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By: Kendal Blust

Three elderly women sat together Wednesday at the Asilo de Ancianos Franciscano, silently soaking up the morning sunlight. As they sat, they listened to a half-dozen yellow and grey birds chirping contentedly in a cage below a long window in the hallway outside the facility’s women’s dormitories.

The only residential nursing home in Nogales, Sonora, the Asilo de Ancianos has seen demand grow dramatically since it first opened 50 years ago as a small house for abandoned seniors, said Montserrat Moreno Esquivel, its administrative director. Today, 30 seniors live in the facility with six more already on the waiting list, and Moreno expects the need to continue increasing in coming years, she said.

“It’s a real problem. We’re seeing it already and it’s growing,” she said.

Though many families in Nogales, Sonora keep older family members in their home as they age, there are many reasons why a greater number of seniors need residential care, Moreno said. Those include a declining birth rate and growing elderly population, young parents, economic hardship and migration.

Worldwide, adults 65 and older make up an increasing portion of the population. In 2010, 8 percent of people were in this age range compared to 5 percent in the 1950s, according to data from the Pew Research Center.

In Mexico, decreasing birthrates and greater longevity have led the number of people 65 and older to double in the last 50 years from approximately 3 percent in 1960 to 6.5 percent in 2015, according to the World Bank. That shift means not only more older adults in need of care, but a smaller working-age population to support them.

In Nogales, Sonora, economic hardship has been a contributing factor, Moreno said, leading many people to have smaller families or not to have children at all, making them vulnerable in their old age. People who become parents very young are also at risk, she said.

“When that person is 70 years old and their mother is 85, there are two older adults and one is taking care of the other,” she said. “It’s a big issue. Who is going to provide for them and bring in an income?” she asked. “So we realize that we have to prepare and expand our facility for these demographic changes.”

Migrant populations also play a role in the rising number of what Moreno calls “abandoned seniors.” As people move to Mexico’s northern border for jobs or in hopes of reaching the United States, they often leave behind their support system. In some cases, elderly people are deported, separating them from family in the United States, said Maricruz Zazueta, a long-time volunteer at the nursing home.

In other cases, families just don’t want to care for aging relatives any more, Moreno said.

“There are families with five kids and one senior. The five all work. They all have their kids. And they all have their things to do. And they say they can’t take care of their parent because they have too much to do. Five people, who, if they worked together, could find alternatives,” she said.

Scarce funding

Nogales is not alone in its accelerating need for nursing home care for the elderly. The few residential care facilities elsewhere in the state of Sonora are facing increasing demand, with many “saturated” with older adults whose families cannot or will not care for them at home, the Hermosillo-based newspaper El Imparcial reported in August.

To address the growing need, Asilo de Ancianos is working to increase capacity at the facility and train more caregivers, Moreno said. They are also looking to offer day services so families can bring seniors there during the workday rather than leave them home alone, added Zazueta, who is helping to develop plans for the service.

The facility already has many of the resources it needs, with separated dorm-like sleeping quarters for the men and women, space for medical care and therapy, and a large kitchen with an attached dining area. It also boasts large, well-kept grounds and two community rooms where the residents listen to music, watch TV, play games and even enjoy services like haircuts.

However, adding beds and hiring and training additional staff requires funding that is hard to come by, Moreno said. While Asilo de Ancianos receives support from government grants, donations and charging families who can afford care to keep their seniors at the facility, there is still little focus on elderly care in Mexico, she said.

“Right now there is a huge emphasis on interventions for youth,” she said, noting that there are programs, training and resources for early childhood development, education, children with disabilities and more. “That’s what we need for older adults, because they are a vulnerable population, too.”

No place like home

Linda Manjarrez, the regional director for Luminaria Home Care in Southern Arizona, acknowledged that the nursing home in Nogales, Sonora struggles with resources and doesn’t have as much support from the government as programs in Arizona do. That’s why she brings them donations and supplies when she can.

Luminaria provides home care services for older adults and people with disabilities in Santa Cruz County, including training care providers, half of which become caregivers for their own family members, allowing them to be paid for some of the care they give and helping them keep their family members at home, she said.

Though Santa Cruz County does not currently have any nursing homes, there are several assisted living homes, senior living apartments and resources for home care, which is often a better alternative than uprooting older adults, said Luisa Massee, the manager of Casitas de Santa Cruz, which provides affordable housing and services for low-income seniors.

Moreno agrees. The first choice for most seniors in Nogales, Sonora is to stay at home as long as possible if the family has the resources to provide them a “dignified life,” she said

“This is a great residence,” she said of Asilo de Ancianos. “We have wonderful staff. The seniors are well cared for. They have activities and other people to talk to, good food, medical care and therapy, but when they are in their home, they feel like they belong. Here they will adapt, but they know this isn’t their place, it isn’t their home.”

Still, there is no denying the growing need for residential facilities, Moreno said, and Asilo de Ancianos is preparing to provide care for as many people as possible in the coming years.

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