Business Idea - Independent and Assisted Living

[karlheinz]

I'm a semi-retired Geriatric Nurse Practitioner (that's an Advanced Practice Registered Nurse), having worked in the home health and skilled nursing fields for many many years I can tell you for sure that neither Medicaid nor Medicare is going to be available outside the US. I think as has been said here before; that the logistics are going to be the make / break factor. To not only attract but keep clients from the US you will need english speaking care givers - most will not need any kind of skilled care beyond perhaps one nurse for X / clients to provide a clinical overview of their general health and medicines. But those who provide the actual hands on care need to be able to talk and help their clients - this will be the deal breaker I'm afraid - unless you can start some kind of training program like those used to train CNA's in the states.

One of the more successful programs in the states is shared living - or group clusters of older / younger in a family like setting, often provided by the older person.....housing in exchange for care giving - Could this be duplicated here?

The other thing that has the potential to be a problem is the recent changes in residency - officially one can visit as a tourist for up to 2 months but after that?? a big gray area now - and could these people be eligible for residency and all the crap one has to go through to get that just started / approved?

 

[karlheinz]

another good read / video about this same subject - group living - note the high costs of getting something like this off the ground - 3.8 million dollars.

Shared Meals, and Lives - NYTimes.com

 

[LTSteve]

One million dollars a year gross is not very much when you factor in your cost of operations. If you stick to an independent living facility it might work. A full medical care operation is more than you can afford to charge ex-pats and the liability end of it is probably not worth the risk. The risk/reward is really very questionable.

LTSteve

 

[yapask1]

I would start with restbite home for stays up to 3 months to give carers in the US and elsewhere a break. Full meals and trips to beach etc. Doctor check-up every 2 weeks ; existing medications and holiday insurance. Carer on call with alarmis in case of fall etc.

A couple of extra rooms for family etc.

Start with leasing modern 6-8 bed villa for 12 months modify with ramps ; provide disabled scooters, wheechairs etc.

Many queues for care places in Europe/Canada/US. I believe French seniors can get near free medical insurance WW.

For Americans arrange Air Ambulance service to PR at 2 hours notice.

Do not forget the non-senior retired market and convalescence. International insurers could pay for covalescense abroard.

Ideas.....

yapask1

 

[mountainannie]

yeah.. but i think that an urban retirement center in Gazcue and the Zona would work

for the artists... and the writers and musicians and queer folk like me

the meditators and vegans

you could just do an eldering and conscious dying center

everyone could live independently in their own apartments...

i think that would work here in SD

seems that we are the group that least fits in

and perhaps that just might fit in here

 

[mountainannie]

for those who are wondering.. i am a transgendered gay male... that is about as close as I can get to figuring myself out. But I am working on it. A work in progress

 

[mountainannie]

yeah.. but i think that an urban retirement center in Gazcue and the Zona would work

for the artists... and the writers and musicians and queer folk like me

the meditators and vegans



you could just do an eldering and conscious dying center

everyone could live independently in their own apartments...

i think that would work here in SD

seems that we are the group that least fits in

and perhaps that just might fit in here

for example, i have a cleaner and a personal assistant who is bilingual. She used to be my full time secretary but I am not doing journalism now so it is only part time.. to help get the house right.. clothes to the tailor, papers in order, all arranged.

it would not be hard to find ANY speaking language college graduate here .. their starting pay in their 20s is about $500 US.
so if you even pay them the LIVING WAGE which was determined by the workers rights consortium to be about $600 a month, you are playing fair.

Add in benefits and a shorter work week than their grueling monday thru saturday noon

then you will have private doctors, who are also on the government.. bedside, cell phone,,,

so there would be no shortage of trained and competent and multilingual college grads in Santo Domingo

 

[jasonwebb]

Yeah I agree you are right there are expensive facilities in US and a normal man can't afford them after a level so you should have to prepare a well organized budget first.

 

[jasonwebb]

JD I agree with you , you are right what can anyone do about or even do with them , they are not in such condition if you luckily get a grip on them..

