Resources – Eldercare in Peru

I started this blog as a way to share my family’s experience with eldercare in Peru; however, I realized early on that readers might want pointers on how to they might do this for their own loved ones. Hence, this page, which is designed for expats. A few caveats:

#1) I only have direct experience with my father’s experience in Peru (2011-12) and with a handful of caregivers. This is NOT something that I have researched since the time that I lived in Peru.

#2) Please don’t ask me to recommend a specific casa de reposo (nursing home) or assisted living facility. The facility in San Isidro where my father lived for six months (the one I would recommend) accommodates less than 20 residents and has a long waiting list. I’ve provided links (below) to a few sites that are licensed by the Ministry of Health, as a way to get your quest started.

#3) You must travel to Peru and spend at least a week touring facilities yourself. Expect to reject many of them; there are 500 nursing homes and assisted living sites for elders in Lima, but only 160 are licensed. Don’t expect modern facilities except if you are willing to plunk down a $55,000 “entrance fee” at Arcadia, Peru’s first “luxury retirement community”

#4) Lima is the best-equipped city in Peru for providing eldercare to expats.  There are many staffing businesses from which you can hire trained nurse’s aides and even RNs to care for someone with dementia. The best way to find one is by personal recommendation. See advice below.

#5) I advise against moving an elder expat to Cusco or another city in the Andes. The altitude (12,000 to 13,000 FOS) is too high, and hospitals there aren’t as good as those in Lima.

#6) As a foreigner in Peru, you will need to speak Spanish to be an effective advocate for your elder. Do not expect to find nursing homes or nurse’s aides who speak English. This wasn’t an issue for me because I speak some Spanish, and my husband is a native of Lima.

And now for the links:

Retiring in Peru

I know several expats in their 60s and 70s (without dementia) who are happily living in Peru. I wouldn’t call them retirees because all are still active in their fields, but neither do they work 9-to-5 jobs. All employ housekeepers to make their daily lives easier.

For an overview of one expat retiree’s life in Lima, read the feature “Aging Out of Place in Barranco, Peru” (11/28/14), by Dianne Lange for Senior Planet. Lange profiles American Larry Pitman, who retired to the artist’s district of Barranco in his 60s and began writing for Peru This Week and making podcasts for Soundcloud. The article provides information about healthcare costs in Peru (Pitman gave up Medicare and pays $200/month for private insurance), housing, crime and the expat scene in Lima.

Getting a Retirement (“Rentista”) Visa in Peru

To live in Peru long-term as an expat, your elder will need to obtain a rentista visa (or rather, you will need to obtain one for him). This type of visa is issued people who have a guaranteed monthly pension or payment of US$1,000; once you get this visa, it doesn’t need to be renewed, and it’s good for life. Obtaining the visa involves showing bank deposits, filling out forms and at one point, you will have to bring your elder to a downtown office; thus, this isn’t something you could acquire for a person confined to a bed. (We brought my dad in a wheelchair.) Your elder will enter Peru with his/her passport and get a tourist visa, and then a rentista.

A simplified article on getting a rentista visa, from Just Landed.

Legally Speaking: Visa for Rentistas (Residual Income), by lawyer Sergio Vargas. Peru This Week, July 21, 2014. Gives detailed steps.

Obtaining a Rentista Visa in Peru, by lawyer Ricardo Guevara Bringa, Expat Peru. No pub date. In the comments section, “Steve,” an American expat who isn’t getting social security yet, explains how he got his rentista visa with $1,000 monthly deposits from his IRA.

Home Nursing Service Agencies

We used SEGPERU and like them. To find others, search “enfermeria a domicilio en Lima.” I would also recommend posting on a forum in ExpatPeru to get more recent feedback on hiring enfermeras tecnicas (nurse’s aides) to work in your home.

SEGPERU, S.A.C., Jr. Manuel Gomez 440, Lince; Lima. In Lima dial 472-8507. (The website wasn’t working as of Sept. 2016) This business specializes in providing home-nursing services for geriatric clients. They represent primarily licensed enfermeras técnicas (ETs), who are not licensed to give injections but are trained in overseeing the dispensing of medicines, assisting with daily tasks (washing, dressing, feeding, etc.) and keeping an older person company. We tried about six ETs from this service and settled on two long-term.

