This newsletter is for the many people who plan to grow old here in San Miguel. It is for the expatriate residents who take pleasure in the street life and parks, the fiestas, holy days, and the many sights and scenes of this vibrant country. The benefits of an enriching community life go far in helping us forget the minor and major discomforts and indignities of advancing age.

One of my first clients as a patient advocate in San Miguel was “B”, an active woman in her 80’s who had never been ill. One Saturday, she tripped on her bedroom stairs as she was on her way to the kitchen, but it being a weekend, her housekeeper wasn’t due until Monday.

She was in pain and could not make it to the telephone.

She remained on the stairs for more than 24 hours and when her housekeeper finally found her, she was dehydrated, soiled and semiconscious. A trip to the hospital revealed she had a badly fractured leg, but luckily, fluids and oxygen restored her and she was soon able to return home.

My colleague, Juan Soria, and I visited her there to see what adaptations were needed to accommodate her temporary limitations. As she was unable to bear any weight on her fractured leg, a wheelchair was needed, but her kitchen and bath were both too small to allow its unassisted use. Also, as the bedroom was located at the end of a narrow hall on the second floor, it, too, became a poor choice in a rehabilitation setting. We chose to rearrange the downstairs as a recovery room and ordered a hospital bed and commode and arranged for 24-hour home care.

Her budget wouldn’t allow for round the clock care by a more costly registered nurse, but it could accommodate someone trained as a vocational nurse, whom we installed. We also arranged for a physical therapist to visit regularly and work with her to retain strength and mobility without risking re-injury. Very happily, she recovered fully and without incident.

Naturally, she also decided to do all she could do to prevent a similar event from occurring again.

Be Well services have evolved out of situations like B’s. Through our work with patients such as her we became more familiar with our client’s needs and what resources were available for a wide variety of situations.

We have located and established relationships allowing us to provide home health equipment such as beds, oxygen, respiratory therapists, physicians and other professionals.

Our colleague Juan Soria is an experienced bilingual RN who handles the training and placement of the care teams. Whether you need overnight care or respite care, both can be easily arranged. Some of the care providers are English speaking and all are supervised by Be Well staff.

Costs for services are reasonable, based on local minimum wage and labor practices. Depending on how many hours of care are needed and whether care requires skilled nursing or English language skills, monthly costs range from $2,000 to $5,000USD. (Compared to $8,000 and upwards in the US).

Be Well has a new service, known as “Be Safe”. This is an emergency alert system aimed at increasing your safety at home and on the street. A simple push of a button summons medical help day or night seven days a week. In addition, or as a stand-alone service, we can progam your smart phone to summon emergency personnel to wherever your phone makes the call. We also provide electronic medical records contained in a water resistant flash drive that can be worn as a bracelet, key chain or pendant. Be Safe is closely aligned with UNIMED Hospital, as we believe they deliver the highest quality ambulance and emergency care services in the area. A much-appreciated benefit of our Be Safe system is that our clients receive significant discounts in transport and medical services from UNIMED.


An important second benefit of Be Safe is an in home walk-through to help you identify any unsafe conditions. For many of us, a few simple physical alterations can make life at home completely convenient even after the onset of an infirmity or handicap of some sort. In many cases, those of us who are “aging in place” can remain comfortably at home for as long as we choose.