Moving elder parent to CH with Dementia

Family, Education, Health and Pets
1
Has anyone from a non-EU country (preferably USA) moved an elder parent to CH for Memory Care?

We’re in the position of investigating options at the moment, but I’m in the situation as an only child with relatively no extended family of what to do with a parent with a recent dementia diagnosis. If we use assisted living in the US the parent would be alone and we could only visit one or two times a year. If we move parent here, they are close and not alone, but is it even possible - insurance, immigration etc... we would have the resources to financially support.

Any help greatly, greatly appreciated!

2
Are you EU or non EU? That for starters makes a huge difference.

And do your parents speak any of the local languages?

3

Almost impossible. Meloncollie has made several posts on this subject so check in some of these threads.

https://www.englishforum.ch/search.p…rchid=23081371

Non-EU nationals aren’t really allowed to bring their parents here, only spouse/partner and any children under 18.

" If you come from a third country
You may bring the following family members to Switzerland:

your spouse or registered partner;
your children under the age of 18."

https://www.ch.ch/en/family-and-part…in-switzerland

That said there can be exceptions made if … the parent/s are already financially relying on you to support them and there are no other relatives that could look after them. And what you consider to be enough financial support may not be what the Swiss authorities consider enough.

4
Why would any insurance company want to taker this risk which is not even on the scale of reasonable ?

The downside and the costs are phenomenal, you would need to put up massive solid guarantees and by this i mean think USD4-5 mio before any discussion could begin on according a visa.

You may have the resources now, but what happens when they run out and dementia can get extremely expensive, the state certainly won't want any risk whatsoever of holding this hot potato

5
I've written several posts about our attempt to bring our dependent parents to Switzerland from the US. Rather than repeating those here, you can search for them, probably in the 'family and health' section.

Quick summary:

We live in SZ, which is generally thought to be more skeptical of chain immigration. I have no idea how Basel bureaucrats would react.

I bring this up because my understanding was that IF - and this is a huge 'if' - you were to get something other than an outright 'no', a situation such as ours/yours might be handled on an individual basis, and might comes down to whether or not a case that can be made for compassionate consideration. And of course, you'd need to be wealthy enough to pay for your parent's care on your own.

So think about how you would present your case.

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As Medea point out, there is very little chance under regular immigration rules. As a non-EU non Swiss you have no right to bring parents here.

Our first attempt went nowhere, because both parents were still alive, albeit incapacitated. The assumption was that two people can care for one another, so no compassionate case could be made. After MIL died we tried again to bring FIL here.

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The assumption from local Powers That Be was that we should go home to care for our parents. I might guess that many would feel similar about non-EU folks, so be prepared.

You'd need to think about how to argue that one. Do you contribute to Switzerland to such an extent to make a compelling case that it is in Switzerland's interest for you to stay here, and bringing your parent here is needed in order for you to stay? Are you a business leader, job creator, wealthy, or fall in some other category where Switzerland tends to roll out the red carpet?

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Key in speaking to the Gemeinde was finances. We had to show that we had the assets, now, to care for FIL for the expected rest of his life, showing that money from Swiss coffers would not be needed.

And yes, it was a lot of money.

Broadly speaking Swiss immigration policy does not want people coming here who have not contributed to the country yet cost the country money.

Our attempt was 10 years ago. At the time even though we expected FIL to live with us we drew up a budget assuming nursing home care.

Some rough updated figures, based on what friend are paying monthly for dementia care:

Dementia ward in local Gemeinde (public) nursing home: 8K for the room, plus around 2K for daily care. In a private nursing home, 12K for the room, another 3K for daily care.

A note here: The public nursing home costs count in contributions from insurance and the Gemeinde. This could be a sticky point in your argument, as your parent could be seen as taking from the Swiss taxpayer, without ever having contributed.

Were it me, I would base the budget on private care only, to avoid that perception.