 

[dv8]

When I read that, the first thing I thought about was, "what do you do with them when they stop paying?" You can't kick them out, unless you go through a long expensive legal process.
And once you can get them out, would you actually kick an old and sick dying person?
Once one does it, you'd have a rash of other ones doing it as well, when they see how easy it is.

my aunt is mentally underdeveloped and is in a special care facility in poland. she's over sixty now and she receives, always received, a special benefit pension for the government. the place she's in receives her pension.

so maybe an assisted facility with some sort of direct debit from person's pension/benefits? then there will be no danger they will stop paying, right?

 

[mountainannie]

my aunt is mentally underdeveloped and is in a special care facility in poland. she's over sixty now and she receives, always received, a special benefit pension for the government. the place she's in receives her pension.

so maybe an assisted facility with some sort of direct debit from person's pension/benefits? then there will be no danger they will stop paying, right?

That would certainly work with anyone who is on Social Security .. which is the old age pension for the USA. Benefits can be from around 1000 to 3000. There is also the idea that they might BUY in.. as in buy their unit which would provide more capital...

In the States the best elder care facilities are run by groups affiliteated with religions. So there would be a lot of people who could answer this question when and if the project got down the line. It would take some heavy interest from some Dominicans who owned the land or property as well as a professional in the field.

I think that Florida is pretty saturated with these types of places but the best ones are in the northeast .. older and more established. It is cold and very expensive but everyone thiings that perhaps a once a month visit to granny is worth the expenses..

We might do a sorta adopt a granny program.. since we have soomany kids with out grandparents.

We have too many kids.. they have too many elders

it does seem that there is a match to be made somehow here

 

[mountainannie]

You Are Going to Die - NYTimes.com



aargh could not read the article since i have reached the end of my freebies.. is the Times worth forty bucks a month to me? I do not think so.. but .......

 

[mountainannie]

I'm with you.

It seems to me this would be a gold mine if it were run right. I have a friend who had a couple of retirement homes in Florida, and the guy got stinking rich (excuse the pun) off of them.

It would have to be a lot cheaper to run down here.

I agree. What they do up in North Carolina Asheville which is a retirement haven.. is build great facillities but have no staff. I have to say that it will be great here with all the Dominicans to help because they are extremely loving and caring to their elders. I have more than one young person friend (I give English lessons) . so worried and concerned about losing their elders at ONLY 72 or 60 or whatever. I said to one friend yesterday... that at 60 or 72 one has LIVED a life.

Once in the hospital here I was crying and one of the interns. woman.. came in and rubbed my back in a circle saying

no llores. no llores. nosotros no querimos que tu llores.....

omg! Better medical attention that i could ever imagine .

There are tons of doctors here, well trained and compassionate. And THAT to me is one of the great pluses.

Add to that the fact that they are realistic about death here . there is only one insurance policy that covers you after 70, after that.. well.. it is over.

So it would be go to talk with an insurance company about that since now the age for buying has to be before 65 and lots of people are just not ready or thinking about death at that age. IF there were a big medical consortium.. that would help.

Most elders that I have met are at least mindfull of the fact that they are going to die... they just want attention.

The isolation in the States is not good.. they are locked up pretty much with other elders and never mingle with the kids.

Some of the Quaker homes have programs with the local colleges which pair the students up with the elders.. of course with the young girls here and the old men.. well.. all sorts of possibiiliteis.

But a more loose structure.. with more freedom .. maybe even not in one facilites but in CARE.. if you can understand what I am getting at.. in that I do not really want to lIVE with everyone but it would be great to play Scrabble and know that I had a team

I do have a team but it has taken me seven years to build it myself.

do not know if I am making myself understandable this morning

not enough coffee yet

 

[Fernandez]

I have often thought about this as an idea that could work in the DR. or USA/Mexican border towns.
The issue of carting the elderly off to a foreign land at a long distance form family usually requires a great leap of faith the the caretakers will watch over the person- with no immediate way to confirm or validate the care.
Also, hospitals and clinics with full capacity to handle elderly is an issue.
Interesting never the less... I would buy in.

 

[mountainannie]

I have often thought about this as an idea that could work in the DR. or USA/Mexican border towns.
The issue of carting the elderly off to a foreign land at a long distance form family usually requires a great leap of faith the the caretakers will watch over the person- with no immediate way to confirm or validate the care.
Also, hospitals and clinics with full capacity to handle elderly is an issue.
Interesting never the less... I would buy in.

