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The Goodman Institute Health Blog

Long Term Care a Long Way from Home

Posted on May 19, 2026 by Devon Herrick

Long term care is expensive. According to the American Council on Aging, the average cost per day for a shared nursing home room is $327. That works out to be about $10,000 a month for an annual cost of nearly $120,000. Few families can afford that, but consider this: A private nursing home room in Santa Rosa, California is $1,000 a day for a yearly cost of $365,000. Where can you go that is less expensive? Decatur, Illinois is a mere $85,000 a year. Monroe, Louisiana is $67,000 annually. Cape Girardeau, Missouri is $56,560. 

In Texas the cost varies widely, Abilene is $76,285, Dallas $100,000, but only $89,425 in Sherman (about 50 miles northeast of Dallas). The cost near Brownsville along the border with Mexico, is $176,000. Indeed, the costs are far higher in South Texas (Corpus Christi $119,000, McAllen $121,500, El Paso $130,000). Higher costs in South Texas are due to the higher concentration of retirees who seek warmer climates. 

It pays to check around. The town two hours away from home could cost $10,000, or $20,000 less per year than the nursing home five miles away. Then there are those who really move away in search of cheaper long-term care. A writer in Slate Magazine tells the story of a man from the Pacific Northwest, whose family moved him to Chapala, Mexico for long-term care. The following is from Slate:

His dementia and poor physical health had become too much for his husband to handle at their home in Washington state, and insurance would no longer cover his care at a medicalized facility outside Seattle. They feared that if he continued living in a nursing home stateside, it would bankrupt them.

Arriving at the 21-person nursing home in Chapala was a stark difference from the towering hospital-like building my dad had moved from back home. The residents who gathered on the sunny patio for meals, socializing, and mobility classes were not so different, however. They were mostly English-speaking Americans and Canadians who knew little if any Spanish.

The writer’s father had been in a nursing home in Seattle, at an out-of-pocket cost of $500 per day, or about $182,500 a year. That sounds like a bargain: the American Council on Aging estimates the cost of care in Settle around $219,000 a year. The cost in Mexico? Around $55,000. A fledgling industry has sprung up to help Americans move abroad for long-term care. More from Slate:

[C]onsultants work with families specifically looking to relocate elders to assisted-living facilities abroad. For Americans, they most often suggest Mexico, but those I spoke with also send elderly clients to Costa Rica, Panama, Ecuador, and other parts of the world. They scout locations, match clients to an appropriate home, and help families budget and tackle the logistics of the move.

John Kelly, who founded Eldercare Global in 2025, is part of this new wave. His father suffers Lewy body dementia, and Kelly was not satisfied with the memory care facility they first tried in Minnesota.

From her base in Lake Chapala, self-described “wellness shepherd” Wendy Jane Carrel also consults North Americans who are looking to move abroad for care. Carrel says that the writing has been on the wall since the early 2000s, when assisted living and nursing care in the U.S. was already becoming unaffordable for the average older adult in need. She has since experienced increasing demand for her services and has helped over 200 people move from the U.S. to care facilities in Mexico and Ecuador.

Experts caution there is a transition to moving abroad for long term care. Family is much farther away and cannot visit as easily or as often. There is a language barrier as well. The writer in Slate relayed the story of her father, who died not long after her visit. After a series of strokes, he had to be transported 45 minutes to a trauma center and suffered an undetected infection. The writer wonders if things would have been different had he stayed in Seattle. Perhaps, her father would have lived longer… and bankrupted his family. She also proposed the U.S. government do more to “help families avoid such painful situations by investing in innovative care infrastructure: expanding home-based services, bolstering the caregiving workforce, and creating a durable way to finance long-term care.” Yet, it’s doubtful that most families could afford those options either.

Read more at: My dad’s nursing home almost bankrupted my family. So we did something drastic.

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For many years, our health care blog was the only free enterprise health policy blog on the internet. Then, when the NCPA closed its doors, the health blog stopped as well.

During this five-year hiatus no one else has come forward to claim the space. So, my colleagues and I have decided to restart the blog in connection with the Goodman Institute. We invite you and others to use this forum to share your views.

John C. Goodman,

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