Another issue, perhaps of growing importance:

There are not enough nursing home places in Switzerland to meet demand, the shortage is acute in dementia care. Many nursing homes have a wait list. By bringing your parent here, you could be seen as taking a place from a Swiss citizen who has been waiting for the room. If you base your argument assuming you would use private care only, financed by you, at least there isn't the perception of taking advantage of local citizens.

Again, I make this recommendation based on my experience in SZ I have no idea if other cantons/communities would feel the same way. You might face completely different attitudes.

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What this boils down to is - go ahead and try, but be prepared for a 'no'. Make a compelling case as to why bringing your parent here is necessary.

It's a pretty steep uphill climb.

We never got an answer to our application, as FIL died before a decision was made. We withdrew the application.

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An alternative consideration:

The money we budgeted for elder care here went a long way to providing care for the ILs in the US. During the worst of those years, one of us traveled back and forth every few weeks. It's a hellish juggling act, but it can be done.

Dementia care means that someone needs to be on hand to advocate for the patient, even in the best of facilities. Do you have anyone trustworthy you could ask (and perhaps pay) to take on that roll for the times you can't be there?

Or a friend's solution was that the employed spouse stayed in Switzerland, the other spouse went back to the US for 3 months at a time, making sure to remain within the boundaries of her permit. Again, hellish on the couple, but doable if you are both on the same page.

We had help from ILs' neighbors and members of ILs' church. If your parent was active in a church community you might find help there, as many have extensive outreach programs.

And as an FYI, if by chance your parent is in the Chicagoland area, I can recommend an outstanding memory care facility, the one we ultimately used for my father. (Yes, we were dealing with three parents' needs at the same time.) FYI, we did not consider bringing my father here, as there was no way in his state of dementia he would be allowed on a plane.

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These are extremely difficult times, I know. You have my sympathy. I hope you can find a solution that works for you and your family, and your parent.

Wishing you all the best.

6
Assume parent is covered by Medicare, which only provides coverage in the US. As for Medicaid, it can be a problem just going from one state to another.

But main concern should be the stress and alienation due to relocation. Just moving from one's own home to assisted living can cause problems and be sometimes fatal.

7
Then there's the language issue....

First attempt: Würdet Sie gäre öppis drinke s'ha?

Second attempt: Möchten Sie etwas zu trinken?

Third attempt: Trink! Trink! Trink!

8

For a timeline estimation here is a good life expectancy calculator

9
Pretty well impossible and as someone who has dealt with two aged people with this in the past I would not think it is a good idea at all. They will remember the past not the present or the future. Being out of the environment that they are familiar with will means they loose independence more quickly - at least for a while they will be able to do the things they always did - go to the shops, warm up food or cook a light meal and so on and of course be able to communicate with the people around them they already know and who know them. Putting them in a completely new environment with a different language can be very frightening for them when they forget they have moved.

For instance my mother in law is 92 and dementia, if she is in her own kitchen and needs to make pasta she knows exactly which pan to pick up, how to turn the kittle and of course where the past is stored because that is what she has always done. But if she is in our kitchen (where she has been hundreds of times as we live on opposite sides of the garden) she quickly becomes upset and confused because she has to make a decision which pan to use, identify what object on the counter is the electric kittle and where the pasta is stored.

10
Even naturalized Swiss people whose parents are not EU citizens can't bring them here.

11
I looked into bring dad (non-EU) to CH a while back for stroke rehabilitation.

In his case, we looked at the "self sufficient retired" route - and speaking to the clinic they felt that as long as he could pay (up front) the clinic bills, they wouldn't have a problem getting him a 3-month visa to stay at their facility.

If you want, I can dig up the clinic details - they specialise in strokes, but maybe they can help.

Note - it wasn't cheap, the estimate was CHF 70k/month on the lower end.

12

Was that with or without breakfast ?

13
I know your comment was tongue in cheek; but you're actually not far off - there were different menu types; each with an associated cost...

14
70K per month......wow

15

That's more than my income!

Who's the lucky doctor?

16

He's already retired, sorry.

17
Spinal's post brings up an important point.

There is a difference between an Altersheim and a Pflegeheim. A Pflegeheim has rehab capacity, and is usually geared to short(er) term stays for acute care.