In 2011, it cost 850 soles per month for one ET to work a 24-hour shift every other day; normally, you would contract with two nurses from the agency to work on alternating days. The agency gets a finder’s fee (200 soles in 2011). If you don’t like the ET, you contact SegPeru, and they send you another. On her first day, the nurse gives you a copy of her licenses, diplomas, letters of reference, ID card, her national police report, and a declaration that she is certified to work in the home under Law 28882. Never let an ET work in your home without receiving all her paperwork.

Assisted Living Facilities and Nursing Homes with Dementia Care

In Lima there are 500 geriatric residencies, of which about 150 are licensed by Peru’s Ministry of Health. Here is a list of licensed residences for senior citizens, Ministry of Health (PDF, in Spanish), dated June 6, 2015.

(Note: A Peruvian Alzheimer’s Adventure does not endorse any of the facilities listed below. This list is for information only.)

Casa de Reposo Brahms: Short- or long-term facility for senior citizens in San Borja, Lima. Founded in 2012. Staff includes medical specialists, nurses, nurse’s aides and nutritionists. Help with daily tasks of living. Socializing and recreational activities. Licensed by various state agencies (“Todo en orden”). Website in Spanish. Sister location is Casa de Reposo Sisley, in San Borja.

Geriatrics Peru: Facility for geriatric dependent or independent living, in Surco, Lima. Founded in 1992. Certified by the Peru Ministry of Health. Private or shared rooms. Staffed with nurses and nurse’s aides 24/7; care provided by a team of 20 doctors. Emergency ambulance system to local hospitals. Alzheimer’s care. Website in Spanish.

Las Lilas Residencia Boutiques: Nursing homes in La Aurora, Miraflores, Lima (2 locations—converted large homes, near the La Aurora senior center). Overseen by Dr. Luis Sandoval.  Price (unknown at this point) includes room, cleaning, food and laundry, plus cable TV. On-site nurse. Private nurse’s aide is extra. Website in Spanish.

Mi Dulce Hogar: Geriatric Home in San Isidro, Lima. On-duty nurse 24/7. Occupational and recreational therapy. Spanish-language website. Note: Pictures on website are not of residents.

Residencia El Olivar: Small nursing home in two converted private homes in San Isidro, Lima. Founded around 2000. Overseen by Dr. Carlos Del Castillo, whose family started Clinica El Golf. 24-hour private nurses (cost in addition to room and board). Close to the El Olivar public garden. Website in Spanish.

Arcadia “Luxury Retirement Resort” (website in English and Spanish): Peru’s first continuing care retirement community (CCRC), opened in 2014. Located in the town of Pachacámac, 25 miles southeast of Lima, Arcadia contains approximately 100 apartments for individuals or couples, and can accommodate up to 140 people. Residents have access to a pool, a garden, a gym and recreational programming such as yoga and art classes. Levels of care range from independent living to assisted living to care for people with memory loss. As of 2013, entrance costs are US$55,000; monthly charges are the equivalent of $2,400. Arcadia is part of IAHSA (International Association of Homes and Services for the Ageing).  English website: http://www.arcadia.pe/eng/index.html

How Peru Treats Its Own Elderly Population

While expats from abroad can pay for good care in Peru, sadly there are thousands of poor Peruvians who receive little help from the state when they become old and infirm. Traditionally families have shouldered the eldercare burden themselves, but this is not adequate for everyone, especially those in poor rural areas, and the aging of Peru’s demographic has intensified the problem. In some cases, the Church steps in, but their facilities often are understaffed.

Two recent reports make these points apparent.

One is an Oct. 20, 2014, feature from the Pulitzer Center on Crisis Reporting. In “Peru Unresponsive to Aging Population,” reporting fellow Michelle Ferng investigates how Peru’s healthcare system has not kept pace with the needs of its rapidly aging population.

Another view comes from student anthropologist and CAN Ryann Hotchkiss, from Utah State University. She reports on her five-week-long fieldwork in rural Peru in Taking Care of the Elderly in Peru. Hotchkiss volunteered at a Catholic nursing home in Trujillo and interviewed local people about attitudes towards nursing homes (generally negative). Some her interviewees reiterate traditional Peruvian ideas about eldercare: that family must care for elders and that putting a love’d one in a nursing home is “cold.”