James M. Berklan, McKnight's Editor

The latest controversy in long-term care has nothing to do with upcoding, sex among seniors or Medicare scams. Rather, it evolves around “exporting” one’s loved one to another country for cheaper care.

Medical tourism has ridden a wave of popularity in recent years as patients in need have traveled to other countries to avoid high prices or unwanted bureaucracy. But what the Germans are gaining notoriety for is farming out Grandma to other lands.

In one of the more fascinating senior care stories you’ll ever read, Naomi Kresge details (in both video and article form) a powerful trend. Powerful for, among other things, the emotions it conjures.

Has Ilona von Haldenwang lost her mind or heart to leave her 94-year-old mother in another country? Is she only out to save money? Is she callous and alone in her strategy?

The answers turn out to be no, no and no.

With Germany’s plunging birth rate and relatively low government spending on long-term care, 1 in 5 Germans now say they’d consider long-term care abroad, according to a Bloomberg article. In Haldenwang’s case, her mother is 350 miles away — about the same distance from Chicago to Cleveland.

Her mother is cared for in a palatial-looking care home where exquisite meals and round-the-clock therapy are the norm. It is in Szklarska Poreba, Poland, her mother’s native land. The nurses, however, speak German for the nearly half of the residents who are from Germany.

The home’s owners quickly found they could profit more handsomely from Germans — who pay about a third of what care costs in Germany. They say their philosophy is to keep residents off sedatives as much as possible and engaged in therapy instead.

That is the key, Haldenwang said. In a video interview, she repeatedly lamented the many pills she said her mother was fed to keep her sedated while in a German facility. She said she also suspected her mother was getting insufficient nutrition, which led to her wilting health.

In other words, when it came to making a move, care giving made the difference yet once again. There seems to be a pretty good lesson to be learned out of this. Just not the one most people might be thinking about.


James M. Berklan is the Editor of McKnight’s Long-Term Care News. Follow him @LTCEditorsDesk.