An Altersheim is a residence, usually offering basic daily care - but the degree of care offered can vary quite a bit.

Medical costs, including rehab therapy, are usually charged on top of accomodation and 'basic daily care' in an Altersheim.

A Swiss resident, with Swiss insurance, will have some portion of medical/rehab covered through the KK - but not necessarily all. The 'mice type' in your contract with the Altersheim needs to be studied very carefully., and you need to understand what your KK covers. If you have private insurance you might find more is covered.

A 'medical tourist' will pay the full whack. And that could be a LOT of money, depending on the needs of the patient.

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Some Altersheim don't have rehab staff so the family might need to organize a rehab plan with the patient's doctor and bring in outside rehab folks to visit the patient. And of course you have to organize the patient's Hausarzt visits. Most Altersheim have an arrangement with a local GP to visit in case of emergencies, though.

It's also very important to understand what is, and is not, included in 'basic daily care'.

Things my friends have run into caring for their spouses:

At some Altersheim/Pflegeheim one is charged for the food as part of the package. If the patient can't eat the food, you still pay for meals. If you know going in that the patient cannot eat you could try to negotiate that part. But once the contract is signed, you pay for meals.

There is a worrying staff shortage in many Altersheim and Pflegeheim. That might mean that basic daily care is done on a schedule rather than by need, and thus family might need to help with that, especially if washing/cleaning the patient is needed 'off schedule'.

In the case of dementia care... you really need to understand what kind of care is offered.

If you can find a facility with a dedicated memory care unit you likely will find more care available than in a local Altersresizenz whose focus is on residential living, where a patient with dementia is sometime more or less just 'warehoused'.

If you think that residential care is even on the distant horizon, now is the time to evaluate what your local Altersheim and the area private Altersheim offer. Do it early, so that you can evaluate with a clear head.

In most of my friend's cases, the need to go into a home arose from an emergency, there was no lead time - and the patient had to take whatever was available, wherever, there was no choice. If you have researched options ahead of time, at least you are spared some of the crisis running around.

By the bye, most Altersheim charge an entry fee close to what one pays for a month, so your first month will likely be twice as expensive. Plus fees when the patient leaves. I bring this up because if your loved one is unhappy with the place found during the crisis and you want to move them once a place is available in a more suitable residence, be aware that there may be a lot of up front money involved.

One should also talk to an independent advisor, such as an expert from Pro Senectute or a similar group, to understand what additional help with finances might be available. Be aware, though, that qualifying for help is fairly difficult, that you need to spend down much of your assets before qualifying.

Lots to consider. Researching options now, even if just to keep that info inthe background, is a prudent thing to do.

18
As the hard truth transpires, we only way to be close to parents who suffer this fate is to move back yourself.

If that is not an option, I'd try to arrange for in-house care for as long as possible.

We might sometimes belittle people who never left the village they were born in - but in these moments, we realize that everything comes with a cost/benefit ratio.

19
Excellent point, Olygirl!

Dementia manifests itself in such a wide variety of ways, so generalizing can be problematic.. however, in my father's case he lost the ability to speak coherently long before he lost the ability to understand.

It was clear to family, friends, and most importantly care staff that he understood what was said to him, even when his responses were nonsensical. Knowing that he understood determined much about how he was cared for.

If he had been placed somewhere he did not understand the language, even with the most caring and attentive staff, that he retained cognitive function might not have been apparent. That last vestige of dignity would have been taken away from him.

Just something to think about, OP.

20

It’s been mentioned briefly upthread, but I just wanted to highlight Pro Senectute. Their advisor has been helping my friend navigate this difficult time; I’ve sat in on some of these meetings, I am impressed at not only their knowledge but also their kindness to the family.

She has been dealing with Pro Senectute Ausserschwyz, but there are groups in all cantons/regions.

If you find yourself confused as to how to navigate options in dealing with aging issues, do take advantage of the knowledge that Pro Senectute can offer.

https://www.prosenectute.ch/de/ratgeber.html