Eldercare Is Easier in a Nonlitigious Society

This quote, by 17th-century French satirist Jean de la Bruyere, might be said to sum up the attitude of many Peruvians toward civil lawsuits.

I knew when we brought my father to Lima in 2011 that it would be cheaper to give him personalized care there. What I didn’t anticipate is how much easier it would be work with doctors, nurses, health aides and hospitals—in contrast with the bureaucracy and complications of the U.S.

After thinking it over, I’ve come to realize what, exactly, made these interactions easier: Peruvian culture is not very litigious. Unlike in the United States, people don’t generally sue others and institutions over civil matters. And when it comes to medical issues, people rarely take doctors or hospitals to court, even when things go very wrong. For instance, the whole seven years I lived in Lima, Continue Reading

How Lima’s Compassionate, Affordable Home Health Aides Saved My Father–And My Family

When my 86-year-old father was diagnosed with Alzheimer’s in early 2011, he was living in northern Florida, and my husband, son and I were working and studying in Lima, Peru. We didn’t have money to put my father in a dementia-care facility, and we knew he needed more than a few hours daily of at-home nursing care. My dad, like everyone with Alzheimer’s, needed help with everything from bathing, to making meals, to remembering to take his medications. Short of moving back to the States without employment there, what could we do, we wondered?

The answer, it turned out, was right in front of our noses: Lima’s plentiful supply of professional home-health aides.

We had seen these young women in white or blue scrubs escorting elderly Limeños through the neighborhood parks—holding their hand as they walked slowly along the sidewalk or pushing them in wheelchairs. We’d also known two of these health aides personally. They had cared for my sister-in-law’s very sick mother for two years in her house. What had always struck me about the aides, or enfermeras técnicas [technical nurses], as they are called, was their patience, attentiveness, and positive outlook. They didn’t rush their patients, they didn’t ignore them to look at their cell phones; they did what had to be done—present, in the moment—and with kindness and good humor.

It clicked in our heads then: These aides would be perfect for caring for an Alzheimer’s patient. Even if they didn’t speak his language.

Cut to the chase: We moved my father to Lima, installed him in a room in the back of our house, and hired two licensed health aides to care for him 24/7.

That was March 2011. Cost for his round-the-clock care? US$670 per month for both aides, plus three meals a day. The two aides rotated shifts.

In future posts, I’ll explain how we found these aides and the legalities of hiring (and firing) domestic workers, as they are considered, in Peru. The important thing is that because my husband knew the city and the culture and spoke Spanish (he was born in Peru), it was easy for us to find excellent help and to arrange a good set-up for my father. We went through a personnel service that my sister-in-law had used, and it ensured that the aides were well trained and licensed, and had passed background and police checks. We had to go through a few ETs until we got the right fit for my dad, but within two months, we had found the ideal aides.

That’s my dad, above, with his enfermera tecnica Erika. Every afternoon they went for a walk in the park, or if he wasn’t up to it, for a ride in a wheelchair. My husband used to say that she had the patience of a saint.

The affordability of at-home care in Lima meant that my father was never alone as he battled Alzheimer’s.  These caring, capable women helped him in the tasks of daily living and stayed calm and upbeat in difficult situations that had me tearing my hair out.  It was brutal seeing my dad go on a hunger strike, as he did when he first came to Lima, and watching him succumb to hallucinations. I was overwhelmed witnessing my father’s suffering, but the health aides had seen it all. They knew that it was going to get better (with the doctor’s help), and they stayed strong in their faith.

His health aides not only saved him—they saved me and my family.

We were more fortunate than many caregivers in the United States, who have to hold down jobs and must patch together care strategies with hourly sitters and/or family members taking turns. My husband and I still spent many hours caring for my father in Lima, but we had the necessary luxury of being able to go up to our room at 10 p.m., shut the door, and sleep through the night without worries. The aides prevented him from wandering all over at 2 a.m. Just that fact alone let us keep a better grip on our sanity.