This might fly better if pegged to the Domnican and Puerto Rican expat community in the States.. as in .. they have elders who have roots here perhaps and would have extended family to visit them but they are used to the USA. Cannot imagine a lot of the diaspora suddenly moving back with no structure.. giving up medicare, all that.. it is a hard sell but ..

i agree..
I am already planning .. should i.. god forbid.. go dotty and need in house care,, to go to one of the Catholic homes here. I know that the food will not suit me since I am not Dominican and think that their food is pretty boring.

And I do not have family to visit. But now I have a lot of younger friends who will perhaps at least bother to pop in and wipe the drool off my lip. Anyway . at that point i do not think that I will care.

Just like many. I simply do not want to be a burden to others.

 

[dv8]

the facility where my aunt lives is run by the nuns. i know whey receive her entire pension directly, she herself gets no cash ever but then she does not need it nor she does not know how to use it.

i am thinking of a place in DR that would receive a pension (for those mentally ill or totally incapacitated) or a certain part of it by direct debit. so as long as the person lives there will be money to pay bills. i cannot see "buying in" as a valid idea. you want all the units to belong to the facility so when the person dies their belongings are sent to the family or given to the poor (if so was the will) and then the room/apartment is ready for the next patient. without paperwork or worrying over inheritance laws.

a hotel part of the facility would serve family and friends on as needed basis and no limits to how often someone visits in a year. they would receive all inclusive treatment and a daily maid service.

 

[mountainannie]

the facility where my aunt lives is run by the nuns. i know whey receive her entire pension directly, she herself gets no cash ever but then she does not need it nor she does not know how to use it.

i am thinking of a place in DR that would receive a pension (for those mentally ill or totally incapacitated) or a certain part of it by direct debit. so as long as the person lives there will be money to pay bills. i cannot see "buying in" as a valid idea. you want all the units to belong to the facility so when the person dies their belongings are sent to the family or given to the poor (if so was the will) and then the room/apartment is ready for the next patient. without paperwork or worrying over inheritance laws.

a hotel part of the facility would serve family and friends on as needed basis and no limits to how often someone visits in a year. they would receive all inclusive treatment and a daily maid service.

This is good. This is taking on a sort of form. I think that this might work in Puerto Plata which has a village where they could walk. I think it also has DREAMS

You are talking about perhaps more of a total care facilities and i am talking about aging in place. Most of the folks who have a very fragile member would not bring or send them away from the care in thier home countries. But I know that the medical is good here... if there were a family .. say in their 50s who wanted to immigrate though, and had an elder parent that they wanted to bring.. this would serve them

 

[mountainannie]

we have lots of levels now in the states.. independent living is first, then skilled nursing at the end of life.

we have what are called Adult Active Retirement which might be the niche.. no one under 50 is allowed. I guess we get snappy at the children and start cuffing the teens.. i do not know. But most of them are AGE isolated and I do not like them. One of the great things that I have enjoyed is making a difference in the lives of the young

We pack off our elders . who are the wisdom keepers... guess we .. by that i mean Yanks.. are too busy working and do not have enough time to care for them.

From what I have seen, elders need .. well. listening to! They want to be heard. They want human contact.

 

[dv8]

well, i am thinking there are plenty of folks in the states and in europe who cannot care for their sick and/or elderly relatives and send them to care facilities. and sometimes do not come back to see them at all or visit every few months. a place in DR we are talking about would be perfect: a person would receive a full care and if the door was open to all nationalities one one would ever feel alone or out of place.

another bunch of potential clients are dr1ers, in a way. my parents are in their late sixties, i do not know what will happen when they get much older and need care. i could put them in a place in poland and visit once a year (time and money). but wouldn't it be better to bring them here? know they live in comfort, with meals, with maid service, with on site doctors? and living independently from me for their mental comfort? and mine too?

we talked about it before, sometimes people leave DR in order to care for someone, worried about their parents. why leave if you could bring your elderly here where they would receive excellent care and be close enough for you to visit more often?

 

[mountainannie]

would it not work to think of this WITHOUT the facilities.. as in.. rather than starting with the real estate, start with the person.

First let us say the mind set is the most important thing. Yes, you might provide for them physically but what about the practical daily living? They would be in a completely strange place without knowing the language.

what would they do with their TIME

all the elder homes that I know of .. ones that attract the upper middle and upper .. they have tons of activity.

do we keep them going on Quads for tours of the coffee country?