For Part One of this article, read here.
While my mind reeled at the thought of my mother being subjected to prejudice and ridicule, I intensely searched for the top physicians in Barbados. I contacted the Barbados Alzheimer’s Association and the Barbados Association of Medical Practitioners; one photocopied a list of every doctor on the island and made it available for pickup at the front desk, while the other simply directed me to the Yellow Pages and told me, “They are all good.” The Internet offered little assistance as most practitioners have no online presence. So it was on complete and total faith that I scrolled through the relatively small list of people-fixers, landed on a handful of names, and did my best to piece together a competent care team.
While I was unsure of what to expect, riding around trying to figure out what little alley or side road would take us to our scheduled appointments turned into an adventure and was a surprisingly good way to learn our way around. My mother, who is often anxious and disoriented in new and unfamiliar settings, equally enjoyed the unintentional sightseeing as she took in the water and sunshine along the way. I was feeling pretty good about the medical expertise in Barbados as I spoke with front desk clerks and physicians. Our family practitioner admitted that she knew very little about rare dementias but that we should be in good hands with the specialists. And we are. Except for the matter of the missing medical records.
Prior to leaving the States, we knew that we would have to transfer all of our medical records from our physicians there to our new doctors in Barbados. Unfortunately, we did not anticipate the tremendous difficulty we would have in obtaining visit notes and test results, although we were just a few hours and phone calls away.
One major hurdle to this process is the fact that the United States has in place the Health Insurance Portability and Accountability Act (HIPAA), a federal mandate protecting patient privacy. While I certainly appreciated the associated policies while receiving medical care in the U.S., it has really become a proverbial pain in my behind as we have attempted to jerry-rig nonexistent medical record request forms that are HIPAA compliant.
Many days have been spent on the phone and at a computer keyboard trying to ensure that all of my family’s medical needs are met. I often watch as my new set of peers leave our gated neighborhood to immerse themselves in the pulsating beats of soca music and EDM, libations flowing freely and bodies moving rhythmically.
I watch because while the other 30-somethings lead seemingly laissez-faire lives in this earthly paradise, I am still coordinating doctors appointments, dispensing medication, and doing my best to remain patient as my mother asks for the tenth time today if her favorite retail stores are nearby.
After about our second month in Barbados, it had become painfully apparent that although the scenery and accents had changed, the inherent frustration and pain of caregiving remained very much the same. The carefree existence I had promised myself wherein my mother would be occasionally cared for by a highly skilled professional and I would be free at times to pursue my own island fantasy has not come to fruition. Not yet.
While the pace of life outside of our four walls is indeed much slower and contributes to an overall calmer atmosphere within our home, the many differences in cultural communication and federal regulation have made pieces of the transition very difficult. Tasks we took for granted, like having immediate access to the prescribed medication, retrieving medical records, or registering for health insurance, now come with obstacles for which we were unprepared.
Even the initial excitement over a lower cost of living was short-lived as we realized that the goods and products we were accustomed to using in America, like certain brands of toothpaste or apples, more than doubled in price in Barbados to compensate for import costs. Prior to moving, I looked forward to the idea of eating off the land, shopping at local markets, and supporting local farmers and fishermen. However, when you are caring for a person with dementia, for whom consistency and familiarity are key, trying new and different foods is just not high on your list of priorities.
Our existence here in the Caribbean is certainly not a miserable one. Our quality of life has been vastly improved by this relocation. We are blessed to live in a community with a large expatriate presence and we never tire of seeing the wonders of God’s creation as we spend our weekends by the Caribbean Sea and the Atlantic Ocean. People are generally friendly and respect my commitment to my mother’s well-being. Although my life does not currently read like a grocery store romance novel and we are working on getting some of our wires uncrossed, I am grateful for the move. As with any new environment, there is a period of adjustment. Only time will tell just how long this period will last. I guess even in paradise, life requires a little patience.