Elder Care in Portugal

Author’s Note: I started writing this article back in 2019, long before the coronavirus hit. I hesitated to post this now thinking it might be insensitive but then opted to consider the other option…. that someone might really need this information now.

What will you do when you get old?

Independent Living

Every year, the internet churns out a new top 10, 25, 100 places to retire. For the billionaires, that may include the French Riviera or the Caymans. For the rest of us, we’re just looking for a place to live in comfort without running out of money. We look for things like a low cost of living, comfortable quality of life, and excellent medical care at affordable prices. But we don’t consider the follow-up question. What happens when we get old, old? When we can no longer take care of ourselves and there’s no family safety net for us? Fear not, elder care in Portugal is very much a thing, and it is available to everyone.

Ideally, we all want to maintain our independence.  We want to live in our own homes, sleep in our own beds, and die in our sleep.  At most, we will augment our lives with help as needed.  The services are the same here in Portugal as they are in the States:

Enfermagem ao Domicilio

In-home nursing.  These agencies offer a wide range of services.  They can staff a residence 24/7 or be available on call.  Beyond medical care, agencies can assist with domestic needs such as cleaning, laundry, and grocery shopping.  Caregivers can accompany clients on trips to the market, the museum or the cinema; some will even travel with the client abroad.  Prices vary based on the level of care, but nursing services start around €8.50/hr.  To put this in perspective, as of this writing, private Portuguese lessons typically cost around €10/hr.  This is also an option for Cuidados Paliativos (palliative) and hospice care.

Cuidados Continuadoc

Continuous care.  Similar to Enfermagem ao Domicilio except that patients may also be seen in clinics.  The out-of-pocket cost depends on whether you paid into the social security (SNS) system.  For more information:

Centro de Dia

Literally, “Day Center”, these facilities are more than just a place to park old people.  Many offer activities that stimulate mental and physical health, such as sewing classes (on sewing machines), computer classes, singing, storytelling and much more.  They organize shopping trips, beach outings, visits to cultural sites and holiday activities.  Meals, transportation, and hygiene assistance are also available.  Seniors are picked up and dropped off at their homes by facility drivers.  Many day-care centers are affiliated with retirement homes (lars) but some are stand-alone facilities.  Fees are typically 40-65% of your monthly income, depending on the level of care required.  For example, a person with a monthly income of €2000 may pay €400 per month, while a person making €400 per month would only pay €160 for the same level of service.  Assuming a person goes to the center five days per week, that works out to €1- 3 per hour for a day of care, entertainment, bathing (if needed) and meals.   Centers are typically closed on the weekends when family members step in to provide care.  For those without families, they can make other arrangements such as home delivery of meals.  Examples around Braga are:

Communal Living

Whether it’s the idea of living in a house that needs maintaining, or they simply don’t want to (or can’t) be alone, independent living is not for everyone.  However, there are options.

Residência Seniores – Private Care Facilities

These facilities are like living on a cruise ship!  Guests enjoy generous private suites with private baths, queen-size beds, and sitting areas.  Some facilities even have private bungalows–ideal for couples.   Gourmet meals (including wine if medically allowed) prepared to the individual nutritional needs of each guest and served in a restaurant-style dining area or they can call for room service, available 24 hours/day.  Guests are free to come and go as medical conditions allow, but they may prefer to stay on site.  Facilities offer an array of activities to encourage socializing, mental health, motor skill development and just plain fun.  There are organized trips to local events, movies, and shopping excursions.  And during the holidays, there are parades, shows and parties!  Sometimes they even go to the beach!  Each facility is different, but at their core they exist to provide excellent care for their guests.  Waiting lists to move in are typically many years long, as most residents expect to stay until the end of life, although some also function as convalescence homes.  The average cost is around €2-3000/month, with some requiring an entrance fee that can be as high as €30,000.  Examples around Braga:

Lares de Idosos – Public Care Facilities

Lares de Idosos (or simply Lar’s) literally means “senior homes”, but colloquially it is understood to be the public retirement facilities.  This is a bit misleading because technically, there are no “public” facilities; residents are charged based on their ability to pay, with any deficit being picked up either by social security, the church (if affiliated), or both.  The average out-of-pocket fee is around €750 per month.

Conditions may not be as posh as those found at the private facilities, but many are still quite nice with similar amenities and luxuries – like wine with meals.  Most rooms are double occupancy (some are private but at a higher cost), with private bathrooms, televisions, etc.  Smaller facilities tend to be more personable than the larger ones, but the focus is still on the physical and mental wellbeing of the residence in a warm, comfortable and respectful environment.  As with the private lars, waiting lists are very long, so pre-planning is a must.  Examples around Braga:

Social Security and The Red Cross

These noble organizations exist for the most destitute.  This is not where you want to land.

Conclusion

Moving to Portugal does not have to come with an exit plan to return to the States when you ease into your later years.  Elders in Portugal have the same needs as elders in any other part of the world, and contrary to popular belief, their families cannot always be the answer for them either.  Fortunately, a system exists that is comfortable, affordable and available to everyone.  Although this article cites locations around Braga, there is a Portugal-wide site with more information.

My next post will cover end-of-life options in Portugal.

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