If there is one thing that caregivers of Alzheimer’s patients need, it’s this: Reliable, experienced help in overseeing the daily tasks of living. Alzheimer’s robs a person of the ability to do even the simplest of things—getting dressed, reading a book, remembering where one’s house is. Until there is a cure for this brutal disease, at-home help should be an affordable option for all Alzheimer’s patients, not just the very rich. Long-term care should be a right for all Americans.

My dad lived just a year and a half after his diagnosis. But that period was filled with caring and compassion. We have his health aides to thank for making those months—his Peruvian Alzheimer’s Adventure–a positive last chapter in his life.

How to Make Traditional Peruvian Apple Water (Recipe)

I explained in my last post the benefits of agua fresca [fresh water], an economical drink that is popular in many Peruvian households. You boil fruit and spices in water, strain it, and sip the liquid throughout the day to stay hydrated. The health aides who took care of my father in Lima used to make this for him daily, and he took to it immediately. He hadn’t been in the habit of drinking much water in the U.S., but I think that the mild flavoring of agua fresca was what made this drink so easy for him to consume.

There are many methods for making agua fresca. Here is a recipe for agua de manzana [apple water] that my husband’s family used back when he was a boy growing up in Miraflores. More often his mom would make apple juice, but this recipe served nicely when fruit was less plentiful.Continue Reading

“Fresh Water”: A Peruvian Tradition for Healthy Living and Eldercare

One of the healthiest habits that my father picked up when he was an Alzheimer’s patient in Lima (2011-2012) was drinking agua fresca throughout the day. Agua fresca, or “fresh water” as it is translated into English, is a popular drink throughout Latin America, but a bit of research on my part turned up an interesting fact: The Peruvian version that my father consumed day in, day out, differs in several ways from the agua fresca served elsewhere in Latin America. And those differences are what I’d like to explain for North American readers because this drink can benefit elders, their caregivers and people in general.Continue Reading

Don’t Give Up on the Old Folks, Folks

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Old people can suprise you. My father sure did. At age 86, newly diagnosed with Alzheimer’s and unable to care for himself, he agreed to go to Peru to live with me and my husband. He boarded a plane in Orlando and said goodbye to his house, his dog, his country — every trace of the person he had been. From the moment his plane touched down in Jorge Chavez Airport, his life was never the same. Alzheimer’s + a foreign country + a completely unknown language (Spanish). His new reality was, to say the least, disorienting.

Some elderly people might have wanted to kick the bucket right then and there. And at first, my father did. “Why are you feeding me?” he asked. “Go away. I’m dead.” He went on a hunger strike. He barely drank. For days this went on, then we hooked him up to an IV and pumped some fluids into him. An intelligent doctor prescribed an appetite enhancer, an antidepressant. One day my father showed up at the dinner table: “What’s to eat? I’m starving.”

My father had nursing aides to care for him at our house. They were sweet-tempered, patient souls who didn’t speak a word of English. When he took off all his clothes and threw them in the corner, they calmly picked them up and held them out. “Mister John, put them on, please,” they said in Spanish. Take your pastillas [pills]. Drink your jugo [juice]. Day after day after day. Thank god for the language barrier. They had no idea he called one of them “the fat one” and thought that the small, androgynous aide with glasses was a man.

Fast forward six months: My father is sitting side by side with his nurse, on the couch, watching a telenovela. A drop of mucus hangs from his nose. She glances over, reaches into her sweater sleeve, and wipes the drop off with a tissue that she keeps there for for that purpose. Then she checks her wristwatch.

“Meester John, sus pastillas.”

“Okay.”

“Quieres algo a tomar?”

“Si,” he says.

“Jugo de manzana?”

“Si. Jugo.”

We all thought his story was over. But as he continued to show us, right up to the end, a new chapter was writing itself. The true wine of astonishment, indeed.

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