doesn't help. There is no home to come back to.
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Pack it up and come back home or learn some Spanish.
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